Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

M R C P > gastro > Flashcards

gastro Flashcards

1
Q

what stimulates g cells to release gastrin

A

luminal peptides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

plummer vinson syndrome

A

Triad of:
dysphagia (secondary to oesophageal webs)
glossitis
iron-deficiency anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

primary billiary cholangitis, CFs, symptoms, treatment, Ix

which autoimmune condition is also seen in 80% of PBC pts

A

middle aged females, IgM, ALP, raised bilirubin

CFs:
pruitus, clubbing, hepatosplenomegaly

Ix: bloods, MRCP (exclude extrahepatic cause)

Treatment: ursodeoxycholic acid- slow progression
cholestyramine- itching
fat soluvle vit supplementation
Liver transplant if bili>100

MOST associated w sjogrens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

wilsons disease associated with which type of anaemia?

A

haemolytic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

keiser fleischer rings =— what condition

A

wilsons disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

wilsons disease

A

symptoms;
hepatitis, cirrhosis, speech/psych problems

kayser fleischer rings

BLOODS:
reduced caeruloplasmin
reduced total serum copper
increased 24hr urinary copper excretion
ATP7B gene

Mx
penicillamine- chelates copper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hep b serology
HBsAg

anti-HBc
Anti-HBs

IgM anti-HBc negative

A

HBsAg = ongoing infection, either acute or chronic if present > 6 months

anti-HBc = caught, i.e. negative if immunized

Anti-HBs = immunity

IgM anti-HBc negative= chronic infection

IgM anti-HBc positive= acute infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is budd chiari syndrome

A

hepatic vein thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is budd chiari syndrome caused by

A

polychythaemic rubra vera
thrombophillia- protein c resistance, antithrombin 3 def
pregnancy
COCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

triad of symptoms budd chiari syndrome

A
  1. abdominal pain: sudden onset, severe
  2. ascites → abdominal distension
  3. tender hepatomegaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

c diff morphology

A

gram positive rod

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

alphafetoprotein elevated in Hepatocellular carcinoma or cholangiocarcinoma

A

hepatocellular carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

underlying aetiology of hepatorenal syndrome?

A

Splanchnic vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

hepatorenal syndrome treatment

A

vasopressors analogue -eg terlipressin
liver transplant
20% albumin
transjugular intrahepatic portosystemic shunt

Terlipressin= vasopressor= splanchnic CONSTRICTION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Boerhaave syndrome

A

severe vomiting causing oesophageal rupture – chest pain and shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

raised conjugated bilirubin, black liver

A

Dubin-Johnson syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

which anti emetic can cause tardive dyskineseia

A

metoclopramide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

which anti emetic can cause tardive dyskineseia

A

metoclopramide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Familial adenomatous polyposis which chromosome is mutated

A

chromosome 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

elderly patient who has a history of aortic stenosis presents with rectal bleeding. A colonoscopy shows multiple small, flat, erythematous lesions with scalloped edges

A

Angiodysplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

a man who presents with intussusception is noticed to have multiple polyps on colonoscopy. These are later shown to be hamartomatous. He also has pigmented lesions on his lips and palms

A

Peutz-Jeghers syndrome

LKB1 or STK11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Whipple’s disease

A

Tropheryma whippelii infection. It is more common in those who are HLA-B27 positive and in middle-aged men.

jejunal biopsy shows deposition of macrophages containing Periodic acid-Schiff (PAS) granules

Management
oral co-trimoxazole for a year ., sometimes preceded by a course of IV penicillin

W-weight loss , worn out joints
H- Hyper pigmentation , Hyperactive bowel(diarrhea)
I- Inadequate absorption of minerals , vitmains
P-pleurisy
P-Pericarditis
L-Lymphadenopathy
E-elevated macrophages on Biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Diarrhoea, weight loss, lymphadenopathy, arthralgia, fever in a question is most likely to indicate:

A

whipples disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

mesalazine or sulfasalazine more likely to cause acute pancreatitis?

A

mesalaizine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

causes of cause of jejunal villous atrophy

A

Jejunal villous atrophy
coeliac disease
tropical sprue
hypogammaglobulinaemia
gastrointestinal lymphoma
Whipple’s disease
cow’s milk intolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

which antibiotic can cause cholestasis

A

co amxiclav

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

which monoclonal antibody targets c diff

A

Bezlotoxumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

hereditary non-polyposis colorectal carcinoma HNPCC inheritance pattern

A

autosomal dominant
DNA Mismatch repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

HNPCC associated with which other type of cancer

A

endometrial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

FAP
which chromosome affected

A

is a rare autosomal dominant condition which leads to the formation of hundreds of polyps by the age of 30-40 years.

CHROMOSOME 5
APC gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

way to remember coeliac HLA genes

A

That person with coeliac disease is da cutie (DQ2) and quiet (Q8)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

which chromosome haemochromatosis and which deficiency causes it>

A

haemachromotoSIS (SIX)

HFE deficient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

first line management NAFLD

A

weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

ischaemic colitis- most likely to affect ?part of colon

A

splenic flexure

superior and inferior mesenteric arteries.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

secondary prophylaxis of hepatic encephalopathy
medications

A

lactulose
rifaximin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

how to remember recessive vs dominant

A

MRDS- MR Denotes Surgeon
(Metabolic-Recessive; Dominant-Structural)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

UC- which part of colon most commonly affected

A

terminal ileum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Cholestasis Drugs:

A

Choleostasis Drugs: FAt-E CRAPS (Steatorrhea)
- Fibrates
- Antibiotics (penicillin, co amox, erythromycin, fluclox)
- Erythromycin

  • COCP
  • Rare (nifepdipine)
  • Anabolic steroids/testosteorne
  • Phenothiazides
  • Sulphonylureas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

nicotinic acid test tests which condition

A

gilberts syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what type of anaemia common in alcoholics

A

macrocytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

heart condition as result of hypomagnesia in refeeding syndrome

A

torsade des pointes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

first line type of gastric band surgery

A

laparoscopic-adjustable gastric banding (LAGB)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

eosinophilic oesophagitis management

A

DIET and steroids
fluticasone

44
Q

which laxative is carcinogenic

A

co danthramer

45
Q

diarrhoea + pigment laden macrophages on colonoscopy=?

A

laxative abuse

46
Q

reversal dabigatran

A

Idarucizumab (Praxbind)

47
Q

avoid which type of laxative and what laxative in iBS

A

avoid lactulose and stimulant laxatives

48
Q

chronic pancreatitis gold standard Ix

A

CT pancreas- look for calcification

49
Q

management eosinophilic oesophagitis

A

diet modification
fluticasone topical steroid

50
Q

which monoclonal antibody can be used for c diff?

A

bezlotoxumab

51
Q

Small bowel bacterial Overgrowth investigation test
and abx treatment

A

hydrogen breath test

rifiximin

52
Q

what indicates severe pancreatitis (6)

A

age > 55 years
hypocalcaemia
hyperglycaemia
hypoxia
neutrophilia
elevated LDH and AST

53
Q

macrocytic anaemia + hypothyroid = what type of anaemia

A

pernicious anaemia

54
Q

crohns=

A

GOBLET AND GRANULOMAS
kantors string sign
rose thorn ulcers
proximal bowel dilation

55
Q

where do VIPomas arise from

A

pancreas

56
Q

thumbprinting assosicated with?

A

ischaemic colitis

57
Q

risk factors for oesophageal cancer: SCC vs adenocarcinoma

A

SCC= smoking, alcohol, plummer vinson, achalasia

Adenocarcinoma= barretts oesophagus

58
Q

what reduces mortality in alcoholic pts with UGI bleed

A

prophylactic abx

59
Q

how to tell if pt has secondary haemochromatosis vs primary

A

secondary= older pts, ass’d with regular blood transfusions, new onset diabetes

60
Q

pancreatitis cause= hyper triglyceride or hyper cholesterol

A

HIGH TRIGYLCERIDS=== RISK FOR PANCREATITIS

(not high cholesterol)

61
Q

drugs causing hepatocellular damage- can lead to hepatitis– ALT is more increased

A

paracetamol
sodium valproate, phenytoin
MAOIs
halothane
anti-tuberculosis: isoniazid, rifampicin, pyrazinamide
statins
alcohol
amiodarone
methyldopa
nitrofurantoin

62
Q

coeliac investigation

A

You cannot interpret TTG level in coeliac disease without looking at the IgA level

63
Q

how to test exocrine function in chronic pancreatitis pt

A

faecal elastase

64
Q

Post-cholecystectomy syndrome

A

recognised complication of cholecystectomies. Typically symptoms of dyspepsia, vomiting, pain, flatulence and diarrhoea occur in up to 40% patients post surgery.

Cholestyramine, to bind the excess bile acids and thus preventing lower gastrointestinal signs

65
Q

abx prophylaxis for patients with ascites

A

to prevent spontatnious bacterial peritonitis :

PO ciprofloxacin
or norfloxacin
most common bac= e coli

66
Q

causes of NAFLD (5)

A

Associated factors
obesity
type 2 diabetes mellitus
hyperlipidaemia
jejunoileal bypass
sudden weight loss/starvation

67
Q

is gilberts syndrome conjugated or unconjugated bili

A

gilberts= unconjugated

68
Q

haemochromatosis Ix bloods

A

transferrin and ferritin

69
Q

how to differentiate HNPCC and FAP

A

hundreds of polyps= FAP, caused by nutation in tumour suppressory gene ACP

70
Q

double duct sign==?dilatation of the common bile duct and pancreatic ducts.

A

pancreatic cancer

71
Q

PPI side effects

and MOA

A

incr c diff risk
MICROscopic colitis
hypo natremia hypo magnesia
osteoporosis

MOA= Proton pump inhibitors (PPI) cause irreversible blockade of H+/K+ ATPase of the gastric parietal cell.

72
Q

Spontaneous bacterial peritonitis
cfs
group most at risk
tx
ix

A

form of peritonitis usually seen in patients with ascites secondary to liver cirrhosis.

Features
ascites
abdominal pain
fever

Diagnosis
paracentesis: neutrophil count > 250 cells/ul
the most common organism found on ascitic fluid culture is E. coli

Tx= IV cefotaxime

73
Q

when to give abx prophylaxis regarding spontaneous bacterial peritonitis
and which abcx to give

A

give ciproflox

IF:
-prev episode SBP
- high fitz pugh score (9) or hepatorenal syndrome
- fluid protein LOW (<15)

74
Q

what is the iron study profile in pt with haemochromatosis

A

Typical iron study profile in patient with haemochromatosis
transferrin saturation > 55% in men or > 50% in women
raised ferritin (e.g. > 500 ug/l) and iron
low TIBC

75
Q

how to Ix microscopic colitis as a result of PPI use

A

colonoscopy and biopsy

76
Q

gold standard Ix for achalasia (difficult to pass scope down)

A

oesophageal manometry

77
Q

acute fatty liver of pregnancy
what stage of preg does it occur
cfs
tx

A

occurs third trimester
or the period immediately following delivery.

Features
abdominal pain
nausea & vomiting
headache
jaundice
hypoglycaemia
severe disease may result in pre-eclampsia

Investigations
ALT is typically elevated e.g. 500 u/l

Management
support care
once stabilised delivery is the definitive management

78
Q

antibodies (LKM1) positive in?

A

autoimmune hep type 2

high titres of igg

79
Q

dubin johnson syndrome inheritance
cfs

A

Dubin-Johnson syndrome is a benign autosomal recessive disorder

CONJUGATED hyperbilirubinaemia

80
Q

Ongoing diarrhoea in Crohn’s patient post-resection with normal CRP →

A

cholestyramine to manage symptoms

81
Q

refeeding syndrome electrolytes

A

hypophosphataemia
hypokalaemia
hypomagnesaemia: may predispose to torsades de pointes
abnormal fluid balance
LOW EVERYTHING

82
Q

Child-Pugh A cirrhosis
B
C management

A

Child-Pugh A cirrhosis: without signs of portal hypertension who have single lesions <2cm in size should be treated with surgical resection

Child-Pugh A and B cirrhosis and 2-3 tumours <= 3 cm or 1 tumour <=5 cm without vascular invasion or extrahepatic spread should be considered for liver transplantation. As a bridge to liver transplantation these patients can be treated with TACE or RFA.

Child-Pugh A or B cirrhosis , good performance status, and evidence of vascular, lymphatic or extrahepatic spread the multiple tyrosine kinase inhibitor, Sorafenib, has been shown to prolong survival.

Those with Child-Pugh C cirrhosis have end-stage liver disease and are poor candidates for therapy as they lack any hepatic functional reserve to tolerate either resection, TACE or RFA. These patients are best treated symptomatically

83
Q

peutz jeughers
inheritance
cf
tx
cause

A

autosomal dominant condition characterised by numerous hamartomatous polyps in the gastrointestinal tract.

freckles on lips
pigmented freckles on the lips, face, palms and soles
LKB1 or STK11

Features
hamartomatous polyps in the gastronintestinal tract (mainly small bowel)
small bowel obstruction is a common presenting complaint, often due to intussusception
gastrointestinal bleeding
pigmented lesions on lips, oral mucosa, face, palms and soles
IDA
Tx = conservative unless problems

84
Q

Metabolic ketoacidosis with normal or low glucose: CAUSE LIKELY?

A

ALCOHOL EXCESS

85
Q

hypokalemia
eg 3 polyps in colon ==?

A

vilous ademona

causes hypo kalemia

86
Q

secondary prophylaxis of hepatic encephalopathy

A

lactulose

rifiximin

87
Q

severe alcoholic hepatitis mx

A

prednisolone

88
Q

when to screen for hep carcinoma HCC : which groups

A

patients liver cirrhosis secondary to hepatitis B & C or haemochromatosis

MEN (not females) with liver cirrhosis secondary to alcohol

89
Q

. A sigmoidoscopy is performed which shows multiple white plaques adhered to the gastrointestinal mucosa ==?

A

psudomembranous colitis

assd with c diff

90
Q

marker of severity acute pancreatitis

A

CRp

91
Q

signet ring cells associated with?

A

gastric adenocarcinoma

92
Q

investigation of choice for bile acid malabsorption

A

SeHCAT scan

93
Q

investigation carcinoid syndrome

A

urinary 5-HIAA
plasma chromogranin A y

94
Q

primary sclerosing cholangitis Ix

A

MRCP= definitive
pANCA may be positiv e

95
Q

when is urea breath test inaccurate

A

should not be performed
within 4 weeks of treatment with an antibacterial

or within 2 weeks of PPI (e.g. a proton pump inhibitor)

96
Q

NICE bariatric referral cut-offs

A

NICE bariatric referral cut-offs
with risk factors (T2DM, BP etc): > 35 kg/m^2
no risk factors: > 40 kg/m^2

97
Q

which genetic conditions is the most prevalent in a Caucasian population?

A

haemochromatosis

98
Q

must eat gluten for how many weeks before coeliac testing

A

6 weeks

99
Q

. What is the most likely vessel to be responsible? in variceal bleed

A

gastroduodenal artery

100
Q

negative HVC RNA but positive anti HCV==?

A

previous hep c infection

101
Q

increase risk of HCC

A

Aflatoxin

102
Q

achalasia CFs
Ix
tx

A

food and drink, regurg, heart burn

Ix= oesophageal manometry
barium swallow= birds beak
RETROCARDIAL air fluid level

Tx
ballon dilation first line

severe and sx needed= hellers myotomy

103
Q

angiodysplasia Ix

A

capsule endoscopy

104
Q

unsafe drugs in acute intermittent porphyria

A

Drugs unsafe in acute intermittent porphyria:
If you go to a BAR on a BENZ,say HALO to a guy,take a SULFi,have some ALCOHOL n dont forget the OCP.(barbiturates;Benzodiazepines,HAloperidol,Sulfonamides;alcohol and OCP.

105
Q

obeticholic acid

A

FXR agonist
it is used in PBC

M R C P (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions