Gastro Flashcards
Three most common causes of chronic liver disease
Alcohol
Viral hepatitis
Non-alcoholic fatty liver disease
What are the abdominal causes of finger clubbing?
IBD
Cirrhosis
Coeliac Disease
Hepatocellular carcinoma
Sx of IBD
RIF Mass
Abdo tenderness
Aphthous ulcers in the mouth
Enteropathic arthropathy
Conjunctivitis/episcleritis/anterior uveitis
Tx of UC vs Crohn’s
Crohns:
induce remission with glucocorticoids
maintain remission with azathioprine or mercaptopurine
UC:
Induce remission with topical aminosalicylate (then oral)
maintain remission with topical aminosalicylate
Name some side effects and complications of immunosuppressants?
Gum hypertrophy – ciclosporin
Hirsutism – ciclosporin
Hypertension – ciclosporin
Cushingoid features – steroids
Purpura – steroids
What causes unilateral/bilateral palpable native kidneys
Polycystic kidney disease
What could an AV fistula indicate
Renal transplant/dialysis
What to do to complete an examination in a renal failure patient
Perform fundoscopy to assess for either diabetic or hypertensive retinopathy
Extrarenal mainfestations of PKD
Cysts in liver, pancreas, spleen, thyroid and lungs
Intracranial Berry Aneurysm and rupture causing SAH
Polycythaemia
Anaemia
Hypertension
Mitral valve prolapse
Signs of chronic liver disease
Palmar erythema
Dupuytrens contracture
Leuconychia
Spider naevi
Gynaecomastia
What is the usual cause of ascites without features of chronic liver disease
Malignancy
Causes of massive splenomegaly
CML, AML, myelofibrosis
Malaria, HIV
Inguinal hernia reappears when you cough
Direct inguinal hernia
indications for stomas
temporary exteriorisation: perforated or contaminated bowel e.g. hartmann’s
protection of distal anastomosis
bypass of distal obstructing lesion
Feeding: gastrostomy/jejunostomy
Differences between ileostomy and colostomy stoma
Ileostomy: RIF, spout, watery contents
Colostomy: LIF, flush, formed faeces
Sx for loop or end colostomy
End colostomy: AP resection, Hartmann’s
Loop colostomy: Anterior resection
Complications of stoma
ischaemia
High output (can lead to hypokalaemia)
parastomal abscess
parastomal hernia
obstruction; adhesions
stoma prolapse
stenosis or stricture
Anatomical order of structures in midline laparotomy
skin
camper’s fascia
scarpa’s fascia
linea alba
transversalis fascia
pre-peritoneal fat
peritoneum
Cause of Kocher’s scar
Top right of abdomen - cholecystectomy
Use of mercedes-benz scar (other name)
Rooftop
Liver transplant
Liver resection
Scar used for caesarian
Pfannenstiel
Complications og CLD
Ascites
Coagulopathy
Encephalopathy
Sepsis/SBP
Tx of encephalopathy
Lactulose
Rifaximin
Causes of hepatomegaly
Hepatitis
CLD
Congestion secondary to heart failure
Malignancy, lymphoma
Causes of splenomegaly
CML, CLL, Lymphoma
myelofibrosis
Amyloidosis
malaria
Causes of small spleen
Portal hypertension (secondary to cirrhosis)
EBV
CML Mx
Imatinib
dDx of enlarged kidneys
ADPKD
RCC
Cysts
Amyloidosis
Mx of ADPKD
↑ water intake, ↓ Na, ↓ caffeine (may ↓ cyst formation)
Monitor U+E and BP
Genetic counselling
50% chance of transmission
Induce remission in crohn’s
Steroids
