Gastro Flashcards

1
Q

Three most common causes of chronic liver disease

A

Alcohol

Viral hepatitis

Non-alcoholic fatty liver disease

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2
Q

What are the abdominal causes of finger clubbing?

A

IBD
Cirrhosis
Coeliac Disease
Hepatocellular carcinoma

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3
Q

Sx of IBD

A

RIF Mass
Abdo tenderness

Aphthous ulcers in the mouth
Enteropathic arthropathy
Conjunctivitis/episcleritis/anterior uveitis

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4
Q

Tx of UC vs Crohn’s

A

Crohns:
induce remission with glucocorticoids
maintain remission with azathioprine or mercaptopurine

UC:
Induce remission with topical aminosalicylate (then oral)
maintain remission with topical aminosalicylate

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5
Q

Name some side effects and complications of immunosuppressants?

A

Gum hypertrophy – ciclosporin
Hirsutism – ciclosporin
Hypertension – ciclosporin
Cushingoid features – steroids
Purpura – steroids

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6
Q

What causes unilateral/bilateral palpable native kidneys

A

Polycystic kidney disease

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7
Q

What could an AV fistula indicate

A

Renal transplant/dialysis

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8
Q

What to do to complete an examination in a renal failure patient

A

Perform fundoscopy to assess for either diabetic or hypertensive retinopathy

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9
Q

Extrarenal mainfestations of PKD

A

Cysts in liver, pancreas, spleen, thyroid and lungs
Intracranial Berry Aneurysm and rupture causing SAH
Polycythaemia
Anaemia
Hypertension
Mitral valve prolapse

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10
Q

Signs of chronic liver disease

A

Palmar erythema
Dupuytrens contracture
Leuconychia
Spider naevi
Gynaecomastia

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11
Q

What is the usual cause of ascites without features of chronic liver disease

A

Malignancy

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12
Q

Causes of massive splenomegaly

A

CML, AML, myelofibrosis

Malaria, HIV

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13
Q

Inguinal hernia reappears when you cough

A

Direct inguinal hernia

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14
Q

indications for stomas

A

temporary exteriorisation: perforated or contaminated bowel e.g. hartmann’s

protection of distal anastomosis

bypass of distal obstructing lesion

Feeding: gastrostomy/jejunostomy

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15
Q

Differences between ileostomy and colostomy stoma

A

Ileostomy: RIF, spout, watery contents

Colostomy: LIF, flush, formed faeces

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16
Q

Sx for loop or end colostomy

A

End colostomy: AP resection, Hartmann’s

Loop colostomy: Anterior resection

17
Q

Complications of stoma

A

ischaemia
High output (can lead to hypokalaemia)
parastomal abscess

parastomal hernia
obstruction; adhesions
stoma prolapse
stenosis or stricture

18
Q

Anatomical order of structures in midline laparotomy

A

skin
camper’s fascia
scarpa’s fascia
linea alba
transversalis fascia
pre-peritoneal fat
peritoneum

19
Q

Cause of Kocher’s scar

A

Top right of abdomen - cholecystectomy

20
Q

Use of mercedes-benz scar (other name)

A

Rooftop

Liver transplant
Liver resection

21
Q

Scar used for caesarian

A

Pfannenstiel

22
Q

Complications og CLD

A

Ascites
Coagulopathy
Encephalopathy
Sepsis/SBP

23
Q

Tx of encephalopathy

A

Lactulose
Rifaximin

24
Q

Causes of hepatomegaly

A

Hepatitis
CLD
Congestion secondary to heart failure

Malignancy, lymphoma

25
Causes of splenomegaly
CML, CLL, Lymphoma myelofibrosis Amyloidosis malaria
26
Causes of small spleen
Portal hypertension (secondary to cirrhosis) EBV
27
CML Mx
Imatinib
28
dDx of enlarged kidneys
ADPKD RCC Cysts Amyloidosis
29
Mx of ADPKD
↑ water intake, ↓ Na, ↓ caffeine (may ↓ cyst formation) Monitor U+E and BP Genetic counselling 50% chance of transmission
30
Induce remission in crohn's
Steroids