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OBS and gynae > Gastro > Flashcards

Gastro Flashcards

1
Q

What test is positive in UC and negative in crohn’s

A

pANCA

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2
Q

What would you seen in the histology of a patient with UC

A

lead piping due to loss of haustral markings and pseuopolyps

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3
Q

which is granulomatous, UC or crohns

A

UC is non and crohns is caseating gran

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4
Q

gold standard investigation and emergency treatment for UC

A

sigmoidoscopy with biopsy and surgery: proctocolectomy, topical ifnot prednisolone

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5
Q

treatment for functional dyspepsia

A

amitriptylline

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6
Q

which drugs would you avoid in someone with GERD

A

anticholinergics and calcium channel blockers

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7
Q

Which drugs can cause upper GI bleed

A

ODEVICES, Omeprazole, Disulfram Erythromycin, Valproate, Isonazid, Ciproflaxcin, Ethanol Sulphonamides

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8
Q

What is causes jaundice with metabolic acidosis

A

drug induced hepatitis

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9
Q

What causes AST:ALT ratio to be over 2

A

alcoholic liver disease

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10
Q

What causes ALT/AST to be over 1000IU

A

ischaemic hepatitis, viral hepatitis and atuoimmune hepatitis

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11
Q

what is the fetal equivalent of albumin

A

alpha fetoprotein

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12
Q

Disease with isolated bilirubin

A

gilberts syndrome

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13
Q

What is the ALT/AST/GGT/ALP pattern for viral hepatitis

A

ATL/AST grossly elevated and GGT and ALP is moderately elevated

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14
Q

What is the most common inheritable cause of colorectal cancer

A

lynch syndrome

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15
Q

Difference is clinical features between oesophageal cancer and achalasia

A

achalasia is difficulty with solids and liquids from the start

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16
Q

features of biliary colic

A

intermittent coliky upper quadrant right sided pain, no fever

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17
Q

stages of hepatic encephalopathy

A

1: mood change and disrupted sleep and wake cycle

2: dizziness, confusion, slurring speech

3: restlessness, incoherency, liver flap

4: coma

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18
Q

how many weeks with a previously healthy liver would you need to have to now be diagnosed with acute liver failure

A

less than 26 weeks

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19
Q

how would you treat renal dysfunction in acute liver failure

A

fluid resuscitation with human albumin solution rather than crystalloid solution

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20
Q

drugs you would use to treat encephalopathy and cerebral oedema

A

encephalopathy: oral lactulose and oedema: IV mannose

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21
Q

how would you treat recurring hepatic encephalopathy

A

rifamicin

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22
Q

went on holiday 3 weeks ago, GP suspects viral hepatitis and pt says she tried many different foods in spain. which infection is it likely to be

A

Hep A incubation period of 2-3 weeks and faecal-oral transmission

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23
Q

went on holiday 3 months ago, jaundice, itchiness. GP suspect viral hepatitis, what is the most likely causative agent?

A

Hep B, incubation test- 60-90 days and transmitted through sex and vertical transmission.

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24
Q

treatment for alcohol withdrawal first and second line

A

chlordiazepoxide and iv lorazepam

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25
Q

score used for cirrhosis

A

child-hugh score

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26
Q

Treatment of asities

A

fluid restriction, furosemide and spironolactone

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27
Q

treatment for pruritis

A

cholestyramine is a bile acid sequestrant so binds to bile acids and presents absorption

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28
Q

gi bleed and oesophageal varices will present with which type of anaemia?

A

normocytic

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29
Q

which electrolyte abnormality can lead to cirrhosis

A

low albumin and hyponatraemia

30
Q

different types of autoimmune hepatitis

A

1: anti-smooth muscle antibodies and anti-nuclear antibodies
2: anti-liver microsomal antibodies
3: anti-soluble liver antibodies

31
Q

what is the treatment for autoimmune hepatitis

A

30mg oral prednisolone: for immunsupressive therapy and aziathioprine as a DMARD and reduce over 2 years

32
Q

pt presenting with jaundice, oedema and confusion with a paracetamol overdose 30mins ago. management?

A

activated charcoal

33
Q

pt presenting with jaundice, oedema and confusion with a paracetamol overdose 5hours ago. management?

A

NAC

34
Q

pt presenting with jaundice, oedema and confusion with a paracetamol overdose 3 hours ago. management?

A

wait another 4 hours and do a treatment line

35
Q

pt presenting with jaundice, oedema and confusion with a paracetamol overdose but doesnt know how long ago management?

A

NAC immediately

36
Q

What is the role of N-acetycysteine

A

a toxic metabolite of paracetamol: NAPQI which is toxic to the kidney and liver. Gluthiaone detoxifies it. and increased paracetamol depletes the stores, NAC replenishes these stores.

37
Q

what is the most common type of gastric cancer

A

adenocarcinoma

38
Q

When would you do an urgent referral in 2 weeks for stomach cancer

A

dysphagia at any age, 55 and over for unintentional weight loss

39
Q

when would you refer for 6 weeks for stomach cancer

A

haematemesis at any age, 55 and over with treatment resistant dyspepsia, abdo pain and nausea and vomiting

40
Q

investigation for stomach cancer

A

endoscopy, CTAP and MRI treatment with partial and total gastrectomy

41
Q

treatment for barrett’s oesopahgus

A

surgery

42
Q

apart from PPI therapy- what are the other treatment for ERD

A

antacids like magnesium trisilicate, alginates like gaviscon

43
Q

two types of hiatus hernia and the most common

A

rolling and sliding and sliding is more common

44
Q

First line investigation for hiatus hernia

A

barium swallow then oesophageal mano

45
Q

which condition is increased gastric emptying a risk factor for

A

duodenal ulcer

46
Q

which condition is delayed gastric emptying a risk factor for

A

gastric cancer

47
Q

when is duodenal ulcer pain worse

A

without food or over night

48
Q

when is a gastric ulcer more painful

A

with food pain intensifies

49
Q

first and second line treatment for infectious colitis

A

oral vancomycin, and oral fidaxomicin. if severe: oral vanco and IV metronidazole

50
Q

family history with colorectal cancer is likely to be at risk of which cancer

A

endometrial cancer

51
Q

which feature would you see in acute liver disease

A

smooth tender hepatomegaly

52
Q

does melaena suggest a lower GI or upper GI bleed

A

upper and at risk with NSAID

53
Q

which GI disorder has halitosis:
peptic ulcer disease, GERD

A

GERD

54
Q

difference between gastric and duodenal ulcer symptoms

A

gastric: shortly after food pain. duodenal is pain with hunger and made better with food

55
Q

When are people offered the Hep B vaccine

A

8, 12 and 16 weeks of age

56
Q

does gilbert syndrome have conjugated or unconjugated bilirubin

A

unconjugated

57
Q

what does a streptoboccus infection predispose you too

A

infective endocarditis and colorectal cancer

58
Q

recurrent clostridium difficile infection

A

oral fidaxomicin

59
Q

Courvoisier’s law

A

palpable mass in the RUQ is more likely to be a malignant obstruction of the common bile duct rather than obstruction due to stones.

60
Q

most common affected site in crohns

A

ileum

61
Q

abdo pain and diarrhoea with duodenal ulcer s and high PTH

A

zollinger ellisons syndrome around 1/3 of these patients have multiple endocrine neoplasia type 1

62
Q

what can transfer in swimming pools and causes a malabsorption

A

giardia lambia

63
Q

for a PE do you used LMWH or a DOAC

A

DOAC

64
Q

variceal haemorrhage treatment

A

terlipressin + IV antibiotic

65
Q

what cancer is pernicious anaemia associated with

A

gastric cancers and carcinoid tumours

66
Q

what cancer is zollinger-ellison associated with

A

gastrinoma

67
Q

what cancer is hpylori associated with

A

MALT lymphoma

68
Q

what cancer is coeliac disease associated with

A

t cell lymphoma

69
Q

what cancer is ulcerative colitis associated with

A

cholangiocarcinoma and colorectal cancer

70
Q

treatment for wilsons disease

A

d-penicillamine

71
Q

treatment for achalasia

A

hellers cardiomyotomy

OBS and gynae (17 decks)

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