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Paeds - TAS > Gastro > Flashcards

Gastro Flashcards

1
Q

Risk factors for pyloric stenosis

A

Prematurity
bottle fed
male sex
first born child
FH

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2
Q

Wilsons disease - inheritance

A

AR
mutation in gene ATP7B chromosome 13

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3
Q

Presentation of Wilsons disease

A

hepatic involvement - liver failure, chronic cirrhosis or hepatitis
personality changes and mood disorders
movement disorders - asymmetrical tremor
ataxia, clumsiness with hands
Kayser-Fleischer rings (green/gold or brown ring on cornea)
renal faconi syndrome
myopathy
cardiac arrythmias and cardiomyopathy
hypoparathyroidism
pancreatitis
infertility

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4
Q

Diagnosis of Wilsons

A
  • low serum caeruloplasmin and presence of Kayser-Fleischer rings
  • elevated basal 24 hour urinary excretion of copper
  • increased intrahepatic copper secretions
  • definitive = liver biopsy (only if other results unclear)
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5
Q

Management of Wilson’s

A

avoid high copper foods: liver, chocolate, nuts, mushrooms, legumes, shellfish
start on chelating agent: penicillamine or trientine

stable patients continue with low dose chelating agent and zinc or just zinc

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6
Q

Macroscopic findings on endoscopy in UC

A

friable mucosa
mucosal and submucosal inflammation
goblet cell depetion
crypt abscesses

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7
Q

Macroscopic findings on endoscopy in Crohns

A

transmural inflammation
apthous ulcers
fissures
cobblestoning
strictures
non caseating granulomas

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8
Q

what causes mumps

A

RNA virus

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9
Q

Criggler Najjar Syndrome

A

severe persistent unconjungated hyperbilirubinaemia
happens in first few days of life
defect in UGT1A1 gene (which conjugates bili)
treatment: phototherapy and plasmapheresis

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10
Q

Duodenal atresia

A

double bubble sign on xray
anatomical location most likely for obstruction second segment of duodenum

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11
Q

Difference between gram neg and gram pos organism

A

cell walls of gram pos lack lipopolysaccharies - these form outer layer of all gram neg organisms

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12
Q

which HLA associated with coeliac

A

HLA-DQ2
HLA-DQ8

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13
Q

Which HLA associated with 21 hydroxylase deficincy - most common cause CAH

A

HLA-B47

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14
Q

Which HLA associated with risk developing T1DM

A

HLA-DR3 (also associated with SLE and autoimmune hepatitis)
HLA-DR4

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15
Q

what is seen on microscopy for someone with coeliac

A

crypt hyperplasia and flattened duodenal mucosa

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16
Q

CMPA - IgE mediated?

A

can be IgE mediated - IgE antibodies against the proteins in cows milk
symptoms usually occur within 2 hours of ingestion

or non IgE mediated - T cell activation against proteins in cows milk

17
Q

Management of CMPA

A

if BF avoidance in maternal diet
if formula: hydrolysed formula

18
Q

what causes diarrhoea in CMPA

A

osomotic diarrhoea due to damage of the absorptive area
chronic inflammation which causes vomiting, loose stools sometimes with blood

19
Q

Most common part of colon affected in UC

A

Proctitis/ sigmoid
usually starts in rectum and progressively extends further

20
Q

coeliac biopsy

A

subtotal or complete villous atrophy (may exist in other GI conditions)
crypt hypertrophy
lamina propria plasma cell infiltrate
intraepithelial lymphocytosis

21
Q

which layer of intestine wall most affected in Crohns

A

transmural

22
Q

which layer of intestine wall most affected in UC

A

Mucosal

23
Q

which part of the intestine responsible for B12 absorption

A

ileum

24
Q

urea breath test for h;pylori is based on the detection of

A

CO2

25
Q

secretin

A

stimulated by intraluminal acid
it stimulates pancreatic bicarbonate secretion, inhibits gastric acid and pepsin secretion and delays gastric emptying

26
Q

gastrin

A

stimulated by vagal stimulation and distention of stomach
stimulates gastric acid, pepsin and intrinsic factor
causes gastric emptying and pancreatic secretion

27
Q

normal LFTs
hep B surface antibodies

A

vaccinated against Hep B

28
Q

pos hep B surface antigen
hep B e antigen pos
deranged LFT

A

acute hep B infection

29
Q

Hep B surface antibody
Hep B core antibody
Hep B e antibody
normal LFTs

A

recovery from hep B infection

Paeds - TAS (20 decks)

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