gastro Flashcards
What markers are used in the modified glasgow score for pancreatitis severity?
PANCREAS
PaO2 <8
Age >55
Neutrophilia
Calcium
Renal function (urea>16)
Enzymes(LDH and AST)
Albumin
Sugar (>10)
in UC: which of these other features are realted to uc disease activity?
- erythema nodosum
- psc
- arthropathy
- sacroiliitis/ank spon
Erythema nodosum - related
PSC - unrelated
Arthropathy - related
Ank spon - unrelated
Diagnosis?
- middle aged
- jaundiced
- pruritic
- hepatosplenomegaly + RUQ discomfort
primary biliary cirrhosis
diagnostic blood test in PBC?
antimitochondrial antibodies
Vomiting of undigested food
diagnosis?
gastric outlet obstruction
Key test for hiatus hernia? why?
contrast upper GI series
- delineates anatomy
2ww referrals for colorectal cancer.
At what age group would you refer for the following presentations?
- weight loss + abdo pain
- unexplained PR bleeding
- positive FOB test
- new iron deficiency anaemia in man or post menopausal woman
- persistent CIBH
Weight loss and abdo pain >40yo
Unexplained PR bleeding >50yo
Positive FOB test - any age
New IDA - >60yo
Peristent CIBH >60yo
location inguinal vs femoral hernia in relation to pubic tubercle
Inguinal - superior and medial
Femoral - inferior and lateral
how many units in a pint of weaker 4% beer
2
how many units in a small glass of wine
2
guideline for alcohol intake in UK?
14 units, spread out over >3 days of the week
zenker diverticulum, aka…
pharyngeal pouch
Incarcerated hernias are more likely to cause large or small bowel obstruction?
Small bowel obtruction
Causative organism?
bloody diarrhoea and RUQ pain
Entamoeba
RUQ pain due to amoebic liver abscess
Bloody diarrhoea and joint pain
2 possible causative organisms?
Campylobacter
Yersinia
Most common presentation of portal hypertension?
Haematemesis from varices
What is budd chiari syndrome
hepatic vein obstruction - may be thrombotic or non thrombotic
Common vitamin deficiency secondary to carcinoid tumour? How?
NIacin (pellagra - dementia, dermatitis, diarrhoea)
Carcinoid tumours –> tryptophan metabolism increased –> increased serotonin
Features of chronic mesenteric ischemia?
Management?
Post prandial pain in a pt with CVD , esp smokers
Weight loss and fear of eating
Unremarkable abdo exam
Revascularisation
Most commonly affected part of GIT in crohns disease
Terminal ileum
Anatomical landmark used to differentiate between internal and external haemorrhoids
dentate line
Egs of :
bulk forming laxative
osmotic laxative
stimulant laxative
Bulk - fybogel
osmoti - lactulose, movicol
stimulant - senna
Isolated raised ALP
- what are the 2 likely sources? how to differentiate between them?
liver vs bone
measure GGT - if rasied, do USS and antimitochondrial antibodies (PBC)
if not raised, need vit D, calcium, phosphate
oral ocular genital syndrome = deficiency?
B2 deficiency-
Haemochromatosis - which blood test is useful for diagnosis
High transferrin saturation
Features of haemochromatosis (apart from bronzed skin)
liver
diabetes
arthralgia
cardiomyopathy = reversible with treatment
Features of Wilsons disease
copper deposition ++
neurological and liver involvement
kayser fleischer rings
Wilson’s disease - which blood test is useful for diagnosis
low caeruloplasmin
In a pt with IBD with worsening bowel sx, what is the most specific blood test to rule out/in a diagnosis of IBD exacerbation
faecal calprotectin
Triad of sx in plummer vinson syndrome
beefy red tongue
dysphagia
IRON DEFICIENCY
a well patient with isolated raised bilirubin. what do you do next?
repeat unconjug and conjug bilirubin in 1-3 months time
if unconjug bili is increasing –> think haemolysis
middle aged woman with diarrhoea, DVT, depression and rash and weight loss
diagnosis?
glucagonoma
at what age would you refer 2ww a pt with new onset dyspepsia
55yo
relationship btw calcium and pancreatitis
HIGH ca –> pancreatitis
but low Ca = worse prognosis
2 organisms which cause dysentry + joint pain?
campylobacter + yersinia
when are abx indicated in diarrhoea? which one?
clarithromycin - if systemically unwell or campylobacter is suspected
how do HCC and cholangiocarcinoma present differently?
HCC is usually painful RUQ, cholangiocarcinoma is typically painless
