Gastro Flashcards
severe colitis flare management?
hospital admission
IV steroids
if no improvement after 72h - consider adding IV ciclosporin or surgery
pt with blood results showing macrocytic anaemia and low b12, next test?
intrinsic factor antibodies for pernicious anaemia
first, second and third line management for c.diff?
- oral vanc 10d
- oral fidaxomycin
- oral vanc +/- IV metronidazole
which vitamin is teratogenic in high doses?
vitamin A
(retinol)
which blood test are useful to monitor the function of the liver in liver failure?
prothrombin time
(coagulation and albumin generally)
which part of the colon is most likely to be affected by ischaemic colitis?
splenic flexure
which biliary disease is associated with UC?
primary sclerosis cholangitis
tx for haemachromatosis?
first line - venesection
second line - desferrrioxamine
mgt of barrett’s oesophagus?
high dose PPI
+ endoscopic surveillance
management when dysplasia is seen on upper GI endoscopy in barretts oesophagus?
endoscopic intervention ie endoscopic mucosal resection
triggers for UC flares?
stress
medx - NSAIDs, abx
cessation of smoking
features of vitamin C deficiency (scurvy)?
gingivitis, loose teeth
poor wound healing
bleeding from gums, haematuria, epistaxis
general malaise
management of variceal haemorrhage?
ABC
prophylactic IV abx and terlipressin
then endoscopy
painful palpable umbilical nodule associated with advanced malignancy in the pelvis or abdomen?
sister mary joseph’s node
most common bacteria in SBP?
e.coli
then klebsiella
sign on MRCP in pancreatic cancer?
double duct sign (dilatation of pancreatic and common bile ducts)
M rule in PBC?
IgM
anti-Mitochondrial antibodies, M2 subtype
Middle aged females
management for wilsons disease?
penicillamine
features of carcinoid syndrome ?
abdo pain
diarrhoea
flushing
also bronchospasm
prophylaxis of oesophageal bleeding?
non cardioselective beta blocker eg propranolol
mild UC flare?
<4 stools daily with or without blood
no systemic disturbance
normal ESR and CRP
moderate UC flare?
4-6 stools a day, minimal systemic disturbance
severe UC flare?
> 6 stools a day, cont blood
evidence of systemic disturbance
eg fever, tachycardia, abdo tenderness, distention or dec BSs
anaemia
hypoalbuminaemia
management of PBC?
ursodeoxycholic acid
management of pruritus in PBC?
cholestyramine
mgt for liver abscess?
IV abx and image guided percutaneous drainage
monitoring bloods in haemochromatosis?
ferritin and transferrin saturation
investigation of choice for carcinoid tumours?
urinary 5-hydroxyindoleacetic acid
(5-HIAA)
alcohol intake advice?
max 14 units per week
if you drink as much as 14 units it is best to spread it evenly over 3 days or more
findings on AXR in ischaemic colitis?
thumb printing of the small bowel
features of crohns that are diff from UC?
mouth to anus
skip lesions
inflam all layers
goblet cells
granulomas
bowel obstruction, fistulae
typically more weight loss, abdo pain, non bloody diarrhoea
complications of PSC?
cholangiocarcinoma (10%)
inc risk of colorectal cancer
management of perianal abscess in crohn’s pts?
incision and drainage
what is peutz-jeghers syndrome?
AD condition
-> numerous hamartomatous polyps in GI tract
- also pigmented freckles on the lips, face, palms and soles
» often intussusception
associated with gastrointestinal cancers
which malignancy is associated with barrett’s oesophagus?
adenocarcinoma
dx: young man with retrosternal chest pain and dysphagia to liquids and solids
achalasia (LES doesn’t relax)
which autoantibody is positive in PSC?
p-ANCA
symptoms of congestive hepatomegaly?
persistent dull ache
-» mild elevation of ALT
typical blood results in haemochromatosis?
raised ferritin and transferrin saturation
low TIBC
