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GASTRO Flashcards

1
Q

What is pellagra?

A

A deficiency of vitamin B3 (niacin)

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2
Q

How does primary pellagra present?

A

Sunburn-like dermatitis rash
Diarrhoea
Cognitive deficits

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3
Q

What is beriberi a deficinecy of?

A

Thiamine which is B1

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4
Q

What drug can be used for prophylaxis of oesophageal bleeding?

A

A non-cardioselective beta blocker e.g. propalonol

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5
Q

Which part of the colon is most commonly affected by ischaemic colitis?

A

Splenic flexure

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6
Q

Why does A patient who is taking aminosalicylates and becomes unwell with a sore throat, fever, fatigue or bleeding gums needs an urgent full blood count

A

To rule out agranulocytosis

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7
Q

What is the most common type of inherited colorectal cancer?

A

HNPCC

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8
Q

Why do pts with coeliac require regular immunisation?

A

As they have functional hyposplenism

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9
Q

What does pernicious anaemic predispose to?

A

Gastric carcinoma

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10
Q

Management of a perianal fistula in Crohn’s patients?

A

Oral metronidazole

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11
Q

What cause cause a drug-induced cholestasis?

A

combined oral contraceptive pill
antibiotics: flucloxacillin, co-amoxiclav, erythromycin
anabolic steroids, testosterones
phenothiazines: chlorpromazine, prochlorperazine
sulphonylureas
fibrates

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12
Q

Secondary prophylaxis for hepatic encephalopathy?

A

Lactulose and rifaximin

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13
Q

Common features of chronic mesenteric ischaemia?

A

Abdominal pain - intermittent abdominal pain

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14
Q

What is ischaemic colitis?

A

An acute but transient compromise in the blood flow to the bowel
E.,g. May cause abdominal pain and loopy diarrhoea after eating but resolved

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15
Q

Incubation period of staph aureus?

A

1-6 hours

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16
Q

Incubation period of bacillus cereus?

A

1-6 hours

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17
Q

Incubation period of salmonella?

A

12-48 hours

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18
Q

Incubation period of E.coli?

A

12-48 hours

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19
Q

Incubation period of shigella?

A

48-72 hours

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20
Q

Incubation period of campylobacter?

A

48-72 hours

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21
Q

Incubation period of giardiasis?

A

5-16 days

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22
Q

Incubation period of amoebiasis?

A

2-4 weeks

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23
Q

Stereotypical presentation of E.coli gastroenteritis?

A

Watery stools (my be bloody)
Fever
Abdominal cramp
Nausea and vomiting

Last 10 days

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24
Q

Stereotypical presentation of giardiasis?

A

Prolonged, non-bloody diarrhoea
Malaise
Abdominal pain
Loss of appetite
Flatulence and bloating

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25
Stereotypical presentation of cholera?
Profuse ‘rice water’ diarrhoea Severe dehydration = weight loss
26
Stereotypical presentation of shigella?
Bloody/mucusy diarrhoea Fever Vomiting Abdominal cramps Last 5-7 dys
27
Stereotypical presentation of staph aureus gastroenteritis?
Severe vomiting shortly after exposure
28
Stereotypical presentation of campylobacter?
Prodrome of flu-like symptoms Crampy abdominal pain Fever Diarrhoea which may be bloody Nausea and vomiting (May mimic appendicits) Resolves within a week
29
Stereotypical presentation of amoebiasis?
Several weeks of… Gradual onset bloody diarrhoea Severebdominal pain
30
Most common sources of E.coli gastroenteritis?
Raw or undercooked ground meat products Unpasteurised milk Faecal contamination of vegetables Can be transmitted person-to-person via faecal oral route or contact with infected animals
31
Most common sources of giardiasis?
Person-to-person via faecal oral route Contact with faeces of infected animals Consumption of contaminated food and drink Swimming or drinking water from a river or lake Male-male sexual contact
32
Most common sources of cholera?
Poor sanitation./water - Africa, Southeast Asia and haiti
33
Most common sources of shigella?
Most commonly person-to-person by faecal oral route Contaminated food Sexually transmitted - men who ahve sex with men
34
Most common sources of staph aureus gastroenteritis?
Poultry or cooked meat products e.g. corned beef Cream products
35
Most common sources of campylobacter gastroenteritis?
Contaminated food and drink = undercooked meat/poultry, unpasteurised milk, untreated water
36
Most common sources of bacillus cereus gastroenteritis?
Contained cooked foods subjected to inadequate post-cooking temperature control e.g. reheated rice, pasta, meat, veg, dairy products
37
Most common sources of entamoeba histolytica gastroenteritis?
Ingestion of contaminated food or water Sexual contacts Travelling in endemic areas
38
Which type of IBD causes bloody diarrhoea more commonly?
UC
39
Which type of IBD causes perianal disease more commonly?
Crohn’s
40
Which type of IBD causes tenesmus more commonly?
UC
41
Which type of IBD causes gallstones more commonly?
Crohn’s
42
Which type of IBD causes increased goblet cells and granulomas more commonly?
Crohn’s
43
Which type of IBD causes crypt absescess more commonly?
UC
44
Which type of IBD causes pseudopolyps more commonly?
UC
45
Which type of IBD causes the cobblestone appearance more commonly?
Crohn’s
46
Investigation for pharyngeal pouch?
barium swallow combined with dynamic video fluoroscopy
47
What is alcoholic ketoacidosis?
A non-diabetic euglycaemic form of ketoacidosis in alcoholics Due to them not eating regularly, vomiting food when they do eat = malnourished = body produces ketones
48
How is liver cirrhosis diagnosed?
Transient elastopgrphy Acoustic radiation force in pulse testing Do an upper endoscopy to check for varices upon new diagnosis Liver USS every 6 months with AFP to check for hepatocellular ca
49
What should you do for pts with NAFLD to screen for liver cirrhosis?
Enhanced liver fibrosis score to determine if they need further testing
50
Who should be screened for cirrhosis?
Those with hepatitis C infection Men drinking >50 units a week and women >35 units Those with alcohol-related liver disease
51
What investigation is used for liver cirrhosis screening?
Transient elastography
52
Symptoms of bile-acid malabsorption?
Chronic diarrhoea- steatorrhoea ‘pale and greasy’ Crampy abdominal pain
53
Test of choice for bile-acid malabsorption?
SeHCAT: nuclear medicine test using a gamma-emitting selenium molecule in selenium homocholic acid taurine or tauroselcholic acid
54
How is haemochromatosis diagnosed?
Iron study: Transferrin saturation raised, raised ferritin and low TIBC Genetic testing MRI to quantify liver and cardiac iron LFTs
55
Metabolic consequences of refeeding syndrome?
Hypophosphataemia Hypokalaemia Hypomagnasaemia Abnormal fluid balance
56
Coeliac disease investigations?
Must be eating gluten for at least 6 weeks before: TTG and total IgA - first line endomyseal antibody can be done Gold standard - endoscopic intestinal biopsy
57
Findings supportive of coeliac disease in endoscopic intestinal biopsy?
villous atrophy crypt hyperplasia increase in intraepithelial lymphocytes lamina propria infiltration with lymphocytes
58
What antibodies are found in type 1 autoimmune hepatitis?
ANA anti smooth muscle
59
What antibodies are found in type 2 autoimmune hepatitis?
Anti liver/kidney microsomal type 1 antibodies
60
What antibodies are found in type 3 autoimmune hepatitis?
Soluble liver-kidney antigen
61
Investigtaions for ?ischaemic colitis?
VBG to look for I do is and lactate FBC, U&Es, clotting, LFTs Abdominal XR - may show thumbprinting
62
Features of carcinoid tumours?
Flushing Diarrhoea Bronchospasm Hypotension
63
Investigations for carcinoid syndrome?
Urinary 5-HIAA Plasma chromogranin A
64
Which drugs have the highest risk of c.diff?
Clindamycin Second and third generation cephalosporins = most common cause! PPIs
65
What is the double duct sign nd what causes it?
the presence of simultaneous dilatation of the common bile and pancreatic ducts Pancreatic cancer
66
What is budd-chairi syndrome?
Hepatic vein thrombosis
67
What is associated with budd-chiari syndrome?
Polycythemia rubes vera Thrombophilia Pregnancy COCP
68
Triad of budd-chiari syndrome?
Sudden onset severe abdominal pain Ascites Tender hepatomegaly
69
Investigation for budd-chiari syndrome?
USS with Doppler flow
70
What can be used to check for H.pylori eradication?
Urea breathe test
71
What is the most sensitive test for H.pylori?
Gastric biopsy
72
What cell type are 80% of pancreatic cancers?
Adenocarcinoma
73
Which gene mutations are associated with pancreatic cancer?
BRCA2 gene KRAS gene
74
Investigtaions for pancreatic cancer?
High-resolution CT is the investigation of choice - shows double duct sign! Can also do USS
75
Investigations for oesophageal cancer?
Upper GI endoscopy with biopsy for diagnosis Endoscopic USS for locoregional staging CT of CAP for initial staging Laparoscopy may be done to assess for intra-peritoneal metastases

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