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REVISION > GASTRO > Flashcards

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
Q

Stereotypical presentation of cholera?

A

Profuse ‘rice water’ diarrhoea
Severe dehydration = weight loss

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26
Q

Stereotypical presentation of shigella?

A

Bloody/mucusy diarrhoea
Fever
Vomiting
Abdominal cramps

Last 5-7 dys

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27
Q

Stereotypical presentation of staph aureus gastroenteritis?

A

Severe vomiting shortly after exposure

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28
Q

Stereotypical presentation of campylobacter?

A

Prodrome of flu-like symptoms
Crampy abdominal pain
Fever
Diarrhoea which may be bloody
Nausea and vomiting
(May mimic appendicits)

Resolves within a week

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29
Q

Stereotypical presentation of amoebiasis?

A

Several weeks of…
Gradual onset bloody diarrhoea
Severebdominal pain

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30
Q

Most common sources of E.coli gastroenteritis?

A

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

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31
Q

Most common sources of giardiasis?

A

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
Q

Most common sources of cholera?

A

Poor sanitation./water - Africa, Southeast Asia and haiti

33
Q

Most common sources of shigella?

A

Most commonly person-to-person by faecal oral route
Contaminated food
Sexually transmitted - men who ahve sex with men

34
Q

Most common sources of staph aureus gastroenteritis?

A

Poultry or cooked meat products e.g. corned beef
Cream products

35
Q

Most common sources of campylobacter gastroenteritis?

A

Contaminated food and drink = undercooked meat/poultry, unpasteurised milk, untreated water

36
Q

Most common sources of bacillus cereus gastroenteritis?

A

Contained cooked foods subjected to inadequate post-cooking temperature control e.g. reheated rice, pasta, meat, veg, dairy products

37
Q

Most common sources of entamoeba histolytica gastroenteritis?

A

Ingestion of contaminated food or water
Sexual contacts
Travelling in endemic areas

38
Q

Which type of IBD causes bloody diarrhoea more commonly?

A

UC

39
Q

Which type of IBD causes perianal disease more commonly?

A

Crohn’s

40
Q

Which type of IBD causes tenesmus more commonly?

A

UC

41
Q

Which type of IBD causes gallstones more commonly?

A

Crohn’s

42
Q

Which type of IBD causes increased goblet cells and granulomas more commonly?

A

Crohn’s

43
Q

Which type of IBD causes crypt absescess more commonly?

A

UC

44
Q

Which type of IBD causes pseudopolyps more commonly?

A

UC

45
Q

Which type of IBD causes the cobblestone appearance more commonly?

A

Crohn’s

46
Q

Investigation for pharyngeal pouch?

A

barium swallow combined with dynamic video fluoroscopy

47
Q

What is alcoholic ketoacidosis?

A

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
Q

How is liver cirrhosis diagnosed?

A

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
Q

What should you do for pts with NAFLD to screen for liver cirrhosis?

A

Enhanced liver fibrosis score to determine if they need further testing

50
Q

Who should be screened for cirrhosis?

A

Those with hepatitis C infection
Men drinking >50 units a week and women >35 units
Those with alcohol-related liver disease

51
Q

What investigation is used for liver cirrhosis screening?

A

Transient elastography

52
Q

Symptoms of bile-acid malabsorption?

A

Chronic diarrhoea- steatorrhoea ‘pale and greasy’
Crampy abdominal pain

53
Q

Test of choice for bile-acid malabsorption?

A

SeHCAT: nuclear medicine test using a gamma-emitting selenium molecule in selenium homocholic acid taurine or tauroselcholic acid

54
Q

How is haemochromatosis diagnosed?

A

Iron study: Transferrin saturation raised, raised ferritin and low TIBC
Genetic testing
MRI to quantify liver and cardiac iron
LFTs

55
Q

Metabolic consequences of refeeding syndrome?

A

Hypophosphataemia
Hypokalaemia
Hypomagnasaemia
Abnormal fluid balance

56
Q

Coeliac disease investigations?

A

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
Q

Findings supportive of coeliac disease in endoscopic intestinal biopsy?

A

villous atrophy
crypt hyperplasia
increase in intraepithelial lymphocytes
lamina propria infiltration with lymphocytes

58
Q

What antibodies are found in type 1 autoimmune hepatitis?

A

ANA
anti smooth muscle

59
Q

What antibodies are found in type 2 autoimmune hepatitis?

A

Anti liver/kidney microsomal type 1 antibodies

60
Q

What antibodies are found in type 3 autoimmune hepatitis?

A

Soluble liver-kidney antigen

61
Q

Investigtaions for ?ischaemic colitis?

A

VBG to look for I do is and lactate
FBC, U&Es, clotting, LFTs
Abdominal XR - may show thumbprinting

62
Q

Features of carcinoid tumours?

A

Flushing
Diarrhoea
Bronchospasm
Hypotension

63
Q

Investigations for carcinoid syndrome?

A

Urinary 5-HIAA
Plasma chromogranin A

64
Q

Which drugs have the highest risk of c.diff?

A

Clindamycin
Second and third generation cephalosporins = most common cause!
PPIs

65
Q

What is the double duct sign nd what causes it?

A

the presence of simultaneous dilatation of the common bile and pancreatic ducts
Pancreatic cancer

66
Q

What is budd-chairi syndrome?

A

Hepatic vein thrombosis

67
Q

What is associated with budd-chiari syndrome?

A

Polycythemia rubes vera
Thrombophilia
Pregnancy
COCP

68
Q

Triad of budd-chiari syndrome?

A

Sudden onset severe abdominal pain
Ascites
Tender hepatomegaly

69
Q

Investigation for budd-chiari syndrome?

A

USS with Doppler flow

70
Q

What can be used to check for H.pylori eradication?

A

Urea breathe test

71
Q

What is the most sensitive test for H.pylori?

A

Gastric biopsy

72
Q

What cell type are 80% of pancreatic cancers?

A

Adenocarcinoma

73
Q

Which gene mutations are associated with pancreatic cancer?

A

BRCA2 gene
KRAS gene

74
Q

Investigtaions for pancreatic cancer?

A

High-resolution CT is the investigation of choice - shows double duct sign!
Can also do USS

75
Q

Investigations for oesophageal cancer?

A

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

REVISION (25 decks)

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