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UKMLA passmed > gastro > Flashcards

gastro Flashcards

1
Q

Right-sided tenderness on PR exam, think

A

appendicitis

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2
Q

what type of FBC/CRP results do you get in appendicitis?

A

a neutrophil-predominant leucocytosis is seen in 80-90% in appendicitis

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3
Q

The diagnostic investigation for necrotising enterocolitis is

A

The diagnostic investigation for necrotising enterocolitis is an abdominal x-ray

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4
Q

Men who have sex with men should be offered immunisation against

A

Hep A

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5
Q

management of Crohn’s patients who develop a perianal fistula

A

Oral metronidazole is useful in the management of Crohn’s patients who develop a perianal fistula

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6
Q

most common symptom of Crohn’s disease in children?

A

abdo pain

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7
Q

first-line to maintain remission in patients with Crohn’s

A

Azathioprine or mercaptopurine is used first-line to maintain remission in patients with Crohn’s

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8
Q

Patients with hyposplenism should be vaccinated against

A

Patients with hyposplenism should be vaccinated against pneumococcal (5-yearly booster), Haemophilus type B and meningococcus type C

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9
Q

causes of megaloblastic and normoblastic
macrocytic anemia

A
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10
Q

Isolated rise in GGT in the context of a macrocytic anaemia suggests

A

Isolated rise in GGT in the context of a macrocytic anaemia suggests alcohol excess as the cause

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11
Q

Methotrexate therapy may result in

A

megaloblastic macrocytic anaemia secondary to folate deficiency

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12
Q

Patients….. should be given oral ciprofloxacin or norfloxacin as prophylaxis against spontaneous bacterial peritonitis

A

Patients with ascites (and protein concentration <= 15 g/L) should be given oral ciprofloxacin or norfloxacin as prophylaxis against spontaneous bacterial peritonitis

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13
Q

which parameters are used to monitor treatment of haemochromatosis

A

Ferritin and transferrin saturation are used to monitor treatment in haemochromatosis

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14
Q

DPP4 mode of action

A

Gliptins (DPP-4 inhibitors) reduce the peripheral breakdown of incretins such as GLP-1

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15
Q

The AST/ALT ratio in alcoholic hepatitis is

A

2:1

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16
Q

The characteristic clinical features of alcoholic hepatitis are

A
  • jaundice, anorexia, fever, and tender hepatomegaly.
  • AST:ALT ratio of 2 or greater
  • may also present with right upper-quadrant/epigastric pain, hepatic encephalopathy, and signs of malnutrition.
  • Patients often stop drinking as they become ill, so it is common for patients to have stopped drinking alcohol several weeks prior to presentation.
17
Q

alcoholic liver disease investigations

A
  • gamma-GT is characteristically elevated
  • the ratio of AST:ALT is normally > 2, a ratio of > 3 is strongly suggestive of acute alcoholic hepatitis
18
Q

alcoholic liver disease management

A
  • glucocorticoids (e.g. prednisolone) are often used during acute episodes of alcoholic hepatitis
  • pentoxyphylline is also sometimes used
19
Q

common causative agent for ascending cholangitis

A

E.coli

20
Q

nail changes in anemia

A

Koilonychia, or spooning of nails, is a classic clinical sign of hypochromic anemia, especially iron-deficiency anemia.

21
Q

Patients must eat gluten for at least…before they are tested

A

Patients must eat gluten for at least 6 weeks before they are tested

22
Q

In life-threatening C. difficile infection treatment is with

A

In life-threatening C. difficile infection treatment is with ORAL vancomycin and IV metronidazole

23
Q

People with coeliac disease receive the pneumococcal vaccine due to

A

People with coeliac disease receive the pneumococcal vaccine due to hyposplenism

24
Q

Patients with ascites secondary to liver cirrhosis should be given

A

Patients with ascites secondary to liver cirrhosis should be given an aldosterone antagonist like spiranolactone

25
Q

acute infection in hepatitis B will give which serology results

A

HBsAg positive, anti-HBs negative, IgM anti-HBc positive - acute infection

26
Q

previous hepatitis B, now a carrier:

A

previous hepatitis B, now a carrier: anti-HBc positive, HBsAg positive

27
Q

previous immunisation for hep B serology results:

A

previous immunisation: anti-HBs positive, all others negative

28
Q

Severe hepatitis in a pregnant woman - think hepatitis…

A

Severe hepatitis in a pregnant woman - think hepatitis E

29
Q

which antigen can be used to monitor patients with colorectal cancer

A

Carcinoembryonic antigen may be used to monitor for recurrence in patients post-operatively or to assess response to treatment in patients with metastatic disease

30
Q

First line treatment for diarrhoea in IBS

A

Loperamide

31
Q

Erratic blood glucose control, bloating and vomiting in diabetic despite taking meds think

A

Erratic blood glucose control, bloating and vomiting think gastroparesis

32
Q

Liver transplantation criteria in paracetamol overdose:

A

pH < 7.3 more than 24 hours after ingestion

33
Q

when do you start acetylcysteine in paracetamol overdose?

A

Paracetamol overdose: if presentation 8-24 hours after ingestion of an overdose of more than 150 mg/kg start acetylcysteine even if the plasma-paracetamol concentration is not yet available

34
Q

Hep B previous (> 6 months ago) infection, not a carrier

A

HBsAg negative, anti-HBs positive, IgG anti-HBc positive - previous infection, not a carrier (> 6 months ago)

35
Q

The appearance of ground-glass hepatocytes on light microscopy can point towards…

A

The appearance of ground-glass hepatocytes on light microscopy can point towards a diagnosis of chronic hepatitis B infection

36
Q

Red flag symptoms for gastric cancer includes

A

new-onset dyspepsia in a patient aged >55 years
unexplained persistent vomiting
unexplained weight-loss
progressively worsening dysphagia/
odynophagia
epigastric pain

37
Q

Staphylococcus aureus gastroenteritis is characterised by

A

Staphylococcus aureus gastroenteritis is characterised by a short incubation period and severe vomiting

UKMLA passmed (23 decks)

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