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Gastro Flashcards

1
Q
A
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2
Q

What is the most likely site for ischaemic colitis?

A

Splenic flexure

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3
Q

What are the two main interventions for a bleeding ulcer?

A

1- endoscopy, 2- surgery

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4
Q

What condition is associated with painless jaundice?

A

Pancreatic cancer

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5
Q

What symptoms are associated with a pharyngeal pouch?

A

Halitosis, nocturnal coughing, and dysphagia

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6
Q

What is a benign condition affecting the esophagus?

A

Benign oesophageal stricture

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7
Q

What is amylase primarily helpful for diagnosing?

A

Pancreatitis

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8
Q

What lab results are raised due to alcohol consumption?

A

Raised ferritin and raised GGT

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9
Q

What syndrome is caused by a gastrin-secreting tumor?

A

Zollinger Ellison syndrome

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10
Q

How is Zollinger Ellison syndrome diagnosed?

A

Secretin stimulation test

ZESSSST - Zollinger Ellison Syndrome Secretin Stimulation Testing

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11
Q

What is often involved in non-inherited colon cancer?

A
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12
Q

What is the treatment for severe ulcerative colitis with systemic upset?

A

IV Hydrocortisone

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13
Q

What is the management for tense ascites?

A

Draining

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14
Q

What is the treatment for liver cirrhosis with non-tense ascites?

A

Spironolactone

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15
Q

What can gastrinomas cause?

A

Ulcers

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16
Q

What do pigment-laden macrophages suggest?

A

Laxative abuse

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17
Q

What are the characteristics of Peutz Jeghers syndrome?

A

Melaninisation of bowel and skin, polyps

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18
Q

What causes liver enzymes to be in the 1000s?

A

Paracetamol overdose, ischaemia, or viral hepatitis

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19
Q

What medications can cause dyspepsia?

A

NSAIDs, Bisphosphonates, Steroids

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20
Q

Where are gastrinomas mainly located?

A

First part of the duodenum

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21
Q

What is the treatment for life-threatening C. difficile infection?

A

Oral vancomycin and IV metronidazole

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22
Q

What does TIPS often exacerbate?

A

Hepatic encephalopathy

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23
Q

What is the treatment for primary biliary cholangitis (PBC)?

A

Ursodeoxycholic acid

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24
Q

What is gallstone pancreatitis more likely to occur during?

A

Pregnancy

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25
Q

What does HELLP syndrome in pregnancy stand for?

A

Haemolysis, elevated liver enzymes, low platelets

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26
Q

What is VIPoma associated with?

A

Watery diarrhoea, hypokalaemia, and achlorhydria

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27
Q

What clotting factor is characteristically raised in alcohol-related liver disease?

A

Factor 8

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28
Q

What is the strongest risk factor for anal cancer?

A

HPV infection

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29
Q

What do granulomas suggest?

A

Crohn’s disease

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30
Q

What test is used for carcinoid tumours?

A

Urinary 5-hydroxyindoleacetic acid

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31
Q

What can Didanosine, an NRTI, cause?

A

Pancreatitis

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32
Q

What does cholestatic liver function tests indicate?

A

High ALP

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33
Q

What does biliary obstruction affect?

A

Liver enzymes

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34
Q

What is measured to assess progress in haemochromatosis?

A

Ferritin and transferrin levels

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35
Q

What is the risk of hepatocellular carcinoma (HCC) in PBC?

A

20 fold increase

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36
Q

What is the most common cause of HCC worldwide?

A

Hepatitis B

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37
Q

What is the best imaging for oesophageal/gastric cancer?

A

Endoscopic ultrasound

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38
Q

What is suspected if there is difficulty getting through the sphincter?

A

Motility disorder

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39
Q

Where is ulcerative colitis most commonly located?

A

Rectum

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40
Q

What is the refeeding protocol after starvation?

A

Reintroduce diet as half diet for 2 days

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41
Q

What is Gilbert’s syndrome characterized by?

A

Isolated jaundice when stressed; no treatment needed

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42
Q

What is pseudomembranous colitis characterized by?

A

Multiple white plaques in colon

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43
Q

What does Dubin Johnson syndrome cause?

A

Conjugated hyperbilirubinaemia, sometimes jaundice

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44
Q

What is the first line treatment for variceal bleeding?

A

Endoscopic variceal band ligation

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45
Q

What is the treatment if endoscopic variceal band ligation fails?

A

TIPS, connects hepatic vein to portal vein

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46
Q

What is the prophylaxis for varices?

A

Propranolol and endoscopic band ligation every 2 weeks for medium to large varices

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47
Q

What can low magnesium, potassium, and phosphate indicate?

A

Refeeding syndrome

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48
Q

What characterizes tumor lysis syndrome?

A

High potassium, high phosphate, low calcium

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49
Q

What is angiodysplasia associated with?

A

Aortic stenosis

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50
Q

What are the characteristics of primary biliary cholangitis?

A

IgM, AMA, M2 subtype, middle-aged females

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51
Q

What must be done before coeliac testing?

A

Eat gluten for 6 weeks before testing

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52
Q

What are the symptoms of Budd-Chiari syndrome?

A

Abdominal pain (sudden onset severe), hepatomegaly, and ascites

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53
Q

What antibodies suggest autoimmune hepatitis?

A

Smooth muscle antibodies

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54
Q

What is the treatment for eosinophilic oesophagitis?

A

Dietary modification and topical steroids

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55
Q

What is acute fatty liver of pregnancy characterized by?

A

Liver symptoms with equally raised LFTs

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56
Q

What is cholestasis of pregnancy characterized by?

A

Liver symptoms with most raised ALP

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57
Q

What genetic abnormality is associated with familial adenomatous polyposis (FAP)?

A

APC gene abnormality

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58
Q

What test is used for bile acid malabsorption?

A

SeHCAT test

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59
Q

What is the post-eradication test for H. pylori?

A

Urea breath test

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60
Q

What are the symptoms of Whipple’s disease?

A

Diarrhoea, weight loss, arthralgia, ophthalmoplegia

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61
Q

What antibiotics can cause cholestasis?

A

Co-amoxiclav and Flucloxacillin

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62
Q

What imaging is used for Budd-Chiari syndrome?

A

Abdominal ultrasound with Doppler

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63
Q

What is the first line investigation for lactose intolerance?

A

Hydrogen breath test

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64
Q

What indicates adequate response to Hep B immunisation?

A

Anti-HBs check at 6 months

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65
Q

What is a complication of pancreatitis?

A

ARDS

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66
Q

What is the first line treatment for non-alcoholic fatty liver disease (NAFLD)?

A

Weight loss

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67
Q

What score can be used for acute appendicitis?

A

Alvarado score

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68
Q

What is the treatment for a liver abscess?

A

Drainage and antibiotics

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69
Q

What test is needed for NAFLD?

A

Enhanced Liver Fibrosis (ELF) test

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70
Q

What should be assessed before offering azathioprine or mercaptopurine therapy in Crohn’s disease?

A

TPMT activity

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71
Q

What is the recommended procedure for patients identified with FAP?

A

Total proctocolectomy due to high risk of cancer

72
Q

What is the screening test for haemochromatosis in the general population?

A

Transferrin saturation

73
Q

What is the risk associated with FAP?

A

Younger age and more deadly

74
Q

What is more common, HNPCC or FAP?

A

HNPCC is more common and occurs at an older age

75
Q

What does a high albumin gradient suggest?

A

Portal hypertension

76
Q

How is C. difficile transmitted?

A

Faeco-oral through ingestion of spores

77
Q

What is the topical steroid used for oesophagitis?

A

Oral fluticasone which is then swallowed

78
Q

What is the carcinogenic medication that should only be prescribed to palliative patients?

A

Codanthramer

79
Q

What is primary sclerosing cholangitis (PSC) linked with?

A

Ulcerative colitis; MRCP is used for diagnosis

80
Q

What can omeprazole increase the risk of?

A

Severe diarrhoea in C. difficile infection

81
Q

What cancers are associated with HNPCC?

A

Colon cancer and endometrial cancer

82
Q

What does TTG testing not work for?

A

IgA deficient patients

83
Q

What symptoms are associated with a pharyngeal pouch?

A

Dysphagia, aspiration pneumonia, halitosis

84
Q

What is bezlotoxumab used for?

A

C. difficile toxin

85
Q

What can carcinoid syndrome affect?

A

The right side of the heart

86
Q

What are crypt abscesses indicative of?

A

Ulcerative colitis

87
Q

What is the protocol for the urea breath test?

A

No PPI for 2 weeks, no antibiotics for 4 weeks

88
Q

What can cause villous atrophy?

A

Coeliac disease, tropical sprue, hypogammaglobulinaemia, Whipple’s disease

89
Q

What is the treatment for mild-moderate distal UC flare?

A

Topical/rectal aminosalicylate

90
Q

What is the next step if UC affects more of the bowel?

A

Topical steroid, then oral steroid

91
Q

What does a palpable bladder and painless jaundice suggest?

A

Cholangiocarcinoma

92
Q

What indicates recurrent C. difficile infection?

93
Q

What is the treatment for more than 2 flares of UC in 12 months?

A

Azathioprine

94
Q

What causes secondary haemochromatosis?

A

Blood transfusions

95
Q

What does H. pylori cause?

A

Severe gastroesophageal reflux disease (GORD) without diarrhoea

96
Q

What is the second line treatment for IBS?

A

Low dose TCA

97
Q

What is the management for Child Pugh A with tumors <2cm?

98
Q

What is the management for Child Pugh B with multiple tumors <5cm?

A

Transplant, TACE, or RFA in the meantime

99
Q

What is the management for Child Pugh C?

A

Best supportive care

100
Q

What is the first line treatment for C. difficile?

A

Oral vancomycin

101
Q

What should be added if C. difficile is severe?

A

IV metronidazole

102
Q

What is the treatment for gastric malt lymphoma?

A

Eradicate H. pylori

103
Q

What does paracetamol overdose cause?

A

Necrosis; viral hepatitis also causes necrosis

104
Q

What should be done if a hydatid cyst has daughter cysts?

A

Surgery instead of PAIR (puncture, aspiration, injection, reaspiration)

105
Q

What is the HLA associated with coeliac disease?

106
Q

What imaging is used for chronic pancreatitis?

A

CT pancreas to look for pancreatic calcification

107
Q

What causes perianal itching in children and family members?

A

Enterobius vermicularis (threadworms)

108
Q

What does Wilson’s disease not cause?

A

HCC; haemochromatosis does

109
Q

What gene is associated with familial adenomatous polyposis (FAP)?

A

Adenomatous polyposis coli tumor suppressor gene

110
Q

What does retrocardiac air fluid level indicate?

111
Q

What is cirrhosis characterized by?

A

Excess collagen and extracellular matrix deposition in periportal and pericentral zones

112
Q

What is the management for oesophageal biopsy with non-dysplasia?

A

High dose PPI

113
Q

What is the management for oesophageal biopsy with metaplasia?

114
Q

What is the management for oesophageal biopsy with dysplasia?

A

Radiofrequency ablation

115
Q

What is the characteristic effect of oesophageal cancer?

A

Oesophageal stricture with apple core effect

116
Q

What imaging is needed in PBC prior to diagnosis?

A

Ultrasound to exclude extrahepatic dilatation

117
Q

What is the inheritance pattern of FAP?

A

Autosomal dominant on chromosome 5

118
Q

What can diarrhea and hypokalaemia indicate?

A

Villous adenoma

119
Q

What is autoimmune hepatitis characterized by?

A

Hepatitis and amenorrhoea

120
Q

What is the treatment regimen for H. pylori?

A

Lansoprazole, amoxicillin, and clarithromycin or PPI, metronidazole, and clarithromycin

121
Q

What gene is associated with HNPCC?

A

MSH2 gene for DNA mismatch repair

122
Q

What stimulates gastrin release?

A

Luminal peptides

123
Q

What is the best marker of severity in pancreatitis?

A

CRP over 150, WBC over 16, LDH greater than 350, hypocalcaemia

124
Q

What is the risk of colon cancer with severe UC?

A

Increased risk

125
Q

What causes hepatorenal syndrome?

A

Splanchnic vasodilation

126
Q

What is goblet cell depletion indicative of?

A

Ulcerative colitis

127
Q

What is the treatment for a liver abscess?

A

Amoxicillin, ciprofloxacin, and metronidazole

128
Q

What are the criteria for bariatric surgery?

A

BMI 35 with risk factors, BMI >40 without risk factors

129
Q

What is the treatment for diarrhea and hypokalaemia?

A

Villous adenoma

130
Q

What is the treatment for post-resection diarrhea in Crohn’s?

A

Cholestyramine

131
Q

What immunoglobulin is associated with alcoholic liver disease?

132
Q

What immunoglobulin is associated with primary biliary cirrhosis?

133
Q

What immunoglobulin is associated with autoimmune hepatitis?

134
Q

What is the secondary prophylaxis for hepatic encephalopathy?

A

Lactulose and rifaximin

135
Q

What is the treatment for spontaneous bacterial peritonitis (SBP)?

A

IV Cefotaxime

136
Q

What can alcohol cause besides liver disease?

A

Ketoacidosis when glucose is normal

137
Q

What is the treatment for small bowel overgrowth?

138
Q

What condition is Sjögren’s syndrome associated with?

A

Primary biliary cholangitis (PBC)

139
Q

What imaging is used for Budd-Chiari syndrome?

A

Doppler ultrasound of the liver

140
Q

What is the most common organism causing SBP?

141
Q

What imaging is used for pancreatic cancer?

A

High-resolution CT pancreas

142
Q

What is the link between H. pylori and cancer?

A

No link established

143
Q

What is the treatment for alcohol hepatitis?

A

Prednisolone

144
Q

What is the positive predictive value (PPV) of FOB?

145
Q

What does maize not include?

146
Q

What is the diagnostic procedure for microscopic colitis?

A

Colonoscopy and biopsy

147
Q

What is not recommended for patients with dementia?

148
Q

What can transient elastography assess?

149
Q

What is the treatment for severe ulcerative colitis?

A

Admit and IV hydrocortisone

150
Q

What is the prophylaxis for variceal bleeds?

A

Antibiotic prophylaxis

151
Q

What tests are used for haemochromatosis?

A

Transferrin and ferritin

152
Q

What is the inheritance pattern of Peutz-Jeghers syndrome?

A

Autosomal dominant

153
Q

What is gastric adenocarcinoma characterized by?

A

Signet ring cells

154
Q

What neutrophil count indicates SBP?

A

> 250 in paracentesis

155
Q

What symptoms in haemochromatosis are reversible?

A

Skin pigmentation and cardiomyopathy

156
Q

What is the gold standard for GORD?

A

24-hour oesophageal pH monitoring

157
Q

What test is used for Gilbert’s syndrome?

A

Nicotinic acid test

158
Q

What does NICE suggest regarding lactulose in IBS?

A

Avoid lactulose

159
Q

What can pancreatitis cause in the eyes?

A

Cotton wool spots

160
Q

What is hepatic vein thrombosis associated with?

A

More rapid ascites than hepatic portal vein thrombosis

161
Q

What immunoglobulin is associated with coeliac disease?

162
Q

What is the treatment for Wilson’s disease?

A

Penicillamine

163
Q

What is H. pylori associated with?

A

Duodenal ulceration and gastric adenocarcinoma

164
Q

What should be avoided in IBS?

A

Insoluble fibre

165
Q

What characterizes type 1 hepatorenal syndrome?

A

Occurs within 2 weeks; type 2 is more gradual

166
Q

What causes biliary colic after fatty foods?

167
Q

What is the treatment for chronic anal fissure?

A

Topical GTN

168
Q

What is the management for hepatorenal syndrome?

A

Albumin and terlipressin

169
Q

What causes pain on defecation?

A

Anal fissure over internal hemorrhoids

170
Q

What is the treatment for more than 2 flares in 12 months?

A

Oral azathioprine

171
Q

What is the management for newborns exposed to Hep B?

A

Newborn Hep B vaccine + Hep B immunoglobulin

172
Q

What is the prophylaxis for SBP?

A

Ciprofloxacin

173
Q

What test is useful for exocrine function in chronic pancreatitis?

A

Faecal elastase

174
Q

What is the route of administration for Fidaxomicin?

175
Q

What is the most common cause of HCC in Europe?

A

Hepatitis C

MRCP (7 decks)

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