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Zero to finals > Gastro 2 > Flashcards

Gastro 2 Flashcards

1
Q

what is affected in PSC

A

the bile ducts

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2
Q

what condition is PSC associated with

A

ulcerative colitis

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3
Q

what LFT is most raised in PSC

A

ALP

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4
Q

PSC autoantibody

A

none are specific

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5
Q

PSC diagnostic test

A

MRCP

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6
Q

PSC mx

A

strictures can be dilated with ERCP

colestyramine for pruritus

replace fat soluble vitamins

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7
Q

what cancer does PSC increase risk of

A

cholangiocarcinoma

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8
Q

what is IgG4 related sclerosing cholangitis

A

similar to PSC but responds to steroids

associated with autoimmune pancreatitis

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9
Q

main risk factor for hepatocellular carcinoma

A

cirrhosis

due to NAFLD, ALD, hep b, hep c

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10
Q

how is screening in liver cirrhosis patients for hepatocellular carcinoma carried out

A

ultrasound
alpha fetoprotein

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11
Q

hepatocellular carcinoma marker

A

alpha fetoprotein

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12
Q

what histological type of cancer are cholangiocarcinomas

A

adenocarcinomas

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13
Q

tumor marker for cholangiocarcinoma

A

ca 19-9

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14
Q

liver transplant scar

A

roof top (along costal margin) or mercedes benz (along costal margin and midline)

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15
Q

what type of cell is the oesophagus lined with

A

squamous epithelium

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16
Q

what type of cell is the stomach lined with

A

columnar epithelium

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17
Q

red flags for 2WW upper GI endoscopy

A

anyone with dysphagia
above 55
mass
anaemia
weight loss
upper abdo pain

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18
Q

when does dysphagia warrant a 2WW referral

A

always
anyone, any age with new dysphagia refer them

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19
Q

what is a hiatus hernia

A

when a portion of the stomach shifts up through the diaphragm

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20
Q

what surgery is done for reflux

A

laparoscopic fundoplication

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21
Q

what type of bacteria is h pylori

A

gram negative aerobic

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22
Q

what medication needs to be stopped before h pylori testing and for how long

A

stop PPI 2 weeks before

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23
Q

h pylori eradication therapy

A

PPI
amoxicillin
clarithromycin

for 7 days

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24
Q

what is zollinger ellinson syndrome

A

duodenal or pancreatic tumors produce gastrin causing excessive dyspepsia, dairrhoea and peptic ulcers

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25
Q

what is zollinger ellinson syndrome associated with

A

MEN 1

26
Q

what medications increase risk of bleeding from a peptic ulcer

A

NSAIDs
aspirin
anticoagulants
SSRIs
steorids

27
Q

peptic ulcers encompass

A

gastric ulcers
duodenal ulcers

28
Q

changes in weight in gastric vs duodenal ulcer

A

gastric ulcer- weight loss due to fear of eating causing pain

duodenal ulcer- weight remains stable or higher

29
Q

signs of upper GI bleed

A

haematemesis
coffee ground vomit
melaena
low Hb

30
Q

complications of peptic ulcers

A

bleeding
perforation
gastric outlet obstruction- due to scarring and strictures

31
Q

peptic ulcer mx

A

stop exacerbating/ causative medications
h pylori eradication
PPIs

32
Q

sources of upper GI bleed

A

varices
cancer
peptic ulcers
mallory weiss tear

33
Q

mallory weiss tear is a tear in the

A

oesophageal mucosa

34
Q

what score is used to determine risk of upper GI bleed

A

glasgow blatchford score

35
Q

what score is used after endoscopy to assess risk of rebleeding from upper GI bleed

A

rockall

36
Q

when should an endoscopy be done for upper GI bleed

A

within 24 hrs
immediately is emergency

37
Q

what is difference between G+S and xmatch

A

G+S= a sample of patients blood is saved for matching and the blood group is checked

xmatch= units of blood are tested to check compatibility and kept ready in the fridge

38
Q

what platelet level are platelets given

A

<50

39
Q

when is PPI used in upper GI bleed

A

AFTER endoscopy, not before

40
Q

what site is most affected in crohns

A

terminal ileum

41
Q

conditions associated with IBD

A

erythema nodosum
pyoderma gangrenosum
enteropathic arthritis
PSC
red eye eg anterior uveitis, scleritis, episcleritis

42
Q

mild.moderate UC mx

A

aminosalicylate 1st line
corticosteroids 2nd line

43
Q

maintaing remission UC first line

A

oral aminosalicylate
rectal mesalazine

44
Q

surgeries for UC

A

ileostomy- end of small bowel is brought to skin and stoma created

j pouch- ileum is made into a pouch and attached to rectum

45
Q

maintaining remission in crohns

A

azathioprine
mercatopurine
both 1st line

methotrexate if those not suitable

46
Q

how is pain sometimes improved in IBS

A

after opening bowels

47
Q

how is pain sometimes worsened in IBS

A

after eating

48
Q

what must you rule out in someone with bloating

A

ovarian cancer- non specific sx

49
Q

ovarian cancer tumor marker

A

ca125

50
Q

how long do you have to have sx for IBS diagnosis

A

6 months

51
Q

IBS medication used for diarrhoea

A

loperamide

52
Q

IBS medication used for constipation

A

ispaghula husk

53
Q

in IBS do not use what medication for constipation

A

lactulose- can cause constipation

54
Q

new T1DM patients are tested fr what autoimmune conditions even if there are no sx

A

thyroid disease
coeliacs

55
Q

coealiac disease autoantibodies

A

anti TTG
anti endomysial
anti DGP

56
Q

what part of the bowel is most affected in coeliacs

A

jejunum

57
Q

HLA associations in coeliacs

A

HLA DQ2
HLA DQ8

58
Q

deficiencies in coeliacs

A

iron
b12
folate

59
Q

biopsy findings in coeliacs

A

crypt hyperplasia
villous atrophy

60
Q

cancers associated with coeliacs

A

EATL
NHL
small bowel adenocarcinoma

61
Q
A

Zero to finals (11 decks)

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