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Final Year - Passmed > Gastro 2 > Flashcards

Gastro 2 Flashcards

1
Q

achalasia surgical mx?

A

heller cardiomyotomy

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2
Q

Mx of achalasia?

A

balloon dilatation
heller cardiomyotomy

botoulinum toxin

nitrates / CCB

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3
Q

alcoholic hepatitis signs

A

GGT raised
ast:alt ratio >2

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4
Q

small intestinal bacterial overgrowth is developed by?
RF

A

DM

autonomic neuropathy

scleroderma

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5
Q

how to differentiate between Alcoholic ketoacidosis and Diabetic ketoacidosis?

A

normal / low glucose

with ketones

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6
Q

mx of alcoholic ketoacidosis?

A

non-diabetic euglycaemic

infusion of saline and thiamine

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7
Q

why do coeliacs need pneumococcal vaccine?

A

hyposplenism

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8
Q

neuroendocrine tumour

A

secrete serotonin

diarrhoea
bronchial NET > SS
liver mets > SS

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9
Q

Ix carcinoid syndrome / NET

A

Investigation
urinary 5-HIAA
plasma chromogranin A y

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10
Q

signet ring cells

A

gastric adenocarcinoma

large vacuole containing mucin

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11
Q

suspected pharyngeal pouch
Investigation?

A

barium swallow w fluoroscopy

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12
Q

chronic mesenteric ischaemia?

A

colicky post prand meal

abdominal bruit
weight loss

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13
Q

Bowel Ischaemia RF

A

age
A fibrillation
CVD; smoke/ HTN/ DM
cocaine

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14
Q

Ix bowel ischaemia

Imaging of choice?

A

CT

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15
Q

acute mesenteric ischaemia?

A

small bowel ischaemia
Afib

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16
Q

ischaemic colitis?

A

acute but transient

large bowel

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17
Q

what is a watershed area?
what sign on xray?

A

splenic flexure
SMA /IMA

thumbprinting on xray
mucosal oedema / haemorrhage

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18
Q

budd chiari syndrome
Imaging?

A

hepatic vein thrombosis

> USS with doppler flow studies

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19
Q

what is the triad for budd chiari syndrome

A

abdominal pain
ascites
tender hepatomegaly

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20
Q

Causes of budd chiari syndrome

A

polycythaemia rubra vera
thrombophilia activated protein C
pregnancy COCP

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21
Q

Pyogenic Liver Abscess mx?

A

drainage
abx

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22
Q

which organism in liver abscess?

A

e coli (adults)

staph aureus (children)

23
Q

what abx?

A

amoxicillin
ciprofloxacillin
metronidazole

24
Q

Reintroduce gluten for at least _______ and arrange serological tests

A

6 weeks

25
Q

toxic megacolon

A

transverse colon >6cm in diameter

systemic upset

Ix: abdo Xray

26
Q

role of endoscopy after a Upper GI bleed?

A

endoscopy within 24 hours

27
Q

Resus upper GI bleed
active bleeding?
if on warfarn?

A

ABC
wide bore IV access 2

platelet transfusion

Prothrombin complex concentrate

28
Q

FFP given in upper gi bleed when?

A

fibrinogen <1g/l
INR >1.5

29
Q

C diff RF

A

abx
> clindamycin
>cephalosporins
PPI

30
Q

dysphagia

A

difficulty swallowing

31
Q

odynophagia?

A

pain on swallowing

32
Q

Truelove and Witts severity index
what is it for?

what is the criteria?

A

UC
37.8^C
90 beats per minute
Anaemia (105g/L)
ESR >30

Temp
Rate
Uh (neami)
EESR >30

33
Q

Dx of Oesophageal cancer?

A

upper GI endoscopy w biospy

USS

CT-Scan
fdg-pet ct

34
Q

PSC has what antibodies?

A

p- ANCA

35
Q

what is PSC?

A

inflammation and fibrosis

intra and extra hepatice bile ducts

36
Q

gold standard Ix for PSC?

A

MRCP

ERCP - more invasive
> beaded

37
Q

peutz jeghers syndrome

what lesions on colonoscopy?

A

hamartomas

38
Q

co amoxiclav

A

amoxicllin
clavulanate

hepatotoxic

= cholestasis

39
Q

Treatment for oesophageal cancer

operable?

A

t1n0mo

surgical resection
ivor lewis oesophagectomy

adjuvant chemo

40
Q

Neoadjuvant chemoradiotherapy followed by surgical resection

oesophageal cancer

A

locally advanced cancers to downstage it

41
Q

metoclopramide

A

d2 receptor antagonist

pro kinetic

= promotes gut peristalsis

42
Q

how does Metoclopramide decrease nausea?

A

promotes gut peristalsis
5-HT3/5

which inhibits chemoreceptor trigger zone of the medulla

43
Q

SAAG >11 ascites

A

portal htn

> cirrhosis
RHF
budd chiari

44
Q

SAAG <11

A

hypoalbumin
> nephrotic syndrome
malnutrition

45
Q

therapeutic abdo paracentesis?

A

albumin cover needed

ciprofloxacin <15g/l of protein

46
Q

bulk forming laxative?

A

isphagula usk

47
Q

osmotic laxative

A

macrogol

48
Q

UC histology

A

depleted goblet cells and mucin from gland epithelium

49
Q

crohns hsitology

A

goblet cell increased
granuloma

50
Q

carcinoid syndrome can affect the heart how?

A

right side of the heart
> tricuspid insufficiency
>pulmonary stenosis

51
Q

Mx of perianal fistula

A

oral metronidazole
seton drain

> metronidazole
ciprofloxacin

52
Q

pre-operative workup for a patient undergoing a Nissen fundoplication for treatment-resistant GORD

A

oesophageal manometry
oesophageal pH

53
Q
A

Final Year - Passmed (9 decks)

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