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Gastro Flashcards

1
Q

Features of Crohn’s Disease

A 
o	Diarrhoea
o	Crampy abdo pains
o	Perianal disease
o	Oral ulceration
o	Malabsorption
o	Obstruction
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2
Q

Most common extra-intestinal feature in Crohn’s

A

arthritis

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3
Q

Nutritional causes of peripheral neuropathy

A

o Alcohol
o B12 deficiency
o B6 EXCESS

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4
Q

Urgent TWR OGD indications

A

o Anyone with dysphagia
o Anyone with upper abdo mass consistent with gastric cancer
o >55yo and weight loss + dyspepsia/epigastric pain/reflux

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5
Q

Definition, cause, and histology of melanosis coli

A

• Melanosis coli = disorder of pigmentation of bowel wall
o Histology ~pigment-laden MPs
o ~laxative abuse, especially Senna

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6
Q

Genetics and complications of haemochromatosis

A

HFE gene

o Reversible:
 CM
 Skin discolouration

o	Irreversible:
	DM
	Arthritis
	Hypogonadism
	Liver cirrhosis
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7
Q

How do the levels of clotting factors change in coagulopathy of liver disease?

A

all clotting factors low except 8 which is high

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8
Q

What is the most significant risk factor for HCC?

A

Hep C virus

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9
Q

Management of UC (induce remission/maintain remission)

A

INDUCE REMISSION
o Mild/moderate:
 Topical +/- oral aminosalicylate always first line depending on severity. Match up to colonoscopy findings

o If severe
 IV steroids

MAINTAIN REMISSION: aminosalicylates

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10
Q

Top cause of HCC; UK + worldwide

A

o Hep B worldwide

o Hep C UK

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11
Q

Granulomas are characteristic of Crohn’s or UC?

A

Crohn’s

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12
Q

Pseudopolyps are characteristic of Crohn’s or UC?

A

UC

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13
Q

Features of Giardia? (incubation period, management)

A

longest incubation period ~4days

Rx: metronidazole

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14
Q

Indications and treatment for SBP prophylaxis

A

Ascites + protein <15

Rx: PO Cipro or Norfloxacin

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15
Q

Nutritional source of vitamin D

A

oily fish

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16
Q

Alcohol vitamin deficiency Rx

A 
Give THIAMINE
(Vit B coStrong is not in guidelines)
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17
Q

Beefy red and sore tongue, yellow-tinge to skin

PMH: gastrectomy

A

Pernicious anaemia

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18
Q

Dx of IBS

A

Abdo pain + altered stool form + 2 of the following:

  • passage of rectal mucus
  • altered stool passage (straining, urgency, incomplete evacuation)
  • Sx worsened by eating
  • Abdo distension/hardness/bloating
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19
Q

45yo woman with secondary amenorrhoea and deranged LFTs

A

AI hepatitis

antibodies can attack smooth muscle

20
Q

Instructions prior to 13c urea breath test

A

No ABx for 4 weeks prior

No PPI for 2 weeks prior

21
Q

Incubation period for norovirus

Seasonal period for norovirus

A

36-72h

Winter

22
Q

Features and deficiency in pellagra

A

Dermatitis + dementia + diarrhoea

Vitamin B3/niacin deficiency

23
Q

Diarrhoea + skin symptoms + howel-jolly bodies

A

Coeliac disease

Howel Jolley bodies related to splenic atrophy in Coeliac - also seen in splenectomy

24
Q

Gastric cancer RFs

A

Smoking
H pylori
Gastritis
Adenoma

NB. Alcohol not an independent RF for gastric ca

25
Q

Causes of mouth ulcers

A

Crohns
Coeliac
Behcet’s
HIV

26
Q

Female with positional nausea + GORD.

Dx + Ix?

A

Sliding hiatus hernia

Barium meal

27
Q

Saint’s triad

A

Sliding hiatus hernia + gallstones + diverticular disease

with atypical abdominal symptoms

28
Q

Rx of <55 with dyspepsia

A

Review meds causing dyspepsia
Lifestyle advice
Test and treat for H. pylori OR 4/52 PPI

29
Q

Name and details of classification for oesophagitis

A 
LOS ANGELES classification
A- <5mm mucosal breaks
B- >5mm breaks
C- breaks extending between the tops of 2 mucosal folds but <75% circumference
D- circumferential breaks (>75%)
30
Q

Cheilitis

Causes?

A

Inflammation of lips + perioral skin:

  • dry lips
  • painful cracks at angles of mouth
  • erythema
Ax:
nutritional deficiency
sun exposure
dryness
drug-related
31
Q

How long to fast prior to OGD

32
Q

Type 1 vs Type 2 AI hepatitis

A

Type 1:
age 45-70
Anti-smooth muscle
Anti-nuclear

Type 2:
2-14yo
ABs to liver and kidney microsomes (anti-LKM) and liver cytosol antigen (anti-LC1)

33
Q

Rx for AI hepatitis

A

Azathioprine

Glucocorticoids

34
Q

Infertility in men secondary to drug

A

sulfasalazine ~hypospermia

35
Q

IV treatment for UC that can cause severe allergies

A

Infliximab

36
Q

What are the Milan criteria and what are they for?

A

HCC patients suitable for liver transplant

1 nodule <5mm
OR
2-3 nodules <3mm

37
Q

Colorectal cancer risk goes up __ years after development of inflammation in IBD

38
Q

Which AI disease and malignancy is associated with UC? Which tumour marker is raised?

A

PSC
Cholangiocarcinoma
Ca 19-9

39
Q

Xeropthalmia

Px and Ax?

A

Prolonged vitamin deficiency in children
Common in Africa
Causes dry cornea, thickened conjunctivae, deficient tear film, blindness

40
Q

USS: normal liver with hyperechoic well-circumscribed lesion

A

Haemangioma - commonest benign tumour of the liver

41
Q

USS pancreas: hypo echoic mass

MRI: T1 hypo enhancement, T2 hyperenhancement

A

Suggests fluid filled ie. pancreatic pseudocyst

42
Q

Signs of alcoholic ketoacidosis

Complications

A

Confusion, dehydration, lethargy, malnourishment, fruity breath
Kussmauls +ve
pH <7.3
HCO3 <15

Complications: cerebral oedema, coma

43
Q

Carcinoid syndrome features, pathology, Dx test, Rx

A

Ftrs:
abdo pain, diarrhoea, RUQ pain, flushing, R heart failure

Path:
5HT secretion from tumour at neural crest originating at TI or appendix, can cause pulmonary stenosis due to fibrosis

Dx test: urinary 5HIAA

Rx: octreotide - blocks release of tumour mediators

44
Q

Management of Crohn’s

A

Induce remission:

  • Glucocorticoid (IV/TOP/PO)
  • Enteral feed with elemental diet instead or as well as
  • 2nd line: 5-asa drugs eg. mesalazine
  • Mercaptopurine/Azathio as an add on
  • Infliximab if refractory
  • Metronidazole for isolated perianal disease

Maintain remission:

  • STOP smoking
  • 1st: Aza/Mercapto
  • 2nd: Methotrexate
  • Consider mesalazine if had surgery
45
Q

First line Ix if suspect UC/IBD

A

Flexi Sig

Not colonoscopy!

46
Q

AI hepatitis RX and conrtaindicated med

A

Azathioprine
Ciclosporin
Transplant
Steroids

NB. IFN C/I’d

47
Q

IBS Dx tool

A

Rome criteria

MSRA (18 decks)

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