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Final year > Gastro > Flashcards

Gastro Flashcards

1
Q

Charcot’s triad

A

Cholangitis - RUQ pain, jaundice, fever

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2
Q

Murphy’s sign

A

Pain on inspiration with hand under right costal margin

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3
Q

Wernicke’s encephalopathy triad

A

Opthalmoplegia, ataxia and confusion

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4
Q

Korsakoff’s syndrome

A

Memory impairment, confabulation, confusion and personaity changes. Normally developed after wernicke’s.

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5
Q

Antibodies raised in PBC

A

IgM and AMA (ANA often raised, as is anti-gp210 and anti-centromere)

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6
Q

Antibodies raised in autoimmune hepatitis

A

IgG and ANA/ASMA

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7
Q

Which hepatic disease is often in conjunction with ulcerative colitis?

A

Primary sclerosing cholangitis

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8
Q

PSC biopsy appearance

A

Onion skin fibrosis

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9
Q

PBC biopsy appearance

A

Inflamm around small bile ducts in liver - granulomatosis

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10
Q

MRCP appearance of PSC

A

String of beads

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11
Q

Main form of diagnosis for PSC

A

MRCP

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12
Q

Most common demographic for PBC

A

Middles aged women

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13
Q

Diagnostic criteria for PBC

A

2 of following is probable, 3 is definite:
Abnormal cholestatic LFTs
Positive AMA
Compatible histology

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14
Q

What 5 factors are included in child pugh score and what is it used for?

A

Bilirubin, albumin, INR, ascites and encephalopathy

Predicting mortality in patients with cirrhosis.

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15
Q

What is cullen’s sign?

A

Bruising around the umbillicus due to acute pancreatitis or an ectopic pregnancy

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16
Q

What is grey-turner’s sign?

A

Discolouration of the flanks caused by retro-peritoneal haemmorhage

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17
Q

What is troisier’s sign?

A

Presence of wirchow’s node in left SCF

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18
Q

Which disease is indicated by raised anti-dsDNA?

A

SLE

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19
Q

Treatments for Wilson’s disease

A

Penicillamine

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20
Q

Which renal condition is assoicated with Wilson’s disease?

A

Membranous nephropathy

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21
Q

Gene affected in Wilson’s disease

A

ATP7B

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22
Q

Which blood group is a risk factor for gastric cancer?

A

A

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23
Q

Risk factors for gastric cancer

A 
Blood group A
Helicobacter pylori
Pernicious anaemia
smoking 
High salt/nitrite diet
(except in cardia - more similar to oesophageal)
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24
Q

Treatment for simple apthhous ulcer

A

Topical steroids

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25
Q

How long can mouth ulcers be preset for before you need to biospy them?

A

3 weeks

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26
Q

Which virus causes oral hairy leucoplakia?

A

EBV

27
Q

Features of small intestinal bacterial overgrowth

A

Chronic diarrhoea, anaemia (low b12, high folate), steatorrhoea and glossitis. Causes malbsorptioj

28
Q

Risk factors for small intestinal bacterial overgrowth

A

Decreased gastric acid secretion
Decreased gut motility
Immunodeficiency
Structural defects/previous surgery

29
Q

Treatment for small intestinal bacterial overgrowth

A

Antiobiotics - eg metro, cipro or coamox

30
Q

Indicators of liver synthetic function

A

Prothrombin is acute indicator, albumin is more chronic (1/2 life of 20 days)

31
Q

Extra articular features of IBD

A

Oral - apthous ulcers (chrons)
Eyes - anterior uveitis, conunctivitis, episcleritis
Joints - seronegative spondyloarthritis (non-deforming and asymetrical usually), sacroilitis
Skin - pyoderma gangrenosum (UC mainly), erythema multiforne, finger clubbing
Liver - PSC (UC)
Anal - fissure (mainly Chrons)

32
Q

Obstruction of which veins cause caput medusa?

A

Superior mesenteric and splenic veins - anastomose to form portal vein

33
Q

Which hormone inhibits gastrin?

A

sOMA

34
Q

Features of UC on barium enema

A

Shortened bowel, loss of haustra (lead pipe colon) and small serration at the bowel edge from ulceration

35
Q

Colonoscopy features of UC

A

Diffuse and contiguous ulceration and inflammatory infiltrates affecting mucosa and submucosa only. Pseudopolyps and crypt abcess both also seen.

36
Q

Long term complication of UC

A

Large bowel adenocarcinoma, toxic megacolon, and PSC. Cancer avoided by total colectomy in long stadning UC or when dysplasia has developed

37
Q

Features of Crohn’s on barium enema

A

Multiple linear ulcers in bowel wall (rose thorn appearance) and bowel wall thickening.

38
Q

Colonoscopy features of Crohn’s

A

Multiple apthoid, linear, stellate ulcers with background inflammed cobblestone mucosa. Inflammation is transmural and has non-caseating granulomas

39
Q

Most appropraite therapy for Hep C genotypes

A

1 - PEG-interferon alpha with ribavarin and a protease inhibitor
Others - No PI

40
Q

What is Budd-chiari syndrome?

A

Hepatic venous outflow obstruction (anywhere from hepatic venules to entrance of IVC)

41
Q

Presentation of budd chiari syndrome

A

Abdo pain, ascites and hepatomegaly

42
Q

Risk factors for Budd-chiari syndrome

A 
Prothombotic conditions
Hormones eg contraception
Pregancy and puerperium
Hepatic infections (inc. parasites)
Malignancy
Trauma
Autoimmune conditions (eg Coeliac, behcets or sarcoidosis)
43
Q

What LFT results would suggest Gilbert’s syndrome?

A

Isolated bilirubinaemia

44
Q

Which enzyme is effected in Gilbert’s syndrome?

A

UDP-glucuronyl transferase

45
Q

What is Crigler-Najjar syndrome?

A

Defect in glucuronyl-transferase activity - presents with death and jaundice in neonates

46
Q

What is Caroli’s syndrome?

A

Congenital dilatation of the intrahepatic bile duct - causes recurrent episodes of cholangitis

47
Q

Features of severe flare of UC

A 
EAT STEroid
ESR >30mm/hour
Albumin <30g/l
Temperature at 0600 >37.8
Stool frequency >6/day with blood
Tachycardia >90bpm
Enaemia Hb <10.5g/dl
48
Q

Treatment of severe UC flare

A

Admit to hospital, IV corticosteriods, fluids and monitoring

49
Q

Differentiating ascites between trasudate and exudate

A

Protein content alone or SAAG
SAAG <11g/L is exudate
Ascitic protein >30g/L is exudate

50
Q

What is achlasia?

A

Failure of lower oesophageal sphincter to dilate

51
Q

Characteristic appearance of achlasia on barium swallow

A

Bird’s beak tapering

52
Q

What investigation can be used to confirm achlasia?

A

Manometry

53
Q

How does severe alcoholism effect amylase levels during acute pancreatitis?

A

Means they may only be moderately raised due to impairment of pancreas.

54
Q

Predicting severity of severe pancreatitis

A 
Modified Glasgow criteria - PANCREAS
PaO2 <8kPa
Age >55yrs
Neutrophilia - WBC >15
Calcium <2mmol/L
Renal function - Urea >16mmol/L
Enzymes - LDH >600iu/L, AST >200iu/L
Albumin <32g/L (serum)
Sugar - BM >10mmol/L
55
Q

Which B vitamin is thiamine?

A

B1

56
Q

Features of pellegra

A

Diarrhoea, dermatitis and dementia

57
Q

What is cope’s/obturator sign?

A

Pain of appendicitis stimulated by flexion and internal rotation of the hip. Works if appendix is retro-peritoneal in orientation

58
Q

What is psoas sign?

A

Pain of appendicitis reproduced when patient laid of side and leg is passively extended (Also positive in psoas abscess)

59
Q

What is pemberton’s sign?

A

Patient with SVC obstruction - raises hand above head , increasing pressure over gthoracic inlet causing venous congestion in face and neck

60
Q

What is rovsing’s sign?

A

Palpation in LIF produces pain in the RIF

61
Q

Most common location for a gastrinoma

A

1st/2nd part of the duodenum and pancreatic head

62
Q

Eradication therapy for H Pylori

A

Omeprazole 20mg BD, Clarithromycin 500mg BD and Amoxicillin 1g BD (swap amox for metronidazole 400mg BD if pen allergic)

63
Q

Which conditions does duodenal scalloping on endoscopy suggest?

A

Coeliac, HIV infection, amyloidosis and giardiasis

Final year (18 decks)

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