Gastro Key facts Flashcards
Primary sclerosis cholagnitits is associated with what lower GI condition
UC
primary sclerosing cholangitis is associated with what ANCA
P-ANCA
what is the criteria for urgent 2WW referral for upper GI cancer query
all patients with dysphagia
all patients with upper abdo mass consistent with stomach cancer
patients aged 55+ with weight loss AND any of the following (upper abdo pain, reflux, dyspepsia)
what is the most common organism found on ascitic fluid culture
E Coli
what is the main diagnostic for haemachromatosis
serum ferritin
what is Wilsons disease
excessive build up of copper in the body
in Wilsons disease what are the rings called in the cornea
kayser-fleischer rings
what are the two main organs that are affected by alpha-1-antitrypsin deficiency
Liver cirrhosis after 50 years old
Bronchiectasis and emphysema in the lungs after 30 years old
what can liver cirrhosis lead to over time
hepatocellualr carcinoma
what is primary binary cirrhosis and what does it lead to
immune system attacks small bile ducts
causes obstruction to outflow of bile
back pressure leads to fibrosis, cirrhosis and liver failure
what does a build up of the following cause ]
bile acids
bilirubin
cholesterol
itcing
jaundice
xanthelasma
which autoantibodies are specific to primary biliary cirrhosis
Anti-mitochondrial antibodies is the most specific to PBC and forms part of the diagnostic criteria
Anti-nuclear antibodies are present in about 35% of patients
what are the following tumour markers for
alpha-fetoprotein
CA19-9
Alpha-fetoprotein is a tumour marker for hepatocellular carcinoma.
CA19-9 is a tumour marker for cholangiocarcinoma
barretts oesophagus is considered premalagiant condition and is a risk factor for the development of which cancer
adenocarcinoma of the oesophagus
how does Wilsons disease usually present
10-25 year olds, present with either liver disease or neurological disease
what are the early symptoms of haemochromatosis
fatigue
ED
arthralgia (often in the hands)
also can cirrhosis, joint pain, pancreatic insufficiency and HF
If someone presents with bleeding gums and a poor diet what does this make you think of
vitamin C deficiency- Scurvy
in gallstone ileus what does plain abdo film usually show
small bowel obstruction & air in the biliary tree
what 3 things can E coli cause
diarrhoea illness
UTI
neonatal meningitis
long term PPI use causes which electrical abnormality
low magnesium
how do you treat PBC
ursodeoxycholic acid
spontaneous bacterial peritonitis; what is the most common organism in ascitic fluid
E coli
what scan is performed to look at cirrhosis
transient elastography aka Fibroscan
can also do liver biopsy
what is used to treat vatical bleed
what is used for prophylaxis
treat with terlipressin
prophylaxis is propranolol
what condition should you always think about if someone presents with pain that is out of proportion to clinical findings, and occurs. after a meal with intermittent and severe pain
ischaemic colitis
how many weeks. before endoscopy do you need to stop PPI
2 weeks
what is Budd- Chiari syndrome
hepatic vein thrombosis
triad of: sudden onset abdo pain, ascites, tender hepatomegaly
how do you calculate alcohol units
% x volume / 1000
what cancer is associated with GORD or Barretts
oesophageal adenocarcinoma
in C diff infection what antibiotic should you prescribe
IV metronidazole or oral vancomycin
how is Wilsons disease treated
pencillamine
in coeliac patients how long do they have to be eating gluten for in order to test them
6 weeks
what is achalasia and how do they usually present
muscles of LOS fail to relax
pt will have trouble with solids and liquids and starts intermittently and regurg food
what are the following cancer marks for AFP CA19-9 CEA CA125
AFP is HCC
CA19-9 is pancreatic cancer
CEA is bowel Ca
Ca125 for ovarian cancer
match the description with the organism
- bloody diarrhoea & abscess, swinging fever, RUQ pain
- travellers diarrhoea
- bloody diarhhoea that is from ingesting uncooked meat and may lead to Gillian barre syndrome
- rice water stools from contaminated water and shellfish
- water diarrhoea from soft cheese, processed meat and pate
a. listeria
b. ecoli
c. entamoeba
d. campylobacter
e. vibrio cholera
1C
2B
3D
4E
5A
positive AMA is associated with what condition
PBC
in eradication of H pylori, which two antibiotics should not be given together (it is either or)
metronidazole or clarithromycin
what is the histological feature of chrons
what is the histological feature of UC
granulomas in areas of transmural inflammation
UC: mucosal inflammation, ulceration and crypt damage
what are the 3 main inherited causes of liver failure
Wilsons
alpha 1 antitrypsin
haemochromatosis
in alcohol excess what is seen in LFT
raised GGT
microcytic anaemia
name the 2 reasons for a TIPS procedure
secondary prophylaxis of oesophageal varies
treatment of refractory ascites
what is librium also known as
chlordiazapoxide
what does PSC predispose a patient to
cholangiocarcinoma and HCC
what criteria is used for liver transplant
kings college hospital criteria
- note that one is a PH less than 7.3 24 hours after ingestion of paracetamol
a patient with ascites secondary to liver cirrhosis should be given what treatment first line
aldosterone antagonist such as spironolactone
which vitamin is tetragenic at high doses
vitamin A
for hepatic encephalopathy what is given for secondary prevention
lactulose and rifaximin
what is the triad for mesenteric ischemia
CVD
raised lactate
soft but tender abdomen
