Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MRCP Master > Gastro: Oesophageal + stomach > Flashcards

Gastro: Oesophageal + stomach Flashcards

1
Q

Common in north Aficans , hx of atropy
Endoscopic Biopsy:
> 15 eosinophils per high power microscopy field.
-reduced vasculature, -thick mucosa,
- mucosal furrows,
-strictures &laryngeal oedema

A

Eosinophilic oesophagitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

rx Eosinophilic oesophagitis

A

RX:
Diet - ppi
If diet fails Topical steroids e.g. fluticasone and budesonide
Oesophageal dilatation
Complications: strictures, Mallory Weiss tears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Barium swallow: shows irreg filling defect
Endoscopy: white patches
With a hx of immunosuppression

A

Oesophageal candidiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

oesophageal manometry (most important diagnostic test)=
excessive LOS tone which doesn’t relax on swallowing

Barium swallow
expanded oesophagus, fluid level
‘bird’s beak’ appearance

chest x-ray
wide mediastinum
fluid level

A

Achalasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Rx Achalasia
1st line
High risk
recurrent

A

Rx: 1st ln- pneumatic (balloon) dilation
Recurrent = Heller myotomy
High risk injection of botulinum toxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes

Sx: are dysphagia, regurgitation, aspiration & chronic cough. Halitosis

Might have midline lump in the neck that gurgles on palpation

A

Pharyngeal pouch
Zenker’s diverticulum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

IX & RX for

A

Pharyngeal pouch
Zenker’s diverticulum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Barrett’s oesophagus
Risk factor & define

A

Risk factors: GORD, male, smoking, Central obesity NOT alcohol

metaplasia of the lower oesophageal mucosa, with the usual squamous epithelium being replaced by columnar epithelium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Rx Barrett’s oesophagus
What is the largest complication

A

Rx: ALL high-dose PPI

Pt w/ metaplasia (but not dysplasia) endoscopy every 3-5 years

Pt w/ dysplasia = 1st ln : radiofrequency ablation:
endoscopic mucosal resection

Increased risk oesophageal adenocarcinoma (50-100%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Indications for upper GI endoscopy:

A

age > 55 years
symptoms > 4 weeks or persistent symptoms despite treatment
dysphagia
relapsing symptoms
weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Most common type of Oesophageal cancer in the world, in the UK

A

Adenocarcinoma most common found in UK gastroesophageal junction

-Squamous cell tumours most common in the world found in the upper 2/3 of the oesophagus.the world is square

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Dysphasia for solids then liquids indicates

A

Oesophageal cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

IX& Rx Oesophageal cancer

A

-Upper GI endoscopy with biopsy

-Endoscopic ultrasound is the preferred method for locoregional staging

CT scanning of the chest, abdomen and pelvis is used for initial staging

Rx surgical resection; complication anastomotic leak

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What cause (DIE)
* Dysphagia (2dary to oesophageal webs)
* Iron-deficiency anaemia/Glossitis
* Esophageal webs

A

Plummer-Vinson syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Plummer-Vinson syndrome
Increases risk to
RX

A

Squamous cell carcinoma

RX iron & dilatation of webs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is caused by severe vomiting & is
Common in alcoholics

A

Mallory-Weiss syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What causes the Mackler triad
1. Severe /repeated vomiting,
2. sudden onset CP

  1. Subcutaneous emphysema
A

Boerhaave syndrome

18
Q

Acute treatment of variceal haemorrhage (4)

A
  1. correct clotting: FFP, vitamin K

2.Terlipressin -benefit in initial haemostasis and prevents rebleeding

  1. prophylactic IV antibiotics :Quinolones - reduce mortality in patients with liver cirrhosis
  2. endoscopic variceal band ligation is superior to endoscopic sclerotherapy.
    * Sengstaken-Blakemore tube if uncontrolled haemorrhage
    * Transjugular Intrahepatic Portosystemic Shunt (TIPSS) if above measures fail- connects the hepatic vein to the portal vein
    o exacerbation of hepatic encephalopathy
19
Q

Prophylaxis of variceal haemorrhage

A
  • propranolol: reduced rebleeding and mortality compared to placebo
  • endoscopic variceal band ligation (EVL) is superior to endoscopic sclerotherapy. It should be performed at two-weekly intervals until all varices have been eradicated. PPI is given to prevent EVL-induced ulceration..’
20
Q

2 causes of gastritis

A
  1. Autoimmune Gastritis - Type 4 hypersensitivity
    Type A (Fundus to Body)
  2. H-Pylori -MOST Common Helicobacter pylori is a Gram-negative bacteria; secretes urease = alkalinization
    Type B (Antrum to Body)
21
Q

What is impaired Autoimmune Gastritis

A

Decrease in intrinsic factor B1
Decrease Fe2+ absorption

22
Q

Risks associated with H-Pylori

A

MALT
Neuroendocrine tumours
duodenal ulcers

23
Q

Dx Autoimmune Gastritis

A

biopsy
antibodies to IF & parietal cells

24
Q

test for eradication of H-pylori

A

Urea breath test
should not be performed within 4 wks of rx w/ an antibacterial or within 2 weeks PPI

25
Q

tests for H-pylori

A

Urea breath test- sensitivity 95-98%, specificity 97-98%; not before 2wks after PPI use or 4 abx

Rapid urease test (e.g. CLO test)- sensitivity 90-95%, specificity 95-98%

Stool antigen test- sensitivity 90%, specificity 95%

26
Q

Rx h pylori

A
  • 7 days: PPI + amoxicillin + (clarithromycin OR metronidazole)
  • if penicillin allergic: a PPi + metronidazole + clarithromycin
27
Q

Duodenal Ulcer relationship to h. Pylori
How is pain relieved

A
  • More common
    90% due to H-Pylori
  • pain when hungry, relieved by eating
28
Q

What worsens Gastric ulcer pain

A

70% due to H-Pylori

-worsened by eating

H- pylori makes acid more basic and induces inflammation

-NSAIDS- Stop production of prostaglandins (normally promote H+ production and mucus secretion)= decreased mucosal protection

29
Q

Acid difference in Gastric and duodenal ca

A

duodenal = increase H more acidic
Gastric = more basic

30
Q

Where do gastric ulcers tend to bleed from

A

left gastric artery on the the lesser curvature

31
Q

gastric ulcers what are they a risk factor for

A

MALT
gastric adenocarcinoma

32
Q

Where do duodenal ulcers tend to bleed from

A

gastroduodenal artery
posterior wall of the duodenum

33
Q

What is the most common type of gastric ca and where is it most likely to form ?

A

Gastric Adenocarcinoma
lesser curvature of the antrum

34
Q

Common sign of adenocarcinoma

A
35
Q

Sign of gastric adenocarcinoma and mer

A
36
Q

Pathology of Acute Pancreatitis

A

Autodigestion of the pancreas= Inflammation & Haemorrhaging

37
Q

Pathology of chronic Pancreatitis

A

Chronic Pancreatitis
Most common type of pancreatic insufficiency lack digestive enzymes = malabsorption, steatorrhea, DM, Vit deficiency E, A, D

38
Q

Common caused of acute Pancreatitis

A

Gallstones, Ethanol, Trauma, Steroids, Mumps, Autoimmune disease, Scorpion sting, Hypercalcemia, Hypertriglyceridemia, ERCP and Drugs.

Inflammation causes enzymes released Proteases, lipase and amylase

39
Q
A
40
Q

Causes of Chronic Pancreatitis

A
41
Q

Sx of chronic pancreatitis

A
42
Q

Signs of acute pancreatitis

A

MRCP Master (47 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions