Gastro - Pass med Flashcards

1
Q

Haemachromatosis

-genetic pattern

A
  • Autosomal recessive iron accumulation

- lethargy, arthralgia, bronze skin, DM,

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2
Q

Mesenteric ischaemia vs Ischaemic colitis

A

Both - abdo pain, diahrohea, rectal bleeding, fever, bloods - elevated white blood cell and lactic acidosis
Diagnosis - CT scan

M - embolism occulsion of artery supplying small bowel. Hx Afib.

  • Pain is severe, sudden onset, out of keeping with physical exam
  • Urgent surgery,

I - acute compromise of blood flow to large bowel, leads to inflammation, ulceration and haemorhage.

  • Thumbprintign may be seen on abdo xray due to oedema/haemorahge
  • supportive management, surgery if conservative mesarues fail
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3
Q

how long before gastroscopy do you stop proton pump inhibitor?

A

2 weeks (as can mask serious pathology)

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4
Q

Urgent endoscopy - suspicion of gastric cancer

Non-urgent

A
  • all patients with dysphagia or upper abdo mass consistent w stomach cancer
  • > 55 w weight loss and one of (upper abdo pain, reflux, dyspepsia)

Non-urgent - patients with haematemeiss
-patient ?55 - treatement resistant dyspesis, upper abdo pain low hb levels, raised platelet count w other gastro signs. .

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5
Q

What anti-emtic should you avoid in bowel obstruction?

A

metoclopramide

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6
Q

Pernicious anaemia

A

  • SOB, fatigue, lethargy
  • lemon tinge skin
  • vibration sensation loss - due tot he low B12 levels (loss of reflex or weakness)
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7
Q

gilberts syndrome

A

autosomal recessive of defective bilirubin conjugation due to UDP glucuronly transferase -

  • hyperbillirubinaemia
  • jaundice
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8
Q

Spontaneous bacterial peritonitis - what do you give long term treatment

A

-If patinets have had SBP with fluid protein less than 15 ,then get antibiotic prolyaxis of ciprofloxacin

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9
Q

Carcionoid syndrome

A

carcinoid tumours - occur when metastases are present in the liver and release serotonin into systemic circulation.

  • diarrhoea, palpitations, flushing , bronchospasm, hypotension
  • nueroendocrine tumour
  • serotonin secretions causes this
  • only occurs once tumour has metastasised to liver as this is where seritonin undergoes first pass metabolims.

inv - urinary 5-Hiaa
-plasma chromogranin

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10
Q

H.pylori - eradication therapy

A

-urea breath test

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11
Q

Malnutrtion score

A

MUST
0BMI <18.5
Unintentional weight loss great than 10% in last 3-6 monhts
BMI - <20 and unintentioanl weight loss great hern 5% within 3-6monhts

-MUST - can reduec risk of pressure sores

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12
Q

What anti-emetic medication is too be avoided ein parkinsons

A

-metoclopramide

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13
Q

When to give antibiotics for SBP in ascities?

A

patients who have had an episode of SBP
patients with fluid protein <15 g/l and either Child-Pugh score of at least 9 or hepatorenal syndrome
NICE recommend: ‘Offer prophylactic oral ciprofloxacin or norfloxacin for people with cirrhosis and ascites with an ascitic protein of 15 g/litre or less until the ascites has resolved’

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14
Q

Marker for hepatocellular carcinoma

A

Alpha feropotein (afp)

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15
Q

type 1 vs type 2 hepatorenal failure

A

type 1 - within 2 weeks

type 2- gradual decline

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16
Q

Crones

A

Inducing remission - glucocorticoids (5asa secondary)
azathioprine, mercaptopurine can be used as add ons

Maintenance -
azathioprine or mercaptopurine is used first-line to maintain remission
methotrexate is used second-line
5-ASA drugs (e.g. mesalazine) should be considered if a patient has had previous surgery

17
Q

Giardia

A

floating stool due to fat malabsortpon

18
Q

wilsons disease

A

-has low serum copper because it is deposited in the tissues
and also reduced caeruloplasmin

19
Q

autoimmune hepatitis

A

Anti-nuclear antibodies (ANA) and/or anti-smooth muscle antibodies (SMA)