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Final Year - Passmed > Gastro Passmed > Flashcards

Gastro Passmed Flashcards

1
Q

Red Flags for gastric cancer?

what age?

A

> 55

new onset dyspepsia
vomiting
weight loss
dysphagia
odynophagia
epi pain

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2
Q

RF for gastric cancer?

A

H Pylori
pernicious anaemia
ethnicity
smoking
blood group A

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3
Q

what is Virchows node?

A

left supraclavicular lymph node - in gastric cnacer

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4
Q

maintaining remission in UC

if severe
or > ?? in one year?

A

if more than 2 exarcebations

oral azathiopurine
mercaptopurine

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5
Q

Severe colitis mx?

A

IV steroids
>72 hours add IV ciclosporin to IV steroids and consider surgery

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6
Q

Mild UC?

A

< 4 stools a day small amount of blood

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7
Q

severe UC

A

> 6 bloody stools
systemic upset
raised Inflammatory markers

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8
Q

eradication of H pylori post therapy test?

A

Urea breath test

detects urease activity

4 weeks after

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9
Q

which cancer is associated with gord / barrets?

A

adenocarcinoma

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10
Q

Upper GI bleed after endoscopy which system?

A

Rockall

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11
Q

hepatorenal syndrome
Mx

A

terlipressin - vasopressin analogue

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12
Q

Splanchnic circulation
which artery supplies the stomach
spleen and pancreas?

A

coeliac artery

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13
Q

what does the SMA supply?

A

pancreas
small intestine
LI > transverse colon

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14
Q

IMA?

A

descending colon

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15
Q

Splanchnic ciruclation

A

aorta
1. Coeliac
2. SMA
3. IMA

portal vein

> liver sinusoids
filteration etc

> hepatic vein
Inferior vena cava

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16
Q

SMA delivers what % of cardiac output?

A

10% of splanchnic

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17
Q

Terlipressin in HRS

A

vasopressin analogue
splanchnic vasoconstricrtion
= reduces portal pressure

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18
Q

what imaging for a PBC?

A

USS
Magnetic resonance cholangiopancreatography
MRCP

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19
Q

Faecal calprotectin?

A

released by bowel in inflammation

detected in stool sample

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20
Q

when is a stool culture recommended?

A

systemic upset

blood/pus in stool

immunocompromised
Abx, PPI / hospitalised

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21
Q

C diff severity what marker?

A

WCC

‘watery diarrhoea’
‘pain’
‘fever’

22
Q

severe c diff?

A

> 15 x10^9 /L

acutely high creatinine

38.5>

23
Q

Mx of C diff?

A

oral vancomycin
oral fidaxomicin

3rd : oral vanc and IV metronidazole

24
Q

life threatening c diff mx?

A

oral vancomycin and IV metronidazole

25
Q

bile acid malabsorption

A

bile acid sequestration

cholestyramine

26
Q

Loperamide

A

mx for diarrhoea

27
Q

HCC marker

A

alpha fetoprotein

28
Q

Hydrogen breath test?

A

small bowel overgrowth syndrome

excess bacteria in the small bowel

29
Q

post procedure mx - oesophageal rebleed prophylaxis

A

non cardioselective beta blocker
propranalol

30
Q

Metoclopramide is a?

A

D2 rceptor antagonist

used in nausea

avoid in bowel obstruction

pro kinetic anti emitc

31
Q

globus hystericus

A

anxiety related
painless
intermittent

32
Q

plummer vinson

A

oesophageal web
association with iron deficiency anaemia

33
Q

when is MRCP indicated

A

to look at gallbladder and pancreas

before ERCP as not invasive

visualise pancreatitise

34
Q

carcinoid tumours secrete?

A

serotonin
> 5-hydroxyindoleacetic acid

excreted in urine

palpitaion
facial flush

35
Q

phaeochromocytoma

what in diagnosis?

A

urinary catecholamines

36
Q

mx of carcinoid tumours?

A

octreotide

somatostatin analogue

37
Q

Pernicious anaemia presents with?

What blood test is most useful in confirming diagnosis?

A

megaloblastic anaemia with associated glossitis

IF antibodies > gastric parietal cell antibodies

38
Q

what is pernicious anaemia?

A

affects gastric mucosa
= vit b12 deficiency

IF antibodies bind to it, stopping vit b12 binding

SCD SC
weakness
ataxia
parasthesia = spastic and paraplegic

39
Q

metabolic consequences of refeeding?

A

hypophosphataemia
hypokalemia
hypomagnesemia

40
Q

torsades de pointes

causes in refeeding

A

hypokalaemia
hypomagnesiamia

41
Q

remission of a first presentation of Crohn’s disease

A

prednisolone
methylprednisolone
IV hydrocortisone

42
Q

seton placement?

A

draining seton
complex perianal fistulae

crohn’s

> thread that is run through the fistula
to allow continuous drainage

43
Q

boerhaave syndrome?

A

transmural oesophageal perforation
2 to vomiting

triad
1. vomiting
2. severe retrosternal pain
3.subcut emphysema

44
Q

Mallory-Weiss tear

A

non transmural tear
less severe as superficial tear

45
Q

what is maize?

A

corn - gluten free

46
Q

diagnostic Investigation of choice for pancreatic cancer?

A

HRCT

47
Q

palpable painless gallbladder?

A

courvoisier’s sign for pancreatic cancer

48
Q

Whipple’s resection

A

pancreaticoduodenectomy

> resectable
head of pancreas

49
Q

peutz jeghers syndrome?

A

pigmented freckles

polyps in GI tract

50
Q

Helicobacter pylori infection strongest association?

A

duodenal ulceration

gastric adenocarcinoma
atrophic gastritis

51
Q

Prolonged vomiting may cause metabolic alkalosis

why?

A

loss of H+ ions from vomit

52
Q
A

Final Year - Passmed (43 decks)

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