Gastro Passmed Flashcards by Lisa Azizi

Red Flags for gastric cancer?

what age?

> 55

new onset dyspepsia
vomiting
weight loss
dysphagia
odynophagia
epi pain

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RF for gastric cancer?

H Pylori
pernicious anaemia
ethnicity
smoking
blood group A

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what is Virchows node?

left supraclavicular lymph node - in gastric cnacer

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maintaining remission in UC

if severe
or > ?? in one year?

if more than 2 exarcebations

oral azathiopurine
mercaptopurine

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Severe colitis mx?

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

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Mild UC?

< 4 stools a day small amount of blood

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severe UC

> 6 bloody stools
systemic upset
raised Inflammatory markers

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eradication of H pylori post therapy test?

Urea breath test

detects urease activity

4 weeks after

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which cancer is associated with gord / barrets?

adenocarcinoma

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Upper GI bleed after endoscopy which system?

Rockall

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hepatorenal syndrome
Mx

terlipressin - vasopressin analogue

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Splanchnic circulation
which artery supplies the stomach
spleen and pancreas?

coeliac artery

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what does the SMA supply?

pancreas
small intestine
LI > transverse colon

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IMA?

descending colon

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Splanchnic ciruclation

aorta
1. Coeliac
2. SMA
3. IMA

portal vein

> liver sinusoids
filteration etc

> hepatic vein
Inferior vena cava

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SMA delivers what % of cardiac output?

10% of splanchnic

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Terlipressin in HRS

vasopressin analogue
splanchnic vasoconstricrtion
= reduces portal pressure

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what imaging for a PBC?

USS
Magnetic resonance cholangiopancreatography
MRCP

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Faecal calprotectin?

released by bowel in inflammation

detected in stool sample

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when is a stool culture recommended?

systemic upset

blood/pus in stool

immunocompromised
Abx, PPI / hospitalised

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C diff severity what marker?

WCC

‘watery diarrhoea’
‘pain’
‘fever’

severe c diff?

> 15 x10^9 /L

acutely high creatinine

38.5>

Mx of C diff?

oral vancomycin
oral fidaxomicin

3rd : oral vanc and IV metronidazole

life threatening c diff mx?

oral vancomycin and IV metronidazole

bile acid malabsorption

bile acid sequestration cholestyramine

Loperamide

mx for diarrhoea

HCC marker

alpha fetoprotein

Hydrogen breath test?

small bowel overgrowth syndrome excess bacteria in the small bowel

post procedure mx - oesophageal rebleed prophylaxis

non cardioselective beta blocker propranalol

Metoclopramide is a?

D2 rceptor antagonist used in nausea avoid in bowel obstruction pro kinetic anti emitc

globus hystericus

anxiety related painless intermittent

plummer vinson

oesophageal web association with iron deficiency anaemia

when is MRCP indicated

to look at gallbladder and pancreas before ERCP as not invasive visualise pancreatitise

carcinoid tumours secrete?

serotonin > 5-hydroxyindoleacetic acid excreted in urine palpitaion facial flush

phaeochromocytoma what in diagnosis?

urinary catecholamines

mx of carcinoid tumours?

octreotide somatostatin analogue

Pernicious anaemia presents with? What blood test is most useful in confirming diagnosis?

megaloblastic anaemia with associated glossitis IF antibodies > gastric parietal cell antibodies

what is pernicious anaemia?

affects gastric mucosa = vit b12 deficiency IF antibodies bind to it, stopping vit b12 binding SCD SC weakness ataxia parasthesia = spastic and paraplegic

metabolic consequences of refeeding?

hypophosphataemia hypokalemia hypomagnesemia

torsades de pointes causes in refeeding

hypokalaemia hypomagnesiamia

remission of a first presentation of Crohn's disease

prednisolone methylprednisolone IV hydrocortisone

seton placement?

draining seton complex perianal fistulae crohn's > thread that is run through the fistula to allow continuous drainage

boerhaave syndrome?

transmural oesophageal perforation 2 to vomiting triad 1. vomiting 2. severe retrosternal pain 3.subcut emphysema

Mallory-Weiss tear

non transmural tear less severe as superficial tear

what is maize?

corn - gluten free

diagnostic Investigation of choice for pancreatic cancer?

HRCT

palpable painless gallbladder?

courvoisier's sign for pancreatic cancer

Whipple's resection

pancreaticoduodenectomy > resectable > head of pancreas

peutz jeghers syndrome?

pigmented freckles polyps in GI tract

Helicobacter pylori infection strongest association?

duodenal ulceration gastric adenocarcinoma atrophic gastritis

Prolonged vomiting may cause metabolic alkalosis why?

loss of H+ ions from vomit