gastro SBAs Flashcards
Levels of plasma bilirubin when jaundice is clinically visible
> 35umol/L
Most appropriate screening investigation in AAA
Abdominal USS
Least invasive and safest screening
Predisposing factors for HCC
Hep B
Hep C
Aflatoxin
Liver cirrhosis
Treatment for C diff
Oral/IV metronidazole
±vancomycin if pseudomembranous colitis and severe
Barrett’s oesophagus definition
55-65years, M>F 2:1
metaplastic replacement of lower oesophageal normal squamous epithelium by columnar epithelium.
GORD -> Barrett’s -> premalignant condition to oesophageal adenocarcinoma
Coeliac disease definition and histology
Chronic intestinal malabsorption and inflammation due to small intestine mucosal damage and intolerance to gluten.
Histology: villous atrophy, flat smooth mucosa, crypt hyperplasia of dyodenum, cuboidal epithelium
Barrett’s oesophagus Rx
Diet
PPIs, H2 receptor antagonist
Surveillance endoscopy + biopsy
(Ablation and surgical resection)
Dermatitis herpetiformis (intense itchy elbow, knees, buttocks blisters) are present in …
Coeliac disease
other PC: malnutrition, abdo discomfort, pain, wt loss, steatorrhoea, diarrohea, anaemia i.e. pallor
IgG anti-gliadin (AGA) is associated with…
Coeliac disease
Diagnostic
Tissue transglutaminase autoantibody is asscoiated with…
Coeliac disease
Diagnostic test for hiatus hernia
Upper GI barium meal/swallow
CXRs can be normal, but some show air fluid level above L hemi-diaphragm
Duodenal ulcers secondary to H pylori infection (90%) diagnostic test
CLO breath test (rapid urease test) to confirm presence of bacteria
IgG serology
Stool antigen test
Treatment for duodenal ulcers due to H.pylori
7 day course of triple therapy: PPI and 2 Abx e.g. 20mg omeprazole, 1g amoxicillin, 500mg clarithromycin
Causes of portal HTN
Pre-hepatic (portal vein thrombosis, splenic vein thrombosis)
Hepatic (cirrhosis 80%, schistosomiasis, sarcoid, congenital fibrosis)
Post-hepatic (Budd-Chiari syndrome, RHF, constrictive pericarditis)
Drugs that induce liver cirrhosis
Methotrexate
Amiodarone
Methyldopa
Appropriate investigations for patient with IDA and red flag symptoms (wt loss)
upper and lower GI endoscopy
Gastroenteritis is usually limiting and will not require pharmacological therapy. Mainstay of treatment involves…
Increase oral fluid intake
Anti-emetics
(only when very severe give IV fluids and cultured bacteria give Abx)
Budd-Chiari syndrome results from hepatic vein outflow obstruction. Triad of symptoms includes…
Acute abdo pain
Hepatomegaly
Ascites
Liver cirrhosis histology
Loss of normal hepatic architecture
Bridging fibrosis
Nodular regneration
(biopsy confirms the diagnosis)
Causes of liver cirrhosis
Alcoholism NASH Chronic HepB/C Autoimmune Budd-Chiari syndrome
Ascites Rx
Low salt diet
Fluid restriction
Osmotic diuretic e.g. mannitol
Primary sclerosing cholangitis can cause
cholangiocarcinoma
Crohn’s disease histology and barium-swallow
Transmural, non-caseating granulomatous inflammation
Fissuring ulcers
Neutrophil infiltrates
Cobblestoning and rose-thorn ulcers
Ulcerative colitis histology
Inflammatory infiltrates
Mucosal ulcers
Goblet cell depletion
Crypt abscesses