Gastroenterology 1 Flashcards
Entecavir or Tenofovir in osteoporotic patients?
Entecavir side effect?
Use Entecavir (guanoside analogue inhibitor) Tenofovir can cause fanconi syndrome - RTA II - low Ca
Lactic acidosis
What factors is protective against hepatotoxicity?
Acute alcohol ingestion
Hypophosphatemia
Most sensitive screening tool for hemachromatosis?
High Transferrin saturation levels
Most common mode of transmission for Hep B?
Vertical transmission
Commonest Hepatitis C genotype in Australia?
Genotype 1
Entecavir or Tenofovir in decompensated cirrhosis?
Entecavir
Extraintestinal manifestations independent of IBD activity
Ankylosing spondylitis Uveitis PSC Pyoderma Gangrenosum Kidney,gall stones
Extraintestinal manifestations dependent of IBD activity
ALONE - very dependent Large joint arthritis Oral ulcers Nodosum erythema Episcleritis
Ratio of transmission in clinical setting from known source
Hep B
Hep C
HIV
Hep B 1 : 3
Hep C 1 : 30
HIV 1 : 300
False negative results for Hep C examples?
Diabetes
Previous transplant
Contracted virus within 6 weeks ago
Acute rejection of liver transplant - what normally do you see?
Obstructive LFT picture
When to test for Hep C antibodies after childbirth?
> 1 year after childbirth - if not false positive
What high transferrin levels highly specific for hematochromatosis?
Men > 60%
Women > 50%
Difference of hemochromatosis and iron transfusional overload?
Hemachromatosis - iron deposited in parenchymal cells first = ferritin normal
Iron transfusional overload - iron deposited in reticuloendothelial cells = ferritin high
Ferritin ( iron storage)
AST > ALT ratio = > 1 - what cause?
AST > ALT ratio = > 2 - what cause?
AST > ALT ratio = > 4 - what cause?
> 1 = NAFLD/ non-alcoholic cirrhosis eg. Hep C
2 = Alcoholic liver disease/ HCC
4 = Wilson’s disease
ALT is found primarily where?
AST is found primarily where?
ALT = liver = hepatocellular injury
AST = enterocytes/ skeletal muscle
Alcoholic liver disease has AST > ALT ratio of > 2 and what else?
Elevated gamma-glutamyl transpeptidase
Contraindication to using Azathioprine?
Pancreatitis
Serum-like sickness
Azathioprine long term side effect?
Non-melanoma skin cancer
Lymphoma
Contraindication to using Infliximab?
Melanoma
TB!
Vanishing bile duct syndrome - commonest drug that cause it?
Chlorpromazine
Gilbert syndrome pathogenesis?
Lack of glucuranyltransferase ( conjugates bilirubin)
Hyperglycemia causes what lung issue?
Pulmonary oedema - increase osmotic gradient
Why malnourished patient gets infection?
Low T cells
Low IgA
Islet B cells release what form of insulin
in ER what happens?
In Golgi what happens?
preproinsulin
ER = pre to proinsulin
Golgi = proinsulin to insulin + C-peptide
How calcium activates insulin?
CREB - calcium responsive element binding protein
Commonest antibodies in T1DM?
GAD antibodies in islet cells
Diabetic type that has higher inheritance rate?
T2DM - monozygotic twins
Fats good for DM?
Fats unsaturated - Mono, poly fats (FUMAP)
Budesonide absorbed where?
Large intestine only
Hep C with cirrhosis duration of treament?
12 weeks ( without cirrhosis = 8 weeks)
