Gastroenterology 1 Flashcards

1
Q

Entecavir or Tenofovir in osteoporotic patients?

Entecavir side effect?

A
Use Entecavir (guanoside analogue inhibitor)
Tenofovir can cause fanconi syndrome - RTA II - low Ca

Lactic acidosis

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2
Q

What factors is protective against hepatotoxicity?

A

Acute alcohol ingestion

Hypophosphatemia

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3
Q

Most sensitive screening tool for hemachromatosis?

A

High Transferrin saturation levels

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4
Q

Most common mode of transmission for Hep B?

A

Vertical transmission

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5
Q

Commonest Hepatitis C genotype in Australia?

A

Genotype 1

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6
Q

Entecavir or Tenofovir in decompensated cirrhosis?

A

Entecavir

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7
Q

Extraintestinal manifestations independent of IBD activity

A
Ankylosing spondylitis
Uveitis
PSC
Pyoderma Gangrenosum
Kidney,gall stones
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8
Q

Extraintestinal manifestations dependent of IBD activity

A
ALONE - very dependent
Large joint arthritis
Oral ulcers
Nodosum erythema
Episcleritis
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9
Q

Ratio of transmission in clinical setting from known source
Hep B
Hep C
HIV

A

Hep B 1 : 3
Hep C 1 : 30
HIV 1 : 300

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10
Q

False negative results for Hep C examples?

A

Diabetes
Previous transplant
Contracted virus within 6 weeks ago

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11
Q

Acute rejection of liver transplant - what normally do you see?

A

Obstructive LFT picture

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12
Q

When to test for Hep C antibodies after childbirth?

A

> 1 year after childbirth - if not false positive

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13
Q

What high transferrin levels highly specific for hematochromatosis?

A

Men > 60%

Women > 50%

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14
Q

Difference of hemochromatosis and iron transfusional overload?

A

Hemachromatosis - iron deposited in parenchymal cells first = ferritin normal

Iron transfusional overload - iron deposited in reticuloendothelial cells = ferritin high

Ferritin ( iron storage)

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15
Q

AST > ALT ratio = > 1 - what cause?
AST > ALT ratio = > 2 - what cause?
AST > ALT ratio = > 4 - what cause?

A

> 1 = NAFLD/ non-alcoholic cirrhosis eg. Hep C
2 = Alcoholic liver disease/ HCC
4 = Wilson’s disease

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16
Q

ALT is found primarily where?

AST is found primarily where?

A

ALT = liver = hepatocellular injury

AST = enterocytes/ skeletal muscle

17
Q

Alcoholic liver disease has AST > ALT ratio of > 2 and what else?

A

Elevated gamma-glutamyl transpeptidase

18
Q

Contraindication to using Azathioprine?

A

Pancreatitis

Serum-like sickness

19
Q

Azathioprine long term side effect?

A

Non-melanoma skin cancer

Lymphoma

20
Q

Contraindication to using Infliximab?

A

Melanoma

TB!

21
Q

Vanishing bile duct syndrome - commonest drug that cause it?

A

Chlorpromazine

22
Q

Gilbert syndrome pathogenesis?

A

Lack of glucuranyltransferase ( conjugates bilirubin)

23
Q

Hyperglycemia causes what lung issue?

A

Pulmonary oedema - increase osmotic gradient

24
Q

Why malnourished patient gets infection?

A

Low T cells

Low IgA

25
Q

Islet B cells release what form of insulin

in ER what happens?

In Golgi what happens?

A

preproinsulin

ER = pre to proinsulin

Golgi = proinsulin to insulin + C-peptide

26
Q

How calcium activates insulin?

A

CREB - calcium responsive element binding protein

27
Q

Commonest antibodies in T1DM?

A

GAD antibodies in islet cells

28
Q

Diabetic type that has higher inheritance rate?

A

T2DM - monozygotic twins

29
Q

Fats good for DM?

A

Fats unsaturated - Mono, poly fats (FUMAP)

30
Q

Budesonide absorbed where?

A

Large intestine only

31
Q

Hep C with cirrhosis duration of treament?

A

12 weeks ( without cirrhosis = 8 weeks)