Gastroenterology Flashcards
Primary biliary sclerosis Test
Anti mitochondrial antibody
Treatment of PBC
Ursodeoxycholic Acid
PSC test
pANCA
Association with UC - PBC or PSC
PSC
Risk of cholangiocarcinoma
PSC
Onion skin lesions
PSC
Association with immune conditions such as Thyroid
PBC
t2d with abnormal LFTs
Non alcoholic fatty liver disease
Small bowel overgrowth syndrome diagnosis
Hydrogen breath test
SAAG >11
Portal hypertension
SAAG <11
Malignancy, infection, pancreatitis, nephrotic syndrome
Variceal hemorrhage management
Terlipressin
Prophylactic Antibiotics in cirrhosis
Quinolones are used
Endoscopic treatment of Variceal hemorrhage
Band ligation > Sclerotherapy
Uncontrolled hemorrhage
Sengstaken-Blakemore tube
Prophylaxis of variceal hemorrhage
Propranolol
Modified Glasgow scale - Pancreatitis
PO2, age, WBC >, hypocalcemia, urea, LDH, Albumin and sugar(BG)
De Musset’s sign
Aortic Regurgitation
Quinke’s Sign
Nailbed pulsation- AR
Most sensitive and specific lab findings indicating cirrhosis in CLD
Thrombocytopenia
H Pylori eradication
Omeprazole, amoxicillin and Clarithromycin
PSC diagnostic test- Gold standard
ERCP/MRCP- beaded appearance
Treatment of C. Difficile
Oral metronidazole 1st line
Severe? Oral metronidazole + IV vancomycin
IBD management Ladder
- Mesalazine
- Oral azathioprine or mercaptopurin - maintain remission
- Calcinuerin inhibitors- Induce remission if steroids are insufficient
- INFLIXIMAB to induce remission
Diagnosis of Toxic megacolon
Abdominal XR
Diagnostic intervention for Acute pancreatitis
Clinical Diagnosis first if clear picture
Rule out Gallstones using USS
Bile duct stones not on USS - MRCP
Lead pipe appearance on AXR
UC
Flare management in UC
IV corticosteroid- Hydrocortisone or methylprednisolone
Double duct sign on CT
Pancreatic cancer
Pigmented gall stones
Sickle cell anemia
Mesalazine can commonly cause what complication
Acute pancreatitis
A very high ALT in a patient with mental health problems
Paracetamol overdose
Gold standard coeliac disease
Duodenal biopsy
Abdominal pain, diarrhoea, and flushing; Bronchospasm, and hepatic Metastasis
Carcinoid tumour
Management of severe alcoholic liver disease
Corticosteroids
Retro Hepaticus
Sweet and fecal breath - Liver failure
Dysphagia, Aspiration pneumonia, halitosis and elderly
Pharyngeal pouch
Diagnosis - barium swallow
A low bicarbonate ion in bloody diarrhoea is an indicative of
Mesenteric ischemia
Triad of dysphagia, Glossitis, iron-deficiency anemia
Plummer-Vinson Syndrome
Woman, Fever, malaise and jaundice, Moderate hepatomegaly.
Anti-smooth muscle antibody positive and anti-nuclear antibody positive
Autoimmune hepatitis
Management of cord prolapse
elevate presenting part manually or filling the urinary bladder.
AST>ALT
Alcohol related disease
First line management for IBS diarrhoea
Loperamide
Only bilirubin raised on blood test; worse on dehydration
Gilbert syndrome
Bilirubin very very high and not Gilbert syndrome
crigler-Najjar Syndrome
Transfuse in a normal patient
<70 Hb
Coagulation impaired
Fresh frozen plasma
ex-smoker, weight loss, dysphagia over time
Esophageal cancer
Surgical management of Ulcerative colitis
Pan-protocolectomy
Surgical management of UC in acute patient; failed medical treatment
Sub-total colectomy
IVDU patient and Acute liver disease
hepatitis C
Obesity and diabetic - Liver disease
non-alcoholic steatohepatitis
Primary sclerosing cholangitis
related to UC; antibody- pANCA; ursodeoxycolic acid is treatment
PBC
Antimitochondrial antibody (AMA) and IgM
IgM high, HIgh ALT and travel to endemic regions
Hepatitis A
Iron deficiency + Glossitis + angular stomatitis + Esophageal webs
Plummer vinson syndrome
progressive dysphagia + GERD + No weight loss
Benign peptic stricture
Metaplasia of distal esophagus
Barrets (Squamous to columnar epithelium)
Acute severe colitis, megacolon >6cm and
Toxic megacolon
Antibiotic treatment before diarrhea; Raised WBC, raised CRP
C. Difficile
symptoms worse after use of steroids
gastroenteritis; Dysentery
gold standard for CD
endoscopy and duodenal biopsy
Endoscopic surveillance with biopsy in what condition
Barrett’s Esophagus
Confirmation of H. Pylori eradication
Stool antigen test
pain relived by meals
Duodenal ulcer
Pain worsened by meals
Gastric ulcer
Maintain remission in UC
Mild to moderate - Aminosalicylate
Severe: Azathioprine or 6MTP
Commonest cause of HCC in UK
Hepatitis C
Acanthus is Nigricans is associated with what cancer
Gastric cancer
Diabetic, severe pain in anus, spiking temperature
Perianal abscess
Barretts with metaplasia
Endoscopic surveillance
If dysplasia on Barretts
Endoscopic mucosal resection and Radiofrequency ablation
Achalasia increases the risk of what cancer
Squamous cell carcinoma
Barrett’s esophagus
Adenocarcinoma
Carcinoid diagnosis
Urinary 5-HIAA
Deranged LFTs + Secondary amenorrhea in a young woman
Autoimmune hepatitis
Treatment of Wilson’s disease
Penicillamine
After USS what should be next investigation in PSC
MRCP
What artery runs posterior to the 1st and 2nd part of duodenum and cause peptic ulcer bleeding
Gastroduodenal artery
Pancreatic pseudo cyst management
1st line - conservative
2nd line: Aspiration or Endoscopic Cystogastrostomy
Grey-Turners sign
Pancreatic hemorrhage
Sudden onset abdominal pain + Ascites + Tender hepatomegaly + deranged Hepatic enzymes and ALP
Budd-chairi syndrome
Wilson’s disease - Serum ceruloplasmin, total serum copper and 24 hour urine copper
Serum Ceruloplasmin and copper is decreased
24 hour urine copper is increased
Mackler triad: Vomiting + thoracic pain + S/C emphysema
Boerhaave syndrome
Antibiotics linked to Clostridium difficile or pseudomembranous colitis
Cefaclor or cephalosporins (Clindamycin)
SBO + air in biliary tree
Gallstone lieus
Vomiting + chest pain after eating a large meal + systematic upset
Boerhaave syndrome
Dude is just feeling ill bro
Duodenum - iron
Jejunum - Folate
Ileum - B12
Bloody diarrhoea and eye symptoms
Ulcerative Colitis
What will differentiate Celiac and Crohn’s Disease
High ESR