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RW FY1 > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

Screening for haemachromatosis

For general population?

For family members?

A

Screening for haemachromatosis

General population –> Transferrin saturation

Family members –> HFE genetic testing

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2
Q

C diff treatment

If Moderate?

If Life threatening?

A

C diff infection

  • Moderate –> PO Metronidazole
  • Severe –> PO Vancomycin + IV Metronidazole
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3
Q

What hormones do these cells produce

D cells

S cells

G cells

I cells

A

D cells –> Somatostatin

S cells –> Secretin

G cells –> Gastrin

I cells –> CCK

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4
Q

Small bowel overgrowth syndrome - causes? Ix?

A

Small bowel overgrowth syndrome

Causes: Systemic sclerosis, Diabetes, Congenital

Ix: Hydrogen breath test

(hydrogen and methane correlate with amount of bacteria)

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5
Q

H. pylori is associated with

A

Duodenal ulcers

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6
Q

Chronic NSAID use is associated with

A

Gastric ulcers

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7
Q

Gut anterial supply

A
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8
Q

Intermittent dysphagia

Regurgitation

Bird’s beaking

Diagnosis? Ix? Tx?

A

Achalasia

[1] OGD

[2] Barium swallow (diagnostic)

Tx: CCBs + Surgical dilatation

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9
Q

Regurgitation

Coughing up food

Halitosis

Diagnosis? Ix?

A

Pharyngeal pouch (Zenkers diverticulum)

Ix: Barium swallow or OGD

Tx: none required

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10
Q

Iron deficieny anaemia + Dysphagia

OGD: Oesophageal webs

Diagnosis?

A

Plummer-Vinson syndrome

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11
Q

Ix for peptic ulcer disease

A

< 55 years old and no red flags –> H. pylori Urea breath test

> 55 years old or red flags –> OGD + Biopsy

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12
Q

H pylori eradication thearpy

A

Clarithromycin AND Amoxicillin AND Omeprazole

Clarithromycin AND Metronidazole AND Omeprazole

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13
Q

Tx of hepatic encephalopathy

A

Oral Lactulose + Phosphate enema

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14
Q

Autoimmune hepatitis

Antibodies

A

Type 1 –> Anti-smooth muscle antibody + ANA

Type 2 –> Anti-liver-kidney microsome Ab (ALKM-1)

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15
Q

Ig levels in autoimmune hepatitis

A

Raised IgG

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16
Q

RAH

RUQ abdo pain

Ascites

Tender hepatomegaly

Diagnosis? ix?

A

Budd-Chiari syndrome (hepatic vein outflow obstruction)

  • Ix: USS Doppler Hepatic vein
  • Tx: Thrombolysis (< 72hr) or ANticoagulation (>72hr)
    • Angioplasty
17
Q

Ascitic tap

↑ polymorphonuclear leucocytes (PMN) >250 mm3

A

==> Spontaneous Bacterial Peritonitis (SBP)

18
Q

Signs of portal hypertension

A

SAVE

  • Splenomegaly
  • Ascites
  • Varices
    • Oesophageal varices (90%)
    • Caput medusa
    • Haemorrhoids
  • Encephalopathy
19
Q

Signs of liver decompensation

A

JACE

  • Jaundice
  • Hypoalbuminaemia
    • Oedema
    • Ascites
  • Coagulopathy → Bruising
  • Encephalopathy
20
Q

Haemochromatosis

Cause

Ix

A

Haemochromatosis

Autosomal recessive mutation in HFE (or multiple blood transfusions)

HIGH Transferrin saturation

Perl’s stain or Prussain Blue stain for Iron

Tx: Venesection +/- Desferrioxamine

21
Q

Hydatid liver cyst

Cause/Risk factors

Ix

Tx

A

Hydatid liver cyst

  • Echinococcus granulosus (Tapeworm) –> Sheep / Dogs on Farms
  • Ix: Western blot
  • Tx: Praziquantel
22
Q

Ix for portal hypertension

1st line

Gold standard

A

USS: [1st line investigation]

Hepatic venous pressure gradient (HVPG) measurement: [Gold standard]

23
Q

Wilson’s disease

Cause

Ix

Tx

A

Wilson’s disease

  • Autosomal recessive –> mutation in ATP7B gene
  • LOW Ceruloplasma
  • HIGH Free Copper, HIGH urinary copper
  • Tx
    • Zinc + Trientine
24
Q

Hepatitis B serology

A
25
Q

Antibodies in PBC

A

IgM Anti-mitochondrial antibodies (PBC)

26
Q

Tx for PBC

A

Ursodeoxycholic acid

27
Q

PSC

Associations

A

PSC + UC

pANCA

28
Q

HLA DQ2 and DQ8

A

Coeliac disease

29
Q

Ix for Coeliac disease

A

Coeliac disease

IgA anti-TTG

OGD + Duodenal biopsy

increase intraepithelial lymphocytes

Villous atrophy + Crypt hyperplasia

30
Q

Mesenteric adenitis

Cause

A

Mesenteric adenitis –> Yersinia enterocolitica

31
Q

Tx for C diff infection

A

C diff infection

(1) PO Metronidazole for 10-14 days
(2) PO Vancomycin for 10-14 days

If severe –> Oral Vancomycin + IV Metronidazole

32
Q

Definition of toxic megacolon

A

bowel diameter >6cm

Barium enenma: Lead piping (loss of haustra)

RW FY1 (15 decks)

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