Gastroenterology Flashcards
Obesity + abnormal LFTs = ?
NAFLD
Coeliac disease is associated with which cancer?
T cell lymphoma
How does carcinoid syndrome affect the heart?
It can cause tricuspid insufficiency and pulmonary stenosis
What are the criteria for treating a pt with ascites with regards to SBP prophylaxis?
Pts with ascites (with protein conc ≤ 15) should be given PO ciprofloxacin
(norfloxacin if cipro C/I)
Low protein = low IG + complement (as they are also proteins) ∴ ↑susceptibility to infections
Memory tool:
How to remember treatment and prophylaxis of SBP (and coincidentally meningitis)
Treat = cefoTaxime Prevent = ciProfloxacin
What is the psoas sign?
RLQ pain with extension of R hip, or with flexion of R hip against resistance
Why are 5-ASAs useful for UC but not Crohn’s?
They are broken down by colonic bacteria, so work locally in the colon and don’t affect other parts of the GIT
Monitoring test for haemochromatosis?
Assume pt is treated with venesection
Ferritin and transferrin saturations
Most common organism in SBP?
E.coli
> E.coli lives in the gut
In ascites, gut becomes ‘leaky’
E.coli colonises peritoneal cavity
Cause of itch in cholestasis?
Increased bilirubin
Uraemic pruritus is associated with CHRONIC uraemia (i.e. CKD), not acute uraemia
What antibodies are typically seen in autoimmune hepatitis?
Anti-nuclear antibodies (ANA)
Anti-smooth muscle antibodies (anti-SMA)
Best investigation for acute liver failure?
Prothrombin time
Prothrombin has a shorter half-life than albumin, making it a better measure of acute failure
Second line for acute Crohn’s flare, which is not responding to IV hydrocortisone?
Infliximab, adalimumab
Anti-TNF⍺ agents
Life threatening C.diff tx
IV metronidazole + ORAL vancomycin
What is a ‘lead pipe colon’?
Complete loss of haustral markings in distal colon, making it look like a smooth pipe on XR/barium enema
What is pellagra and how does it present?
Vitamin B3 (niacin) deficiency
‘dermatitis, dementia, diarrhoea, eventual death’
Sudden, severe abdominal pain + abdominal distension + tender hepatomegaly = ?
Budd-Chiari / hepatic vein thrombosis
How do you differentiate between IDA and AoCD from bloods?
Both are microcytic anaemias.
TIBC is HIGH in IDA
TIBC is LOW in AoCD
In AoCD, ferritin is high, indicating the body is storing iron outside of the blood to keep it away from bacteria (in context of chronic infections) or blood loss (e.g. malignancies, CKD)
TIBC is low, indicating all iron is already bound to avoid being dispersed and lost.
