Gastroenterology Flashcards
3 features of budd chiari
Sudden abdominal pain
Ascites
Tender hepatomegaly
Polycythaemia
2 facts about GORD
Fundoplication
Manometry
3 features of primary biliary cholangitis
IgM
antiMitochondrial antibodies (type M)
Middle aged female
How to calculate alcohol units
MIS x % / 1000
Antibodies in chronic hepatitis B
Positive anti HBC IgG
Negative anti HBC IgM
Drug if varices bleed
Vasopressin analogue e.g. terlipressin
What do you measure in acute liver failure
Prothrombin time
Bacteria in c.diff
Pseudomembranous colitis
Drug if bile acid malabsorption
Cholestyramine to lower cholesterol
What does mesalazine increase the risk of
Pancreatitis
What vaccination do coeliacs recieve and why
Pneumococcal due to hyposplenism
What blood change does alcohol cause
Increased ferritin
What drug do you give in severe alcoholic hepatitis
Prednisolone
What drug do you give if there are oesophageal varices
Propanolol
Features of Wilsons Disease
Liver and neuro sx
Reduced caeruloplasmin
Reduced copper
Penicillamine
Most common site for an upper GI bleed
Ligament of Treitz
Polyps in UC
Pseudopolyps
Feature of the pain in IBS
They will not wake at night
Do you get skin tags in crohns
No
Most common bowel cancer
HNPCC
Side effect of a LT PPI
Reduced Mg
Risk of smoking in crohns
Relapse
Risk of using high doses of laxatives
Melanosis coli
Reduced pigmented polyps
Management of NAFLD
Reduce weight
2 features of B12 deficiency and cause
Red beefy tongue
Macrocytic anaemia
Intrinsic factor antibody
Treatment of alcoholic acidosis
Thiamine and saline
Treatment of mild and severe C.diff
Mild: 1st PO Vanomycin 2nd PO fidaxomicin
Severe: Oral vanomycin + IV metronidazole
Omeprazole and c diff has some link
How many weeks before an endoscopy should you stop a PPI
2 weeks before
UC on imaging
Loss of haustra
What does a carcinoid tumour secrete
ACTH
Causing flushing, diarrhoea and constipation
Imaging for a perianal fistula
MRI
Cancer associated with coeliac
Enteropathic associated T cell lymphoma
Painless obstructive jaundice and palpable gallbladder =
PANCREATIC CANCER
or duct dilation
Diagnostic for pancreatic cancer
High resolution CT
Cells in crohn’s
Goblet cells
First line for mild-moderate UC flare
Rectal aminosalicyclates
e.g. mesalazine
Severe flare of UC
IV steroids in hospital
characteristic iron study profile in haemochromatosis
Raised transferrin saturation and ferritin, with low TIBC
What cancer is primary sclerosing cholangitis associated with
Cholangiocarcinoma
Medication before endoscopy
Prophylactic ABx
Dysplasia on biopsy in Barrett’s oesophagus
Endoscopic mucosal therapy
2 characteristics of wilsons disease
liver and neurological disease
Crohns in children
Abdo pain
Key investigation for aminosalicyclates and fever
FBC - agranulocytosis
HNPCC - other cancers
Endometrial
Pancreatic
H.pylori post-eradication test
Urea breath test
Recurrent C.diff within 12 weeks of Sx
Oral fidaxomicin
Dietary vitamin which lack of causes easy bleeding
Vitamin C
Which way round is B12 and folate
B12 THEN folate
replace B12 IM
Carcinoid syndrome - heart problem
Tricuspid insufficiency and pulmonary stenosis
Medication whilst waiting endoscopy for varices
terlipressin
Gastric adenocardinoma cells
Signet ring
Waterlow score
Pressure sore
MUST score
Malnutrition
Medication to manage severe alcoholic hepatitis
Corticosteroids
patient with ulcerative colitis has had a severe relapse or >=2 exacerbations in the past year
oral azathioprine or oral mercaptopurine to maintain remission
What histology of cancer does barretts oesophagus predispose
Adenocarcinoma
occasional retrosternal chest pain and dysphagia that occurs to both liquids and solids
Achalasia
Side effect of isoniazid
B6 deficiency –> peripheral neuropathy
Which liver tests monitors the function of the organ
Prothrombin time
Investigation for budd-chiari
Ultrasound with doppler
Cruypt absesses
UC
Haemachromatosis
Fatigue, ED, arthralgia
FHx
fever and IBD
Severe flare
Vaccination every 5 years in coeliac
Pneumococcal - hypospenism
Painless jaundice
Pancreatic cancer (doesn’t need palpable abdomen)
PPI electrolyte disturbance
Hyponatremia
Treatment for wilsons
Penicillamine
What do you test in the stool for c diff
Toxin
antigen shows exposure to bacteria not current infection
Suspected perforated ulcer initial investigation
CXR
Which IBD is associated with gallstones
Crohns
Peutz-Jeghers syndrome
Pigmented lesions around mouth and feet
Hamartomas
Septic shock, RUQ tenderness, no jaundice, no gallstones
Acalculous cholecystitis45%
Known gallstones, high fever and jaundice, soft abdomen with mild RUQ tenderness
Cholangitis
Colicky RUQ pain radiating to back and fever with no jaundice and localised peritonism in RUQ
Acute cholecystitis
Secondary prophylaxis of hepatic encephalopathy
Lactulose and rifaximin
Refeeding syndrome
Abnormal fluid balance anda rrhythmias
Mesenteric ischaemia
Metabolic acidosis, severe abdo pain, high lactate
Watery grey and frothy stools
Coeliac
TIPS procedure side effect
Inadequate metabolism of nitrogenous waste
Prophylaxis of variceal bleed
Propanolol
Gold standard for dysphagia
Endoscopy
Isolated rise in bilirubin in response to physiological stress
Gilbert’s syndrome
no investigations
Severe iron deficiency
Smooth glossy tongue with pallor and cheilitis and DYSPHAGIA
Acute flare of crohns after 5 days of IV hydrocortisone
Infliximab
First line antibody for coeliac
Anti TTG
C.diff common causative Abx
Cephalosporins e.g. cefacelor, clindamycin
Antibodies in previous Hep B infection
HBsAg negative, anti-HBs positive, IgG anti-HBc positive
Abdominal pain with blood and leucocytes on dipstick
CT abdo for stones
Omeprazole before endoscopy
Stop 2 weeks before
Dyspepsia with no red flags
PPI at full dose for 1 month
Investigation for perianal fistulae and crohns
MRI
Medication to avoid in bowel obstruction
Metaclopramide
Sengstaken-Blakemore tube may be used to stop an uncontrolled variceal haemorrhage
Triad of intestinal angina
triad of severe, colicky post-prandial abdominal pain, weight loss, and an abdominal bruit