Gastroenterology Flashcards
variceal bleed prophylaxis
propranolol
endoscopic variceal band ligation
variceal bleed Mx
ABC
correct clotting: FFP, vit K
Terlipressin
Prophylactic IV Abx
Endoscopic variceal band ligation
TIPPS if above fail
C Diff Mx
1st - PO Vanc or Fidaxomicin
2nd - PO Vanc + IV Metronidazole
Primary biliary cholangitis Features
IgM
anti-Mitochondrial Abs
Middle aged female
alcoholic hepatits Mx
Prednisolone
coeliac disease Ix
gold standard - jejunal biopsy
positive anti-TTG Abs, anti-endomysial abs
irritable bowel syndrome features (3)
Abdominal pain
Bloating
Change bowel habits
Liver failure clotting profile
all clotting factors are low apart from Factor VIII
haemophillia A clotting profile
low factor VIII
haemophillia B clotting profile
low factor IX
Von willebrand disease clotting profile
low VWF
H Pylori Ix
Carbon 13 urea breath test
Mesalazine (aminosalicylates) SE
agranulocytosis (check FBC) - sore throat, fever
hepatocellular Ca screening in which patients?
liver cirrhosis + Hep B/ C/ Haemochromatosis
MEN with alcoholic liver cirrhosis
ulcerative colitis mild/moderate
Features
Management
Features - <4-6 loose stool (variable blood)
Mx - 1st - rectal aminosalicylate (+oral aminosalicylate if extensive)
2nd - oral steroids if above not successful
ulcerative colitis severe
features
management
Features - >6 bloody stools + systemic upset
Mx - IV steroid (IV ciclosporin if steroid contraindicated)
pancreatic Ca Ix
high res CT
spontaneous bacterial peritonitis prophylaxis
if protein <15 - oral ciprofloxacin
if protein >15 - nil Abx required
isoniazid SE
Vit B6 def (peripheral neuropathy)
primary biliary cholangitis antibodies
Anti mitochondrial antibody
primary biliary cholangitis management
ursodeoxycholic acid
cholestyramine for pruritis
crohns maintenance management
azathioprine/ mercaptopurine
TPMT (thiopurine methyltransferase) needs to be checked prior to starting azathioprine due to bone marrow suppression
crohns acute management
1st - glucocorticoids
2nd - 5-ASA (mesalazine)
3rd - azathioprine/ methotrexate/ mercaptopurine
4th - infliximab
bile acid malabsorption Mx
cholestyramine
C Diff risk factors
PPI, Clindamycin, broadspec abx
Oesophageal Ca Adenocarcinoma risk factors
GORD, Barretts, smoking
Referal for OGD
dysphagia
upper abdominal mass consistent with stomach cancer
Patients aged >= 55 years who’ve got weight loss, AND any of the following:
upper abdominal pain
reflux
dyspepsia
