Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine for Finals > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

liver cirrhosis: causes

A

alcohol
NAFLD
Hepatitis B or C
Metabolic liver disease (Wilson’s, haemochromatosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

liver cirrhosis: most sensitive investigation

A

FBC - thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

liver cirrhosis: complications

A
  • UGIB
  • sepsis
  • spontaneous bacterial peritonitis
  • hypoglycaemia
  • hepatocellular carcinoma
  • hepatorenal syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

liver cirrhosis: monitoring for hepatocellular carcinoma

A

6 monthly USS
Alpha fetoprotein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

decompensated liver disease: triggers

A
  • alcohol
  • Hepatitis A or E
  • infection
  • dehydration
  • constipation
  • UGIB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

acute hepatitis: causes

A
  • Alcohol
  • Hepatitis A or E
  • Autoimmmune
  • Toxicity (e.g. paracetamol)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

autoimmune hepatitis: types and serology

A

Type 1 - ANA, anti-SMA
Type 2 - anti-LMK1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

primary sclerosing cholangitis: distribution

A

intra- and extra-hepatic bile ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

primary biliary sclerosis: distribution

A

intra-hepatic bile ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

primary sclerosing cholangitis: associations

A

ulcerative colitis (in 70% cases)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

primary sclerosing cholangitis: presentation

A

intermittent jaundice and pruritis, classically younger people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

primary biliary sclerosis: associations

A
  • Sjogren’s syndrome
  • Raynaud’s phenomenon
  • arthritis
  • autoimmune thyroid disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

primary biliary sclerosis: presentation

A

insidious onset of fatigue, weight loss, pruritis, classically in middle aged women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

primary sclerosing cholangitis: investigations

A

pANCA in 70% cases (also: ASM, ANA)
ERCP shows stricturing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

primary biliary sclerosis: investigations

A

AMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

primary sclerosing cholangitis: management

A

No curative treatment

Consider cholestyramine (pruritis), ERCP stenting or balloon dilation, liver transplant for end-stage disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

primary biliary sclerosis: management

A

Ursodeoxycholic acid

Consider cholestyramine (pruritis), liver transplant for end-stage disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

primary sclerosing cholangitis: complications

A
  • recurrence
  • biliary cirrhosis
  • Cholangiocarcinoma
  • colorectal cancer
  • portal hypertension
  • malabsorption (metabolic bone disease)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

primary biliary sclerosis: complications

A
  • cirrhosis
  • Hepatocellular carcinoma
  • malabsorption (metabolic bone disease)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

ulcerative colitis: distribution

A

large bowel +/- ‘backwash ileitis’, continuous distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

ulcerative colitis: associations

A

pANCA
Primary Sclerosing Cholangitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

ulcerative colitis: presentation

A

Violent, bloody, mucousy diarrhoea and abdominal pain, systemic malaise.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

ulcerative colitis: extra-intestinal manifestations

A

eyes - uveitis
joints - AS, arthropathy, sacroilitis
skin - erythema nodosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

ulcerative colitis: management of acute flairs

A
  1. topical aminosalicylate (sulfasalazine, mesalazine)
  2. oral aminosalicylate
  3. topical or oral steroid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

ulcerative colitis: maintenance therapy

A
  1. topical or oral aminosalicylate
  2. add azathioprine or cyclosporine
  3. trial anti-TNF (infliximab, adalibumab)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

ulcerative colitis: complications

A
  • toxic megacolon
  • primary sclerosing cholangitis
  • colonic cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Crohn’s disease: distribution

A

can affect any part of the GIT, commonly affects the terminal ileum, see skip lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Crohn’s disease: risk factors

A

smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Crohn’s disease: presentation

A

diarrhoea which may be bloody, steatorrhoea, crampy abdominal pain and systemic malaise

see mouth ulcers and perianal disease (skin tags, fistulae, abscesses)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Crohn’s disease: extra-intestinal manifestations

A

eyes - uveitis, episcleritis
joints - AS, arthropathy
skin - erythema nodosum

31
Q

ulcerative colitis: investigations

A
  • stool culture
  • fecal calprotectin
  • barium contrast studies
  • flexible sigmoidoscopy

Avoid barium studies and endoscopy during acute flair due to risk of perforation

32
Q

Crohn’s disease: investigations

A
  • stool culture
  • fecal calprotectin
  • barium contrast studies
  • colonoscopy +/- OGD
  • haematinics
33
Q

Crohn’s disease: management of acute flair

A
  1. Oral corticosteroid
  2. Azathioprine or mercaptopurine
  3. Anti-TNF (infliximab, adalimumab)
34
Q

Crohn’s disease: maintenance therapy

A

Azathioprine or mercaptopurine

35
Q

Crohn’s disease: complications

A
  • strictures
  • perforation
  • fistulae
  • abscesses
  • malabsorption
  • carcinoma
  • bile duct stones
36
Q

splenomegaly: causes

A
  • malaria
  • visceral leishmaniasis
  • CML
  • myelofibrosis
37
Q

hyposplenism: causes

A
  • iatrogenic
  • trauma
  • Sickle Cell Disease
  • Coeliac Disease
  • Hepatic Disease
  • Grave’s Disease
  • SLE
  • Amyloid
  • Thrombosis
38
Q

Hepatitis A: course

A

Acute hepatitis, typically following 3-6wk prodrome of malaise, anorexia, fever, N&V

39
Q

Hepatitis E: course

A

Acute hepatitis, typically following 3-6wk prodrome of malaise, anorexia, fever, N&V

40
Q

Acute viral hepatitis: serology

A

IgM = acute illness
IgG = past infection

41
Q

Hepatitis A: spread

A

faeco-oral

42
Q

Hepatitis E: spread

A

faeco-oral (Pork and Shellfish)

43
Q

Hepatitis C: course

A

Chronic infection, typically without acute illness. Usually found incidentally.

44
Q

Hepatitis B: course

A

Chronic infection, usually heralded by acute illness and hepatitis which follows 3-6mo incubation period

45
Q

Hepatitis C: serology

A

IgM = acute infection
IgG = chronic infection

46
Q

Hepatitis C: management

A

(IFN-alpha and ribavirin)
Sofosbuvir

47
Q

Hepatitis B: serology

A

HbsAg = any exposure
HbcAg = chronic exposure

Anti-HbcAg IgM = acute infection
Anti-HbcAg IgG = chronic or cleared infection

Anti-HbsAg = in isolation indicates vaccination

48
Q

Hepatitis B: management

A

Acutely, supportive care
Chronic carriage, tenofovir or IFN-alpha

49
Q

Hepatitis D: course

A

Chronic, superinfects Hep B carriers and causes more rapid progression to liver failure

50
Q

Hepatitis B: vaccination criteria

A
  • MSM
  • IVDU
  • occupational risk
51
Q

Hepatitis A: vaccination cirteria

A
  • travellers
  • people with chronic liver disease
  • haemophiliacs
  • MSM
  • IVDU
  • occupational risk
52
Q

acute viral hepatitis: management

A

supportive

53
Q

hepatorenal syndrome: presentation

A
  • cirrhosis
  • ascites
  • renal failure
54
Q

hepatorenal syndrome: management

A

terlipressin

55
Q

ascitic tap

A
  • MC&S
  • Cytology - neutrophils >250 in SBP
  • SAG ratio: >11 = transudate; <11 = exudate
56
Q

causes of transudative ascites

A
  • liver disease
  • heart failure
57
Q

causes of exudative ascites

A
  • pancreatitis
  • malignancy
  • nephrotic syndrome
  • TB
58
Q

spontaneous bacterial peritonitis: diagnostic criteria

A

Ascitic tap neutrophils > 250

59
Q

variceal bleed: management

A

terlipressin
broad spectrum antibiotics
endocscopy (banding or sclerotherapy)

In an emergency, consider Sengstaken-Blakemore tube.

If resistance, consider TIPS

60
Q

peptic ulcer: first-line management

A

oral PPI
H pylori stool antigen (breath test if known previous infection)

61
Q

peptic ulcer: management in H pylori infection

A

eradication therapy:
PPI + amoxicillin + clarithromycin

62
Q

peptic ulcer: management of associated UGIB

A

endoscopic haemostasis (adrenaline injection)
clipping or ablation

63
Q

UGIB: scoring systems pre- and post-endoscopy

A

Pre: Glasgow Blatchford Score
Post: Rockall Score

64
Q

peptic ulcer: risk factors

A
  • H pylori infection
  • Drugs (NSAIDs, SSRIs, steroids, bisphosphonates)
  • smoking
  • alcohol
  • Zollinger-Ellison syndrome
65
Q

peptic ulcer: complications

A
  • UGIB
  • perforation
  • malignancy
66
Q

acute pancreatitis: causes

A

I GET SMASHED

  • idiopathic
  • gallstones
  • ethanol
  • trauma
  • steroids
  • mumps (or other viruses)
  • autoimmune
  • scorpion stings
  • hypercalcaemia or hypertriglyceridaemia
  • ERCP
  • drugs (azathioprine, mesalazine, bendroflumethiazide, furosemide, valproate)

also: smoking

67
Q

acute pancreatitis: most sensitive and specific investigation

A

serum lipase

68
Q

acute pancreatitis: differentials for a raised amylase

A
  • acute pancreatitis
  • pseudocyst
  • mesenteric infarct
  • perforated viscus
  • acute cholecystitis
  • DKA
69
Q

acute pancreatitis: diagnostic criteria

A
  1. Typical history
  2. Amylase or lipase elevated above 3x ULN
  3. Imaging to rule-out gallstones (USS) or perforation (CTAP)

2/3 is diagnostic

70
Q

acute pancreatitis: assessment for severe pancreatitis

A

Glasgow Criteria

  • PaO2 < 7.9kPa
  • Age > 55
  • Neutrophils (WCC > 15)
  • Calcium < 2
  • Renal dysfunction (urea >16)
  • Enzymes (LDH > 600)
  • Albumin < 32
  • Sugar (Glucose > 10)

3+ = high risk

71
Q

acute pancreatitis: management

A

supportive (fluids, analgesia, managed nutrition)

72
Q

acute pancreatitis: complications

A
  • peripancreatic fluid collection
  • pseudocyst (4wks post-attack, raised amylase, if asymptomatic monitor 12wks)
  • pancreatic necrosis (+/- infection)
  • pancreatic abscess (secondary to infected pseudocyst)
  • haemorrhage
  • sepsis
  • ARDS
73
Q

chronic pancreatitis: causes

A
  • alcohol [common]
  • recurrent acute pancreatitis
  • haemochromatosis
  • CF
  • hypercalcaemia
  • smoking
  • CKD
  • ductal obstruction (e.g. tumour, stones, annular pancreas)
74
Q

chronic pancreatitis: management

A
  • enzyme supplements
  • analgesia

Medicine for Finals (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions