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MRCP > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

Wilson’s disease lab findings

A

Low caeruloplasmin concentration
Hepatic, serum and urinary copper all raised

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2
Q

Sweating
Hunger
Weight gain
Low glucose

?cause

A

Insulinoma

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3
Q

Insulinoma (diagnostic test)

A

Prolonged (72h) fasting glucose levels

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4
Q

Loose stool/diarrhoea following resection of bowel (terminal ileum) for Crohn’s disease. Normal CRP/calprotectin

Cause?

A

Bile salt-induced diarrhoea

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5
Q

Bile salt-induced diarrhoea

Treatment?

A

Bile acid binders e.g. cholestyramine

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6
Q

Primary sclerosing cholangitis
linked to…

A

Linked to UC

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7
Q

Primary biliary cholangitis

A

Autoimmune condition
Middle-aged women
Pruritus
Fatigue

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8
Q

Artery supplying stomach -> where bile duct enters duodenum

A

Celiac trunk

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9
Q

Artery supplying duodenum (where bile duct enters) -> 2/3 across transverse colon

A

Superior mesenteric

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10
Q

Hypogonadotropic hypogonadism
Peri-anal dermatitis
Cognitive impairment
Alopecia
Hepatosplenomegaly

A

Zinc deficiency

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11
Q

Niacin deficiency symptoms

A

Pellagra
Diarrhoea, dermatitis, dementia
Mucosal, anogenital lesions

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12
Q

Carcinoid syndrome

Features

A

Flushing
Diarrhoea
Bronchospasm
Tricuspid stenosis
Pellagra

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13
Q

Carcinoid syndrome

Cause

A

Release of serotonin into systemic circulation from liver

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14
Q

Gastrin

Secreted by…
Secreted in…
Effects…

A

G cells
Antrum and duodenum
Increases gastric acid and intrinsic factor production production from parietal cells
Increases pepsinogen release from chief cells
Increases gastric motility

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15
Q

Cholecystokinin (CCK)

Secreted by…
Secreted in…
Effects…

A

I cells
Duodenum, ileum
Stimulates gallbladder contraction
Stimulates release of pancreatic enzymes
Relaxes sphincter of Oddi

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16
Q

Secretin

Secreted by…
Secreted in…
Effects…

A

S cells
Duodenum, jejenum
Stimulates secretion of bicarb from pancreas
Inhibits gastrin and gastric acid secretion

17
Q

Vasoactive int

Secreted by…
Secreted in…
Effects…

18
Q

Gastric inhibitory polypeptide (GIP)

Secreted by…
Secreted in…
Effects…

A

K cells
Reduces gastric acid secretion and motility
Stimulates insulin release

19
Q

Motilin

Secreted by…
Secreted in…
Effects…

A

Mo cells/ECL cells
Increases small bowel motility and gastric emptying

20
Q

Somatostatin

Secreted by…
Secreted in…
Effects…

A

D cells (stomach, small intestine, pancreas)
Inhibits secretion and action of all other GI hormones

21
Q

Young person, deranged LFTs, ascites, abdominal pain

A

Budd-Chiari syndrome = thombosis of hepatic vein

22
Q

Budd-Chiari risk factors

A

Pregnancy/post-partum
COCP

23
Q

Budd Chiari investigation of choice

A

USS abdomen with flow studies

24
Q

Small bowel overgrowth syndrome test

A

Hydrogen breath test

25
Q

Refractory dyspepsia
Multiple duodenal ulcerations
Imaging = ?GI malignancy

Condition
associations

A

Zollinger Ellison syndrome = gastrinoma

Sometimes associated with MEN1

26
Q

Bezlotoxumab

A

Monoclonal for C diff - binds to C diff toxin B

27
Q

Vitamin C (ascorbic acid) -> effect on iron absorption

A

Conversion of Fe3+ to Fe2+

28
Q

Diarrhoea
Pigment laden macrophages on colonoscopy biopsy

A

Laxative abuse

29
Q

Chronic pancreatitis test

A

Faecal elastase

30
Q

ataxia, ophthalmoplegia and confusion

b/g alcohol excess

A

Wernicke’s encephalopathy

31
Q

anterograde amnesia (unable to form new memories), retrograde amnesia (unable to recall past memories) and confabulation (making up new memories)

b/g alcohol excess

A

Korsakoff’s syndrome

32
Q

anal fissure treatment

A
  1. Lidocaine ointment +/- laxatives
  2. Topical GTN (6-8 weeks)
  3. Referral to surgeons
33
Q

Pancreatitis scoring system

A

PANCREAS
PaO2 <8kPa
Age >55
Neutrophilia; WCC >15
Calcium <2
Renal function; urea >16mmol/L
Enzymes: LDH >600; AST >200
Albumin <32
Sugar (glucose) >10mmol/L

34
Q

Middle aged man
Diarrhoea
weight loss
arthralgia
Lymphadenopathy
Ophthalmoplegia

diagnosis?

A

Whipple’s disease
(can be HLA-B27 positive!)

35
Q

Budd Chiari
Investigation of choice

A

USS with doppler flow

36
Q

Most common area to have ischaemic colitis

A

Splenic flexure

37
Q

Screening for haemochromatosis

A

general population: transferrin saturation and ferritin
family members: HFE gene

38
Q

Double duct sign

Sign of..?

A

Pancreatic cancer

39
Q

King’s college liver transplant guidelines (paracetamol toxicity)

A

Arterial pH < 7.3, 24 hours after ingestion

or all of the following:
prothrombin time > 100 seconds
creatinine > 300 µmol/l
grade III or IV encephalopathy

MRCP (19 decks)

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