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Gastroenterology Flashcards

1
Q

Give consequences of a low vitamin A

A

blindness

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2
Q

Give consequences of a low vitamin B1

A

Beri beri
wet - heart failure
dry - neuropathy

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3
Q

Give consequences of a low vitamin B3

A

niacin

Pellagra - diarrhoea / dementia / dermatitis

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4
Q

Give consequences of a low vitamin C

A

Scurvy
bleeding
Poor healing

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5
Q

function of G cells

A

Secrete gastrin - stimulates parietel cells to produce HCL

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6
Q

Function of D cells

A

Secrete somatostatin - inhibits G cells

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7
Q

Function of chief cells

A

secrete pepsinogen

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8
Q

2 factors delaying gastric emptying

A

CCK - also stimulates gallbladder
Secretin - also stimulates pancreas

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9
Q

Where else is somatostatin released other that the stomach

A

Pancreas - Delta cells

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10
Q

Function of CCK

A

Delays gastric emptying
stimaultes gallbladder contraction
stimulates sphincter of Oddi

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11
Q

RF for chrons disease

A

FHx
Jewish
T1DM

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12
Q

RF for chrons disease

A

FHx
Jewish
Chronic stress

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13
Q

Sx and signs of chrons disease

A

sx
- weight loss
- RIF abdominal pain
- Diarrhoea

signs
- clubbing
- pallor
- Apthous ulcers
- RIF Tenderness / mass
- PR fistulae / mass / skin tag

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14
Q

extraintestinal features of crohns

A

Erythema nodosum
Pyoderma gangrenosum
Gallstones
Arthiritis
Anterior uveitis

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15
Q

Features of anterior uveitis and mangement

A

Acute red eye
Ciliary flush
Reduced visual acuity
Small fixed oval pupil
Photophobia

Iris
Ciliary body
Choroid

Mx - urgent opthamology r/v

Cyclopentolate
Atropine
Dilate pupil to prevent pain

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16
Q

Management of crohns

A

C - Smoking cessation

M-
Induce
PO/IV steroids
Mesalazine
Infliximab

Maintain
Azathiporine
MXT

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17
Q

Complications of crohns

A

osteoporosis
Abscess
strictures
small bowel cancer
colorectal carcinoma

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18
Q

Complications of crohns

A

osteoporosis
Abscess
Fistula
strictures
small bowel cancer
colorectal carcinoma

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19
Q

sx and signs of UC

A

sx
- LLQ pain
- tenesmus and urgency
- Diarrhoea
- blood and mucus
- weight loss

Clubbing
Pallor
RLQ mass and tenderness
PSC
- Jaundice + pruritus

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20
Q

Features of PSC

A

Jaundice
Pruritus
Increased bilirubin
Increased ALP
RUQ pain

P-ANCA

Ix - MRCP

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21
Q

Microscopic features of UC

A

Pseudopolyps - ulceration with preserved adjacent mucosa
colon only
circumfrential and continuous

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22
Q

Macroscopic features of UC

A

Pseudopolyps - ulceration with preserved adjacent mucosa
colon only
circumfrential and continuous

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23
Q

Microscopic features of UC

A

Decreased goblet cells
No granuloma
crypt abscess
mucosal inflammation only

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24
Q

barium enema findings of UC

A

Lead pipe colon
Loss of haustral markings

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25
Management of UC - induce
Induce Mild/mod - distal - topical mesalazine extensive - topical - PO Severe - IV steroids
26
Manageemnt of UC - Maintenance
Mild/mod - distal - meslazine extensive PO severe - PO Azathiprine
27
What is toxic megacolon
toxic non obstructive dilatation of colon tenderness and distension
28
Complications of PSC
Biliary stricure cholangiocarcinoma hepatitis LF Fat soluble vitamin def
29
Management of PSC
Liver transplant can be curative but is associated with its own problems ERCP can be used to dilate and stent any strictures Colestyramine is a bile acid sequestrate in that it binds to bile acids to prevent absorption in the gut and can help with pruritus due to raised bile acids
30
Features of IBS
Abdominal pain relieved by defication or associated with change in bowel habit + Abnormal passage of stool mucus PR Bloating sx worse after eating
31
Ix for IBS
FBC - CRP / WCC Feacal calpotectin coeliac serology
32
IBS management
Fluids / smaller meals / decrease alcohol / FODMAP / CBT Cramps - Hycosine butylbromide TCA SSRI
33
define coeliac disease
AI mediated disorder due to insensitivity to proteins in gluten causing chronic inflammation - Type 4 hypersensitivity
34
Sx of coeliac disease
abdominal pain bloating N+V Diarrhoea greasy smelly stooly weight loss fatigue
35
signs of coeliac disease
FTT Short stature wasted buttocks Pallor - Anaemia dermatitis hepatiformis - elbows / knees / buttocks abdominal distension angular stomatitis bloating
36
Complications of coeliac disease
IDA B12 / Folate Hyposplenism osteoperosis T cell lymphoma
37
Investigations of coeliac disease
Stool culture IgA level Bloods - faceal calprotection / FBC / Anti TTG OGD and biopsy
38
Findings on biopsy of coeliac
villous atrophy crypt hyperplasia lyphocyte infiltration
39
features of peritonism
rebound tenderness percussion tenderness guarding rigidity
40
sx of appendicitis
periumbilical --> RIF pain Fever N+V Dysuria Diarrhoea
41
signs of appendicitis
Mc burneys point sign Rovsign sign Obturator sign - pain in RIF on internal hip rotation Psoas sign - pain in RIF on hip extension
42
Investigations in appendicitis
Urine dip and urinalysis FBC / CRP / U+E / Clotting / G&S VBG - Lactate Urine HCG CXR USS - Female CT
43
Define: Diverticulum Diverticulosis Diverticular disease Diverticulitis
Outpouching of colonic mucosa and submucosa Presence of multiple diverticula Presence of multiple symptomatic diverticula Inflammation of diverticula
44
RF for diverticulosis
Increasing age Low fibre diet chronic constipation obesity NSAIDs
45
Presentation of diverticular disease
LIF pain chronic constipation - altered bowel habit PR bleeding
46
management of diverticular disease
hydration high fibre diet bulk forming laxative
47
presentation of acute diverticulitis
pain and tenderness in LLQ Fever diarrhoea N+V PR bleeding
48
Investigations for diverticulitis
Bloods - WCC / CRP AXR CT
49
Management of diverticulitis
PO Co-amoxiclav
50
what is a haemorrhoid
swollen vascular cushion in anal canal
51
classification of haemorrhoids
upper 2/3rds - painless rectal columnar epithelium lower 1/3rd - Painful and itchy stratified squamous
52
RF for haemorrhoids
prolonged sitting obesity constipation increased age
53
sx of haemorrhoids
painless PR bleed perianal irritation mucosal discharge
54
management of haemorrhoids
conservative - prevent constipation - increase fibre / fluid medical - laxatives surgical - topical anaesthetics and steroids - rubber band ligation
55
Risk factors for GORD
Obesity Pregnancy Hiatus hernia Smoking Alcohol NSAIDs Caffeine
56
Definition of GORD
Regurgitation of contents into oesophagus due to relaxation of LOS
57
Sx and signs of GORD
Sx Heartburn Dyspepsia Regurgitation - worse when lying down Epigastric pain cough
58
What is toxic megacolon
toxic non obstructive dilatation >6cm Abdo tenderness Distension
59
Causes of clubbing
CHD - Cyanotic CF Lung cancer UC Bronchiectasis IE IPF Crohns
60
what is acute mesenteric ischemia
thrombus / embolus blocking mesenteric ischaemia RF - AF Sx out of keeping with clinical presentation Ix - metabolic acidosis - 1st line CT angiogram - GOLD - Colonoscopy Mx - IV Abx + Heparin + surgery
61
what is pseudomembranous colitis
inflammation of colon due to overgrowth of C.Diff
62
RF for pseudomembranous colitis
Clindamycin PPI Hospital admission
63
sx of pseudomembranous colitis
diarrhoea abdominal pain Raised WCC Toxic megacolon
64
management of psudomembranous colitis
Vancomycin Fidaxomicin recurrent 12 weeks - fidoxamicin life threatening vancomycin + metronidazole
65
SBO features - causes - sx - signs - Ix
Adhesions / Henria / Crohns stricture Colicky abdominal pain N+ Bilious vomiting Abdominal distension constipation no flatulence abdo tenderness tinkling bowel sounds AXR - >3cm / valvulae all across CT with contrast
66
AXR in bowel obstrcution
Both - fluid level in bowel - no air in distant bowel - distended bowel loops Small - valvuale seen all across large - loss of haustra
67
causes of LBO
Malignancy Volvulus Hernia Diverticular disease Intusussception
68
What is pseudo-obstruction
non mechanical dilatation of bowels due to paralytic ileus
69
causes of pseudo-obstruction
Post op - paralytic ileus Parkinsons disease Opiates electrolyte imbalances recent trauma or surgery Hirschprung
70
causes of appendictis
faecolith foreign bodies lymphoid hyperplasia
71
signs of appendicitis
Rovsings rebound tenderness guarding Psoas sign Obturator - hip flexion and internal rotation
72
Investigations in appendicitis
Bloods - WCC / CRP Urinalysis Pregnancy test Abdominal USS - Children and pregnant women Abdominal CT with contrast
73
Investigations in appendicitis
Bloods - WCC / CRP / lactate Urinalysis Pregnancy test Abdominal USS - Children and pregnant women Abdominal CT with contrast
74
Post gastroenteritis complications
lactose intolerance IBS Reative arthiritis GBS
75
Features of anal fissure
throbbing pain worse on sitting pruritus ani blood / mucus in stool
76
features of oesophageal cancer
progressive dysphasia weight loss hoarse voice odynophagia ALARMS
77
features of gastric cancer
Antrum and lesser curvature RF: Male / older / smoking / Pernicious aneamia / H pylori Epigastric pain wt loss N+V Dysphasia Lymphatic spread - virchows node
78
RF for colon cancer
FAP - Multiple polyps Lynch syndrome - HNPCC Smoking Obesity Alcohol IBD
79
Sx and signs of bowel cancer
Change in bowel habit weight loss PR bleeding Tenesmus Abdominal pain ALARM PR - Rectal mass Abdominal mass
80
Screening for colon cancer
FIIT Test Aged 60 -74 every 2 years
81
what cell type is affected in small bowel cancer
Enterochromaffin

Finals revision (17 decks)

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