gastroenterology Flashcards
what are MEN-I neoplasms
parathyroid - hyperparathyroid
pituitary
pancreas - insulinoma, zolinger-ellinson
what is Zollinger-Ellinson syndrome
gastrin secreting adenoma
most commonly found in the pancreas
dysphasia, regurgitation and halitosis
suggestive of
pharyngeal pouch
management of pharyngeal pouch
surgery
what drug other than antibiotic is a risk for C.diff
omeprazole
how does hepatic encephalopathy present
confusion and altered consciousness
pathophysiology of hepatic encephalopathy
excess absorption of ammonia from bacterial breakdown of proteins
management of hepatic encephalopathy
lactulose - promotes excretion of ammonia (1st line)
rifaximin - modulates gut flora, decreasing ammonia production
does high urea indicate upper of lower GI bleed
upper
what test is most useful to distinguish between IBS and IBD
faecal calprotectin
can PPI cause hyponatraemia
yes
what must be given before large volume paracentesis
IV human albumin solution
1st line investigation for mesenteric ischaemia
serum lactate
what enzymes are good for comparing end stage liver disease
albumin
coagulation enzymes
management of c.diff
- oral vancomycin
- oral fidaxomicin
- oral vancomycin + IV metronidazole
spontaneous bacterial peritonitis most common organism
e.coli
what needs to be stopped before urea breath test
antibiotics 4 weeks before
PPI 2 weeks before
why do patients with coeliac disease require more immunisation
due to hyposplenism
what should be given for prophylaxis against spontaneous bacterial peritonitis
oral ciprofloxacin
SAAG >11 means ascites is caused by what
portal hypertension
1st line for flare of UC
rectal mesalazine
investigation of choice for patient with perianal fistula who has crohns
MRI
how should a severe flare of UC be managed
IV corticosteroids in hospital
Budd-Chiari triad
sudden onset abdominal pain
ascites
tender hepatomegaly
metabolic ketoacidosis with normal or low glucose think…
alcohol
what is AST/ALT ratio in alcoholic hepatitis
2:1
triad of acute cholangitits
fever
jaundice
RUQ pain
what levels are raised in autoimmune hepatitis
IgG
anti nuclear antibodies
anti smooth muscle antibodies
what bug can you get from swimming pool
giardia - resistant to chlorine
isolated rise in bilirubin associated with stress is likely to be
Gilberts syndrome
can PPI cause hyponatraemia
true or false
true
side effect of aminosalicylates
agranulocytosis
- FBC !!!!
how does agranulocytosis present
fever, rigors
what vitamin is absorbed the ileum
B12
gene mutation in Gilberts
UGT1A1
inheritance of Gilberts
autosomal recessive
gene mutation in Wilsons
ATP7B
1st line investigation for coeliac disease
anti-TTG IgA antibody
what immunoglobulin in PBC
IgM
abdominal pain
rose coloured spots on chest and abdomen
salmonella typhi
serum copper levels in Wilsons disease
low
hairy white patch on tongue is suggestive of
epstein barr virus
cancer associated with UC
cholangiocarcinoma
what tumour marker in cholangiocarcinoma
CA19-9
what juice can you not drink whilst taking warfarin
grapefruit juice
blood gas in person vomiting
metabolic alkalosis with hypokalaemia
liver failure following cardiac arrest is due to
Ischaemia hepatitis
SAAG > 11 is it transudate or exudate
transudate
SAAG <11g is transudate or exudate
exudate
management of alcoholic ketoacidosis
IV thiamine and 0.9% saline
what is given prior to appendectomy
IV antibiotics (prophylaxis)
abdominal pain + blood and leukocytes
look for
stones
nitrates on urine dip suggests
urinary infection
management of PBC
antipruritics
ursodeoxycholic acid
investigation of choice in patient with severe flare of UC
sigmoidoscopy
crypt abscess is seen in
UC
what is co administered with isoniazid to precent peripheral neuropathy
pridoxine (vitamin B6)
watery green diarrhoea post cholecystectomy is
bile acid malabsorption
how to treat bile acid malabsorption
cholestyramine
HNPCC causes
colorectal cacner
endometrial cancer
seagull shape appearance on microscopy is
campylobacter
management of campylobacter
azithromycin
easy bruising and gum bleeding is
vitamin C deficiency
management of severe alcoholic hepatitis
corticosteroids
management of patient with ascites secondary to liver cirrhosis
spironolactone
double duct sign is seen in what
pancreatic cancer
periodic acid-stiff (PAS) positive macrophages is seen in
whipples disease
Liver failure triad
Encephalopathy
Jaundice
Coagulopathy
Type 2 diabetes with abnormal liver function is likely to be
non alcoholic fatty liver disease
Gene in HNPCC
MSH2
MLH1
Metabolic alkalosis + hypokalaemia is
prolonged vomiting
Surgical management of achalasia
Heller cardiomyotomy
what drug can worsen symptoms in Parkinsonism
metoclopramide - dopamine antagonist
management of patient who has crohns who develops perianal fistula
metronidazole
what does TIPS procedure connect
portal vien to hepatic vein
where does Crohn mostly affect
ileum
management of autoimmune hepatitis
steroids
medication to maintain remission in crohns
azathoprine
anti emetic contraindicated in bowel obstruction
metoclopramide
medication to induce remission in crohns
prednisolone
what drug can cause cholestasis
co-amoxiclav
gold diagnosis for NAFLD
transient elastography
what does Zollinger Ellinson syndrome cause
several ulcerations in stomach and duodenum due to uncontrolled release of gastrin
definitive management of ascending cholangitis
ERCP
features of ascending cholangitis
Charcot triad
- RUQ pain
- fever
- jaundice
what hepatitis can be spread through shellfish
hepatitis A
what shape is campylobacter
spiral shape
MRCP beaded appearance
PSC