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finals > gastroenterology > Flashcards

gastroenterology Flashcards

1
Q

what are MEN-I neoplasms

A

parathyroid - hyperparathyroid
pituitary
pancreas - insulinoma, zolinger-ellinson

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2
Q

what is Zollinger-Ellinson syndrome

A

gastrin secreting adenoma
most commonly found in the pancreas

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3
Q

dysphasia, regurgitation and halitosis
suggestive of

A

pharyngeal pouch

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4
Q

management of pharyngeal pouch

A

surgery

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5
Q

what drug other than antibiotic is a risk for C.diff

A

omeprazole

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6
Q

how does hepatic encephalopathy present

A

confusion and altered consciousness

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7
Q

pathophysiology of hepatic encephalopathy

A

excess absorption of ammonia from bacterial breakdown of proteins

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8
Q

management of hepatic encephalopathy

A

lactulose - promotes excretion of ammonia (1st line)

rifaximin - modulates gut flora, decreasing ammonia production

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9
Q

does high urea indicate upper of lower GI bleed

A

upper

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10
Q

what test is most useful to distinguish between IBS and IBD

A

faecal calprotectin

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11
Q

can PPI cause hyponatraemia

A

yes

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12
Q

what must be given before large volume paracentesis

A

IV human albumin solution

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13
Q

1st line investigation for mesenteric ischaemia

A

serum lactate

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14
Q

what enzymes are good for comparing end stage liver disease

A

albumin
coagulation enzymes

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15
Q

management of c.diff

A
  1. oral vancomycin
  2. oral fidaxomicin
  3. oral vancomycin + IV metronidazole
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16
Q

spontaneous bacterial peritonitis most common organism

A

e.coli

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17
Q

what needs to be stopped before urea breath test

A

antibiotics 4 weeks before
PPI 2 weeks before

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18
Q

why do patients with coeliac disease require more immunisation

A

due to hyposplenism

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19
Q

what should be given for prophylaxis against spontaneous bacterial peritonitis

A

oral ciprofloxacin

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20
Q

SAAG >11 means ascites is caused by what

A

portal hypertension

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21
Q

1st line for flare of UC

A

rectal mesalazine

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22
Q

investigation of choice for patient with perianal fistula who has crohns

A

MRI

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23
Q

how should a severe flare of UC be managed

A

IV corticosteroids in hospital

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24
Q

Budd-Chiari triad

A

sudden onset abdominal pain
ascites
tender hepatomegaly

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25
Q

metabolic ketoacidosis with normal or low glucose think…

A

alcohol

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26
Q

what is AST/ALT ratio in alcoholic hepatitis

A

2:1

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27
Q

triad of acute cholangitits

A

fever
jaundice
RUQ pain

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28
Q

what levels are raised in autoimmune hepatitis

A

IgG
anti nuclear antibodies
anti smooth muscle antibodies

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29
Q

what bug can you get from swimming pool

A

giardia - resistant to chlorine

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30
Q

isolated rise in bilirubin associated with stress is likely to be

A

Gilberts syndrome

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31
Q

can PPI cause hyponatraemia
true or false

A

true

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32
Q

side effect of aminosalicylates

A

agranulocytosis
- FBC !!!!

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33
Q

how does agranulocytosis present

A

fever, rigors

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34
Q

what vitamin is absorbed the ileum

A

B12

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35
Q

gene mutation in Gilberts

A

UGT1A1

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36
Q

inheritance of Gilberts

A

autosomal recessive

37
Q

gene mutation in Wilsons

A

ATP7B

38
Q

1st line investigation for coeliac disease

A

anti-TTG IgA antibody

39
Q

what immunoglobulin in PBC

A

IgM

40
Q

abdominal pain
rose coloured spots on chest and abdomen

A

salmonella typhi

41
Q

serum copper levels in Wilsons disease

A

low

42
Q

hairy white patch on tongue is suggestive of

A

epstein barr virus

43
Q

cancer associated with UC

A

cholangiocarcinoma

44
Q

what tumour marker in cholangiocarcinoma

A

CA19-9

45
Q

what juice can you not drink whilst taking warfarin

A

grapefruit juice

46
Q

blood gas in person vomiting

A

metabolic alkalosis with hypokalaemia

47
Q

liver failure following cardiac arrest is due to

A

Ischaemia hepatitis

48
Q

SAAG > 11 is it transudate or exudate

A

transudate

49
Q

SAAG <11g is transudate or exudate

A

exudate

50
Q

management of alcoholic ketoacidosis

A

IV thiamine and 0.9% saline

51
Q

what is given prior to appendectomy

A

IV antibiotics (prophylaxis)

52
Q

abdominal pain + blood and leukocytes
look for

A

stones

53
Q

nitrates on urine dip suggests

A

urinary infection

54
Q

management of PBC

A

antipruritics
ursodeoxycholic acid

55
Q

investigation of choice in patient with severe flare of UC

A

sigmoidoscopy

56
Q

crypt abscess is seen in

A

UC

57
Q

what is co administered with isoniazid to precent peripheral neuropathy

A

pridoxine (vitamin B6)

58
Q

watery green diarrhoea post cholecystectomy is

A

bile acid malabsorption

59
Q

how to treat bile acid malabsorption

A

cholestyramine

60
Q

HNPCC causes

A

colorectal cacner
endometrial cancer

61
Q

seagull shape appearance on microscopy is

A

campylobacter

62
Q

management of campylobacter

A

azithromycin

63
Q

easy bruising and gum bleeding is

A

vitamin C deficiency

64
Q

management of severe alcoholic hepatitis

A

corticosteroids

65
Q

management of patient with ascites secondary to liver cirrhosis

A

spironolactone

66
Q

double duct sign is seen in what

A

pancreatic cancer

67
Q

periodic acid-stiff (PAS) positive macrophages is seen in

A

whipples disease

68
Q

Liver failure triad

A

Encephalopathy
Jaundice
Coagulopathy

69
Q

Type 2 diabetes with abnormal liver function is likely to be

A

non alcoholic fatty liver disease

70
Q

Gene in HNPCC

A

MSH2
MLH1

71
Q

Metabolic alkalosis + hypokalaemia is

A

prolonged vomiting

72
Q

Surgical management of achalasia

A

Heller cardiomyotomy

73
Q

what drug can worsen symptoms in Parkinsonism

A

metoclopramide - dopamine antagonist

74
Q

management of patient who has crohns who develops perianal fistula

A

metronidazole

75
Q

what does TIPS procedure connect

A

portal vien to hepatic vein

76
Q

where does Crohn mostly affect

A

ileum

77
Q

management of autoimmune hepatitis

A

steroids

78
Q

medication to maintain remission in crohns

A

azathoprine

79
Q

anti emetic contraindicated in bowel obstruction

A

metoclopramide

80
Q

medication to induce remission in crohns

A

prednisolone

81
Q

what drug can cause cholestasis

A

co-amoxiclav

82
Q

gold diagnosis for NAFLD

A

transient elastography

83
Q

what does Zollinger Ellinson syndrome cause

A

several ulcerations in stomach and duodenum due to uncontrolled release of gastrin

84
Q

definitive management of ascending cholangitis

A

ERCP

85
Q

features of ascending cholangitis

A

Charcot triad
- RUQ pain
- fever
- jaundice

86
Q

what hepatitis can be spread through shellfish

A

hepatitis A

87
Q

what shape is campylobacter

A

spiral shape

88
Q

MRCP beaded appearance

A

PSC

finals (25 decks)

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