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Gastroenterology Flashcards

1
Q

What are the common causes of upper gastrointestinal (GI) bleed?

A

Peptic ulcer disease, oesophageal varices, oesophagitis, Mallory-Weiss tear, Boerhaave syndrome.

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2
Q

What are the symptoms of upper GI bleed?

A

Haematemesis, coffee-ground emesis, melena

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3
Q

How is upper GI bleed diagnosed?

A

OGD (oesophageo-gastro-duodenoscopy)

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4
Q

What is the risk assessment for upper GI bleed?

A

Blatchford score (at first assessment) and Rockall score (after endoscopy).

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5
Q

What is the treatment for PUD causing upper GI bleed?

A

Endoscopic therapy ± blood transfusion + IV PPI.

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6
Q

What is the primary treatment for esophageal varices causing upper GI bleed?

A

Terlipressin IV + endoscopic therapy (EVL) + antibiotic.

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7
Q

How is GORD diagnosed?

A

Endoscopy (if normal, 24h oesophageal pH monitoring ± manometry).

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8
Q

What are the risk factors for GORD?

A

Older age, smoking, alcohol, obesity, hiatus hernia, LOS tone-reducing drugs.

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9
Q

What are the complications of GORD?

A

Oesophagitis, benign stricture, Barrett’s oesophagus.

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10
Q

What is Barrett’s oesophagus and how is it managed?

A

Metaplasia from stratified squamous to simple columnar epithelium; high-dose PPI, regular endoscopic surveillance if metaplasia.

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11
Q

What are the types of oesophageal cancer?

A

Adenocarcinoma (lower ⅓), Squamous cell carcinoma (upper ⅔).

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12
Q

What are the symptoms of oesophageal cancer?

A

Dysphagia, odynophagia, weight loss.

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13
Q

How is oesophageal cancer diagnosed?

A

Endoscopy with biopsy, staging CT.

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14
Q

What are the ‘ALARM Signs’ for peptic ulcer disease (PUD)?

A

Anaemia, loss of weight, anorexia, recent onset/progressive symptoms, melaena/haematemesis, swallowing difficulty.

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15
Q

When is endoscopy indicated for PUD?

A

If >55y and presenting with ‘ALARM Signs’.

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16
Q

What are the risk factors for duodenal ulcers?

A

H. pylori, NSAIDs, steroids, smoking.

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17
Q

What is the primary symptom of duodenal ulcers?

A

Right epigastric pain, better on eating, night pain.

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18
Q

How is H. pylori infection diagnosed in PUD?

A

Endoscopy + H. pylori test (13C-urea breath test or stool antigen).

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19
Q

What is the treatment approach for H. pylori-positive PUD?

A

Stop PPI for 2w, antibiotics for 4w (PAC500 triple therapy).

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20
Q

What is the primary symptom of gastric ulcers?

A

Left epigastric pain, worse on eating, weight loss.

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21
Q

What is the diagnostic approach for gastric ulcers?

A

Endoscopy with biopsy + H. pylori test.

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22
Q

What are the symptoms of gastric cancer?

A

Epigastric pain, weight loss, dyspepsia, N&V.

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23
Q

What is the treatment for gastric cancer?

A

Surgery (endoscopic mucosal resection > subtotal gastrectomy > total gastrectomy).

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24
Q

What is Plummer-Vinson syndrome?

A

Oesophageal webs + iron deficiency anaemia + glossitis; increased risk of SCC oesophagus.

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25
Q

What is achalasia?

A

Failure of oesophageal peristalsis and LOS relaxation; increased risk of SCC oesophagus.

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26
Q

What are the symptoms of achalasia?

A

Dysphagia to both solids and liquids, regurgitation, retrosternal pain.

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27
Q

How is achalasia diagnosed?

A

Endoscopy, barium swallow, oesophageal manometry.

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28
Q

What is the treatment for achalasia?

A

Heller cardiomyotomy.

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29
Q

What is CREST syndrome?

A

Calcinosis, Raynaud’s, oEsophageal dysmotility, Sclerodactyly, Telangiectasia; associated with systemic sclerosis causing dysphagia, retrosternal pain.

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30
Q

What are the symptoms of appendicitis?

A

Colicky → constant periumbilical → RIF pain, pyrexia, anorexia, N&V, may have diarrhea or constipation, worse on moving, dysuria, oliguria.

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31
Q

What is Murphy’s triad in appendicitis?

A

Pain + Vomiting + Fever.

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32
Q

What is McBurney’s sign in appendicitis?

A

Pain over McBurney’s point (⅓ distance between ASIS and umbilicus).

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33
Q

How is appendicitis diagnosed?

A

Bloods (WCC, neutrophils, CRP) + USS or CT.

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34
Q

What is the treatment for uncomplicated appendicitis?

A

Co-amoxiclav IV + Laparoscopic > Open appendectomy.

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34
Q

What is Crohn’s disease?

A

Inflammatory bowel disease affecting the entire gastrointestinal tract, with skip lesions, and inflammation involving all layers of the bowel wall.

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35
Q

What are the common symptoms of Crohn’s disease?

A

Non-bloody diarrhea, weight loss, perianal disease, abdominal tenderness or mass in RIF.

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36
Q

What is diverticulosis?

A

The presence of asymptomatic diverticula in the colon.

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37
Q

What are the risk factors for diverticulosis/diverticular disease?

A

> 50y, low dietary fiber.

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38
Q

What is diverticulitis?

A

Inflammation of the diverticula in the colon.

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39
Q

How is diverticulitis diagnosed?

A

Bloods (WCC, CRP) + AXR + CT.

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40
Q

What is the primary treatment for uncomplicated diverticulitis?

A

Conservative - trial of conservatism for 48h (indications below) - NBM, fluids IV, NG tube, catheter.

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41
Q

What are the common complications of Crohn’s disease?

A

Abscesses, strictures, fistulas, anemia, small bowel cancer, colorectal cancer, osteoporosis.

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42
Q

What is the diagnostic approach for Crohn’s disease?

A

Colonoscopy with biopsy, faecal calprotectin (pos), barium enema (Kantor’s string sign), ASCA.

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43
Q

How is ulcerative colitis diagnosed?

A

Colonoscopy (ulceration, pseudopolyps) with biopsy, faecal calprotectin (pos), barium enema (lead pipe colon), p-ANCA.

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44
Q

What are the common extraintestinal manifestations of IBD?

A

Bones - pauciarticular arthritis, osteoporosis; Skin - pyoderma gangrenosum, erythema nodosum; Eyes - uveitis, episcleritis, scleritis; Other - clubbing, anemia.

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45
Q

What are the symptoms of IBS?

A

Abdominal pain related to defecation, altered stool frequency, and form, with at least two of: Bloating, Mucus, Worsened by eating, Altered stool passage.

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46
Q

How is celiac disease diagnosed?

A

tTG (positive) + Duodenal biopsy (villous atrophy, crypt hyperplasia, lymphocytic infiltration), need gluten for 6w prior.

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47
Q

What are the symptoms of celiac disease?

A

Persistent or unexplained GI symptoms, failure to thrive or faltering growth in children, prolonged fatigue, unexpected weight loss, mouth ulcers.

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48
Q

What is Meckel’s diverticulum?

A

A congenital diverticulum, found in the ileum.

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49
Q

What is the treatment for caecal volvulus?

A

Laparotomy.

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50
Q

What is the treatment for sigmoid volvulus?

A

Rigid sigmoidoscopy.

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51
Q

What are the signs of appendicitis on physical examination?

A

Psoas sign (pain in RIF on right hip extension), Rovsing’s sign (pain in RIF on palpation of LIF), Obturator sign (pain in RIF on internal rotation of right hip).

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52
Q

What are the layers of the bowel wall affected in Crohn’s disease?

A

Mucosa, submucosa, muscularis propria, and serosa.

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52
Q

What antibodies are associated with Crohn’s disease?

A

ASCA

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52
Q

What is the lead pipe colon in ulcerative colitis seen on imaging?

A

A smooth colon appearance without haustral markings, seen on barium enema.

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52
Q

What is the severity classification for ulcerative colitis based on stool frequency and systemic disturbance?

A

Mild (<4 stools/d + no systemic disturbance), Moderate (4-6 stools/d + minimal systemic disturbance), Severe (>6 stools/d + systemic disturbance).

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53
Q

What is the primary treatment for inducing remission in severe ulcerative colitis?

A

Steroids IV.

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54
Q

What is the treatment approach for isolated perianal disease in Crohn’s disease?

A

Metronidazole PO.

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55
Q

What is the diagnostic criteria for irritable bowel syndrome (IBS)?

A

Symptoms present for ≥6 months, with abdominal pain related to defecation and associated with altered stool frequency and/or form.

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56
Q

What blood tests are done for diagnosing celiac disease?

A

IgA tTGA (tissue transglutaminase antibody), IgA endomysial antibody.

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57
Q

What is the mainstay of treatment for uncomplicated diverticulosis?

A

Increase dietary fiber.

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58
Q

What are the symptoms of Meckel’s diverticulum complications?

A

Haemorrhage, bowel obstruction, diverticulitis.

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59
Q

How is Crohn’s disease diagnosed on colonoscopy?

A

Cobblestoning, deep ulcers, skip lesions.

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60
Q

What is the primary treatment for complicated diverticulitis with abscess?

A

Co-amoxiclav PO/IV, managed at home for 72h with PO, admission needed after 72h for IV if persistent.

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61
Q

What is the mainstay treatment for maintaining remission in Crohn’s disease?

A

Azathioprine PO.

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62
Q

What is the treatment for refractory or fistulating Crohn’s disease?

A

Infliximab PO.

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63
Q

What are the extraintestinal manifestations of Crohn’s disease in the skin?

A

Pyoderma gangrenosum, erythema nodosum.

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64
Q

What are the two main causes of acute mesenteric ischemia, and which is the most common?

A

Arterial embolism (#1) and arterial thrombosis.

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65
Q

What is the classic presentation of chronic mesenteric ischemia?

A

Postprandial pain, weight loss, and vascular comorbidities.

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66
Q

Which part of the colon is most commonly affected in ischaemic colitis?

A

Splenic flexure.

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67
Q

What is the significance of CEA in colorectal cancer?

A

Carcinoembryonic Antigen (CEA) is a tumor marker for monitoring colorectal cancer. Elevated levels can indicate the presence or recurrence of adenocarcinoma.

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68
Q

What is the recommended screening test for colorectal cancer in individuals aged 60-74, and how often is it done?

A

Faecal Immunochemical Test (FIT) every 2 years.

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69
Q

What is the primary treatment for a patient with rectal cancer?

A

High anterior resection/sigmoid colectomy (colo-rectal).

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70
Q

What grading system is used for internal haemorrhoids, and what does Grade IV signify?

A
  • Grade I: Do not prolapse
  • Grade II: Prolapse, reduce spontaneously
  • Grade III: Prolapse, reduce manually
  • Grade IV: Prolapse, cannot be reduced.
71
Q

What is the primary treatment for Grade IV internal haemorrhoids?

A

Excisional haemorrhoidectomy.

72
Q

What are the complications of untreated vitamin B3 (niacin) deficiency?

A

Pellagra - Diarrhoea, dementia, dermatitis.

73
Q

What is the common causative agent of C. difficile colitis, and what drugs are often implicated?

A

Clostridium difficile; Drugs - Clindamycin, 2nd or 3rd generation cephalosporins.

74
Q

What is the diagnostic role of urinary 5-HIAA in carcinoid syndrome?

A

It confirms the diagnosis of carcinoid syndrome by detecting serotonin release from a carcinoid tumor.

75
Q

What is lactulose used for in the management of hepatic encephalopathy?

A

Reduction of ammonia levels

76
Q

What is the most common cause of hepatocellular carcinoma (HCC)?

A

Liver cirrhosis secondary to hepatitis B worldwide or hepatitis C in the UK.

77
Q

What is the main purpose of CD antigen and C. diff toxin in the diagnosis of C. difficile colitis?

A

DT (C. diff toxin) indicates current infection, while C. diff antigen indicates past exposure.

78
Q

What are the typical symptoms of a patient with fulminant liver failure?

A

Rapid onset of liver dysfunction, specifically synthetic function and hepatic encephalopathy, in a patient without known liver disease.

79
Q

Which tumour marker is elevated in hepatocellular carcinoma

A

Alpha-fetoprotein (AFP)

80
Q

What are the three classic symptoms of haemorrhoids, and what is their grading based on?

A

Symptoms: Bleeding, pruritis, pain. Grading is based on the extent of prolapse.

81
Q

What is the characteristic presentation of sigmoid volvulus?

A

Abdominal pain, distension, constipation, and a visible “coffee bean” sign on imaging.

82
Q

What is the primary treatment for internal haemorrhoids that prolapse but can be reduced manually?

A

Rubber band ligation.

83
Q

What is the primary diagnostic tool for diverticulitis, and why is colonoscopy not recommended?

A

CT scan is the primary diagnostic tool; colonoscopy is not recommended due to the risk of perforation.

84
Q

What is the most common cause of bowel obstruction in the large bowel?

A

Colorectal cancer.

85
Q

In dynamic (mechanical) bowel obstruction, what is the classic symptom indicating small bowel involvement?

A

Colicky abdominal pain.

86
Q

What are the key symptoms of acute mesenteric ischaemia?

A

Severe abdominal pain out of proportion to clinical findings, patient very ill.

87
Q

What is the primary screening method for colorectal cancer in individuals aged 55?

A

Flexible sigmoidoscopy.

88
Q

What are the two main types of vitamin B12 deficiency?

A

Dietary deficiency and pernicious anaemia.

89
Q

What are the complications of untreated vitamin C deficiency?

A

Scurvy - bleeding and poor healing.

90
Q

What is the classic presentation of carcinoid syndrome?

A

Flushing and diarrhoea.

91
Q

What is the acronym used to remember the components of MEN-1?

A

Parathyroid tumours, Pituitary tumours, Pancreatic hormone-secreting tumours.

92
Q

What is the characteristic sign of sigmoid volvulus on imaging?

A

“Coffee bean” sign.

93
Q

Define Liver Cirrhosis.

A

Irreversible liver damage with loss of normal hepatic architecture

93
Q

What is Hepatorenal Syndrome (HRS)?

A

Renal failure in chronic liver failure

94
Q

Name the risk factors for Liver Cirrhosis

A

Hepatitis B, hepatitis C, autoimmune hepatitis, alcoholic hepatitis, Wilson’s disease, hemochromatosis, A1AT deficiency, Budd-Chiari syndrome

95
Q

What are the complications of Liver Cirrhosis?

A

Chronic liver failure, portal hypertension, malnutrition, vitamin deficiencies, impaired immunity, HCC, HRS

96
Q

How is Liver Cirrhosis diagnosed?

A

Transient elastography (fibroscan), thrombocytopenia (sensitive), Child-Pugh score

96
Q

What is the treatment for Alcoholic Hepatitis?

A

Abstinence, benzodiazepine-reducing protocol, supportive care.

97
Q

How is Hepatitis A transmitted?

A

Faecal-oral transmission.

98
Q

Define Gilbert’s Disease.

A

Autosomal recessive disorder. Leading to jaundice during intercurrent illness

99
Q

What is Wilson’s Disease?

A

Autosomal recessive disorder with copper accumulation, affecting the liver, brain, and cornea.

100
Q

Name the complications of Hemochromatosis.

A

Liver disease, joint symptoms, skin bronzing, fatigue, diabetes, hypogonadism.

101
Q

What is Spontaneous Bacterial Peritonitis (SBP)?

A

Ascites infection with no identifiable cause, commonly seen in liver cirrhosis.

102
Q

Describe Acute Cholecystitis.

A

Inflammation of the gallbladder, often due to gallstones, with symptoms of RUQ pain, Murphy’s sign, and pyrexia.

103
Q

What does SAAG measure in Ascites?

A

Serum Ascites Albumin Gradient; helps differentiate between portal and non-portal hypertension.

104
Q

What are the classifications of Jaundice?

A

Pre-hepatic, hepatic, post-hepatic; unconjugated vs. conjugated bilirubinemia.

105
Q

What are the symptoms of Ascending Cholangitis?

A

RUQ pain, fever, jaundice, part of Charcot’s triad.

106
Q

How is Hepatitis B serology interpreted?

A

HBsAg indicates current infection, anti-HBs indicates recovery and immunity.

107
Q

What is the primary treatment for Primary Biliary Cholangitis (PBC)?

A

Ursodeoxycholic acid ± prednisolone PO.

108
Q

What is Primary Sclerosing Cholangitis (PSC) associated with?

A

Ulcerative colitis.

109
Q

What is the primary cause of Pre-hepatic Unconjugated Bilirubinaemia?

A

Haemolysis.

110
Q

What is the primary risk factor for Hepatocellular Carcinoma (HCC)?

A

Liver cirrhosis, especially secondary to hepatitis B or C.

111
Q

What is the mainstay treatment for hepatic encephalopathy

A

Lactulose

111
Q

Differentiate between Hepatitis A and Hepatitis B transmission

A

Hepatitis A is transmitted faecal-orally, while Hepatitis B transmission can be parenteral, sexual, or perinatal

111
Q

What are the diagnostic criteria for Acute Cholecystitis?

A

RUQ pain, Murphy’s sign, abdominal mass, right shoulder tip pain, pyrexia, anorexia, N&V.

112
Q

What is the primary treatment for Wilson’s Disease affecting the liver?

A

Penicillamine or trientine + zinc + dietary management

113
Q

How is Hemochromatosis diagnosed?

A

Transferrin (>45%), ferritin (high), TIBC (low), and genetic testing are used for diagnosis.

114
Q

What is the primary treatment for Spontaneous Bacterial Peritonitis (SBP)?

A

Cefotaxime IV

115
Q

How is Hepatitis E primarily transmitted, and what is its prognosis in pregnancy?

A

Faecal-oral transmission; high mortality in pregnancy.

116
Q

What are the common causes of Acute Pancreatitis?

A

Gallstones, alcohol, and drugs.

117
Q

Provide the mnemonic ‘I GET SMASHED’ for Acute Pancreatitis causes

A

Idiopathic, Gallstones, Ethanol, Trauma, Steroids, Mumps, Autoimmune, Scorpion bites, Hyperlipidaemia/Hypercalcaemia/Hypothermia, ERCP, Drugs (mesalazine > sulfasalazine, sodium valproate).

118
Q

Describe Cullen’s sign in Acute Pancreatitis.

A

Bruised umbilicus.

119
Q

Explain the significance of Grey-Turner’s sign in Acute Pancreatitis.

A

Bruised flanks.

120
Q

What is the diagnostic importance of lipase and CCT in Acute Pancreatitis?

A

Lipase and CCT (contrast-enhanced computed tomography) are crucial for diagnosis.

121
Q

Outline the treatment approach for Acute Pancreatitis caused by gallstones without cholangitis.

A

Cholecystectomy.

122
Q

What is the primary treatment for Acute Pancreatitis caused by alcohol?

A

Benzodiazepine reducing dose protocol.

123
Q

What is the leading cause of Chronic Pancreatitis?

A

Alcohol

124
Q

List the risk factors for abdominal aortic aneurysms

A

Smoking, family history, increasing age, male sex, connective tissue disorders

125
Q

Explain the concept of ‘Courvoisier’s law’ in Pancreatic Cancer.

A

Palpable gallbladder + painless obstructive jaundice suggests it is unlikely to be gallstones.

126
Q

Differentiate between Inguinal Hernias - Direct and Indirect.

A

Direct hernias pass directly forwards through a defect in the posterior wall, while indirect hernias pass indirectly through the deep ring.

127
Q

What is the primary risk factor for Femoral Hernias?

A

Female sex

128
Q

What is the preferred treatment for Abdominal Aortic Aneurysms if indicated?

A

EVAR (Endovascular Aneurysm Repair).

129
Q

How is severity assessed in Chronic Pancreatitis?

A

CT scan.

130
Q

Describe the primary diagnostic marker for Pancreatic Cancer.

A

CA 19-9

131
Q

Provide the genetic basis and clinical features of Wilson’s Disease.

A

Autosomal recessive; features include liver disease (in children), neurological/psychiatric symptoms (in young adults), and Kayser-Fleisher rings.

132
Q

Define Alpha-1 Antitrypsin (A1AT) Deficiency, its inheritance, and clinical manifestations.

A

Autosomal recessive or co-dominant; manifestations include emphysema and liver cirrhosis.

133
Q

Outline the characteristics and causes of Budd-Chiari Syndrome.

A

Hepatic venous outflow tract obstruction; causes include polycythaemia vera, thrombophilia, pregnancy, and OCP use.

134
Q

Explain the classification of Jaundice based on bilirubin levels and causes.

A

Pre-hepatic (increased unconjugated), hepatic (increased both), post-hepatic (increased conjugated).

134
Q

Describe the bilirubin metabolism process and its key enzymes.

A

Formation from RBCs, conversion to unconjugated bilirubin, conjugation in the liver, and excretion through bile.

134
Q

Provide examples of causes for Unconjugated Bilirubinaemia.

A

Hemolytic anaemia, Gilbert’s syndrome

135
Q

List common causes of both Unconjugated and Conjugated Bilirubinaemia.

A

Viral hepatitis, autoimmune hepatitis, alcoholic hepatitis, Wilson’s disease, hemochromatosis, A1AT deficiency, etc.

136
Q

Which enzyme is used to monitor pancreatic exocrine function in pancreatic cancer?

A

Faecal elastase

137
Q

What causes epiglottitis?

A

Haemophilius influenza

138
Q

What causes croup ?

A

Parinfluenza virus

139
Q

What causes Slapped cheek syndrome?

A

Parvovirus 19

140
Q

What causes hand, foot and mouth disease?

A

Coxsackie virus

141
Q

What causes bronchiolitis?

A

RSV

142
Q

1st line investigation in Budd-Chiari syndrome

A

ultrasound with Doppler flow

143
Q

Investigation of choice in acute cholecystitis

A

Abdominal USS

144
Q

Which test is used in diagnosing and monitoring the severity of liver cirrhosis

A

Transient elastography

145
Q

Treatment of choice for biliary colic

A

Elective laparoscopic cholecystectomy

146
Q

Preferred imaging modality for suspected perforated peptic ulcer

A

Erect CXR

147
Q

How do we differentiate between ascending cholangitis and acute cholecystitis on LFTs

A

Normal LFTs in acute cholecystitis, deranged in ascending cholangitis

148
Q

Most common causative pathogen of ascending cholangitis

A

E coli

149
Q

Histological findings in Crohn’s disease

A

Increased goblet cells, granuloma, transmural inflammatory cell infiltrate

150
Q

Histological findings in UC

A

Inflammatory cell infiltrate is limited to the mucosa and submucosa only, focal crypt accesses, depletion / no goblet cells

151
Q

Which antibiotic is used in Crohn’s peri-anal abscess/disease?

A

Metronidazole

152
Q

Which medication is used as prophylaxis for Spontaneous Bacterial Peritonitis?

A

Ciprofloxacin

153
Q

Which medications cause c.difficile?

A

CLINDAMYCIN, 2nd and 3rd generation cephalosporins, PPIs

154
Q

Histology of c.difficile

A

Gram positive rod

155
Q

Pathophysiology of c.difficile

A

Infection with the gram positive rod following decrease / change to normal gut flora (subsequent to clindamycin/cephalosporin/PPIs) which leads to entotoxin release. This causes pseudomembranous colitis

156
Q

What is seen in severe c.difficile infection

A

Toxic megacolon / severely raised WCC

157
Q

When is oral fidaxomicin used in c.diff?

A

If recurrence of infection within 12 weeks of infection / if oral vancomycin fails

158
Q

Most common cause of traveller’s diarrhoea

A

E coli

159
Q

Investigation of choice in colorectal cancer

A

Rigid sigmoidoscopy +/- biopsy

160
Q

Biopsy changes in ulcerative colitis

A

Continuous Inflammation / Goblet Cell Depletion / Ulceration / Pseudopolyps / focal crypt abscesses

161
Q

Biopsy changes in coeliac disease

A

Villous Atrophy / Crypt Hyperplasia / Intraepithelial Lymphocytes

162
Q

Imaging of choice for primary sclerosing cholangitis (UC complication)

A

MRCP

163
Q

Triple therapy in H pylori infection

A

PPI + amoxicillin + clarithromycin

164
Q

Causes of upper GI bleed

A
  • Perforated PUD
  • Variceal haemorrhage / portal hypertension
  • Mallory Weiss Tear
  • Malignancy
  • Oesophagitis
  • Gastritis
165
Q

Which vessel causes upper GI bleed in perforated PUD?

A

Gastroduodenal artery

166
Q

Immediate interventions as an FY1 in upper GI bleed / major haemorrhage

A
  • Call the on-call surgeons / endoscopist / your senior
  • Protect the airway
  • High flow oxygen through trauma mask / non-rebreather marks
  • Large bore IV access
  • Urinary catheter
  • Fluid resuscitation
  • O negative blood
  • ABG / VBG
  • CXR
  • ECG
  • Make NBM
  • FBC, U&E, Cross match / group and save
167
Q

How do we differentiate between ileostomy and colostomy on examination?

A
  • Ileostomy is spouted vs colostomy flushed to skin
  • Ileostomy has liquid contents vs colostomy contents more solid
168
Q

Which type of anal fissure should make you suspect colorectal cancer?

A

Lateral anal fissure

169
Q

Treatment of choice for diarrhoea in IBS

A

Loperamide

170
Q

Which type of laxative do we avoid in opiate-caused constipation?

A

Bulk-forming

171
Q

Which type of laxative do we use in opiate-caused constipation?

A

Stimulant / osmotic laxative

172
Q

Pathophysiology of Mirzzi syndrome

A

Common hepatic duct obstruction
Caused by extrinsic compression from an impacted stone In the cystic duct or infundibulum of the gallbladder

173
Q

Causes of acute confusion in liver cirrhosis

A

Hepatic Encephalopathy, Intracerebral bleed, Electrolyte or Vitamin Deficiency, Alcohol Withdrawal (Wernicke’s Encephalopathy), Sepsis (eg. Spontaneous Bacterial Peritonitis), GI Bleeding (varices), Drugs

Chat GPT (18 decks)

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