Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

SAQ for finals > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

List 4 differential diagnoses for chronic diarrhoea in a man in their 20s

A

UC
Crohn’s
IBS
Parasitic infection
Coeliac
Medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name a basic test and an invasive test to help diagnose chronic diarrhoea

A

Basic test:
Faecal calprotectin
CRP
FBC (anaemia or WCC)
Vitamin B12
Coeliac screen
Amylase

Invasive test:
Colonoscopy and biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List 2 histological features of Crohn’s disease

A

Granuloma formation
Transmural inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Compare Crohn’s and UC in

a) endoscopic appearance
b) distrubition in body

A

a) Crohn’s - transmural; UC - superficial mucosa, Crohn’s - skip lesions; UC - continuous

b) Crohn’s - entire GI tract (especially terminal ileum); UC - rectum to colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List 2 extraintestinal features of IBD

A

Uveitis
Erythema nodosum
Pyoderma gangrenosum
Arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why are steroid-sparing agents (azathioprine and methotrexate) useful in IBD?

A

Better side effect profile than steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

List 2 serious complications from long term Crohn’s disease

A

Bowel cancer
Perforation
Obstruction
Perianal abscess and fistulae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Infliximab is a monoclonal antibody that can reduce Crohn’s disease activity. How does it work?

A

Antibody against TNF (important in inflamation and granuloma formation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

List 4 causes of upper GI bleeding

A

Gastric ulcer (peptic/duodenal)
Gastric cancer
Oesophogeal varices
Mallory-veiss
Oesophageal perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What 3 medications can contribute to an upper GI bleed

A

PPIs
Steroids
NSAIDs
Anticoagulants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What may be gained from a rectal examination in upper GI bleeding

A

Presence of malaena is evidence of large blood loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hb vs Urea:Creatinine in acute blood loss

A

A fall in Hb may not be seen very soon after bleeding as haemodilution hasn’t occurred, if urea is raised out of proportion to creatinine this is a better indication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What diagnostic investigation is indicated in upper GI bleeding

A

Urgent OGD (oesophagogastroduodenoscopy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What class of medication can be given in upper GI bleeding?

A

PPIs

Do not use a PPI until after endoscopy in patients with non-variceal upper GI bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What disease is oesophageal varices commonly associated with? What is the mechanism?

A

Liver cirrhosis - venous portal hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name a site of portosystemic anastomoses and the symptom it would cause

A

Rectal (superior) vein shunt: haemorrhoids
Paraumbilical vein shunt: caput medusae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Name an endoscopic treatment of oesophageal varices

A

Variceal band ligation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Other than peptic ulcer disease, name 2 differential diagnoses for dyspepsia

A

GORD
Gastritis
Oesophagitis
Duodenitis
Malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name 2 symptoms that would alert you to the possibility of upper GI malignancy with dyspepsia

A

Symptoms of anaemia
Weight loss
Loss of appetite
Dysphagia
Melaena or haematemesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

List 2 risk factors for peptic ulcer disease

A

H. pylori
NSAIDs
smoking
physiological stress e.g. ITU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Explain the basis of H.pylori breath test

A

H. pylori releases urease to break down urea into ammonia and CO2

Radioisotope in the form of urea is ingested and if H.pylori is present the radioisotope CO2 can be measured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the management for H.pylori eradication?

A

7 day course of PPI + 2 antibiotics (amoxicillin + clarithromycin OR metronidazole)

penicillin allergic: clarithro + metro

ongoing symptoms: switch whichever was not used 1st line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What radiological investigation would you use to look for possible perforation in acute upper abdo pain?

A

Erect chest X-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What sign would you be looking for on X-ray in GI perforation e.g. peptic ulcer?

A

pneumoperitoneum (free air under the diaphragm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Red flag symptoms of peptic ulcer and which investigation would be required
Aged >55 years with weight lOss and either upper abdominal pain, reflux, or dyspepsia New-onset dysphaGia New onset Dyspepsia not responding to PPI treatment Investigation: OGD
26
Zollinger-Ellison syndrome
Ectopic gastrin usually from a pancreatic gastrinoma causes peptic ulcers
27
What is the definition of GORD?
excessive entry of gastric contents into the oesophagus through the gastro-oesophageal junction
28
List 2 exacerbating factors of GORD
lying flat straining drugs alcohol obesity food hiatus hernia
29
Patient with GORD has nocturnal wheeze with no history of asthma, what could be causing the wheeze?
Inhalation of small amounts of gastric contents
30
Lifestyle changes in GORD
Weight loss smoking cessation reduce alcohol avoid large meals avoid eating before bedtime sleep on an incline
31
Name 2 causes of dysphagia
Mediastinal lymph nodes Pharyngeal pouch Malignant stricture Extrinsic pressure from lung cancer Mysathenia gravis
32
Explain the term 'oesophageal metaplasia' and its cause in Barrett's oesophagus
A change in lower oesophageal squamous epithelium into columnar epithelium caused by recurrent damage
33
Gold standard for test for proving reflux
Ambulatory pH monitoring
34
What is nissen fundoplication and how does it help reflux? Complication?
Fundus wrapped around the abdominal oesophagus -> creates GOJ sphincter can cause dysphagia
35
Give one example for each of the following causes of jaundice: a) prehepatic b) intrahepatic c) obstructive
a) Haemolytic anaemia: sickle cell, thalassaemia, G6PD b) Hepatitis: viral, paracetamol overdose, alcoholic, autoimmune c) Ascending cholangitis, pancreatic cancer, PBC, PSC
36
What is bilirubin a breakdown product of?
Haemoglobin
37
Dark urine and pale stools Type of jaundice?
Obstructive
38
Why does conjugated bilirubin appear in the urine and unconjugated bilirubin doesn't?
conjugated bilirubin is water-soluble, so dissolves in urine (making it dark)
39
What non-invasive radiological investigation is indicated in obstructive jaundice?
US abdo
40
8-mm dilated CBD and pancreatic mass - which invasive procedure could be diagnostic and therapeutic?
ERCP + stenting
41
What is the commonest histological type of pancreatic carcinoma?
Adenocarcinoma, islet cell tumours
42
Name 2 other symptoms and signs of pancreatic cancer
Jaundice Epigastric pain Back pain Weight loss Dyspepsia Pruritis Hepatomegaly from mets
43
Tumour marker used to monitor response to pancreatic cancer treatment?
CA19-9
44
Name a complication of persistent jaundice
malabsorption increased susceptibility to infection acute renal failure
45
raised ALT > raised AST
Hepatic
46
Routes of spread of hepatitis
Hep A: oral/faecal Hep B: bodily fluids Hep C: bodily fluids Hep D: with Hep B Hep E: oral/faecal
47
List two at risk groups for hepatitis B and ways to reduce risk
IVDU (avoid sharing needles, ensure single use) sex workers (condoms) healthcare workers (wash hands thoroughly after potential exposure)
48
What does having antibodies to hepatitis B core antigen (Anti-HBc) in the serum signify?
past infection (burrowed deep)
49
Name 2 long-term complications of hepatitis B
Liver cirrhosis Hepatocellular cancer
50
What should a healthcare worker do if they sustain a needle stick injury from a Hep B positive patient
Bleed and wash the site Take post-exposure prophylactic treatment
51
Name 2 viruses that a Hep B+ patient may be co-infected with
Hep D Hep C HIV
52
What is the commonest cause of liver cirrhosis in the UK?
alcohol abuse
53
Name an example of both a) a hereditary cause of cirrhosis and b) an acquired cause of cirrhosis
a) a1aT, haemochromatotis, Wilson's b) hepatitis
54
Name 2 signs of chronic liver disease that you may find on examination
leuconychia spider naevi clubbing gynaecomastia hepatosplenomegaly ascites
55
Name 2 investigations to test the synthetic function of the liver
albumin INR/PT (clotting factors)
56
Name 2 complications of cirrhosis
Coagulopathy Encephalopathy Hypoalbuminaemia Sepsis Spontaneous bacterial peritonitis Hypoglycaemia
57
Management of ascites
Fluid restriction Low sodium diet Diuretics Abdominal paracentesis Albumin infusion
58
Name 2 investigations of ascitic fluid you should order in the management of ascites
WCC MC&S Cytology Albumin/LDH/glucose
59
Why is lactulose given in hepatic encephalopathy?
Increasing bowel transit reduces the number of nitrogen-producing bacteria in the gut (which contribute to HE)
60
What is the only definitive treatment for liver cirrhosis?
Transplant
61
Other than coeliac disease, list 2 other causes of GI malabsorption
Crohn's disease Chronic pancreatitis Cystic fibrosis
62
Presentation of coeliac disease
Chronic abdominal pain Unintentional weight loss Steatorrhoea Iron-deficiency anaemia Failure to thrive Infertility IgA defiency Rash (dermatitis herpetiformis)
63
What is the aetiology of coeliac disease?
autoimmune disease where gluten proteins are presented to T cells causing small bowel tissue inflammation
64
Give 4 examples of gluten
Wheat Rye Barley Malt
65
Blood test for coeliac
Tissue transglutaminase
66
Why might IgA antibodies be negative in severe malabsorption in coeliac disease
Severe malabsorption can cause deficiency in proteins including IgA
67
Name a feature of coeliac disease on histology
Villous atrophy Crypt hyperplasia Increased intraepithelial lymphocytes
68
What is the treatment of coeliac disease
Gluten free diet
69
Name 2 autoimmune diseases that coeliac disease may be associated with
T1DM Thyroid disease
70
Name 2 cancers associated with coeliac disease
Gastric Oesophageal
71
Give an example of the following causes of constipation: drug-induced, mechanical and lifestyle
Drug-induced: opioids, iron Mechanical: colorectal cancer, pelvic mass, stricture Lifestyle: lack of fibre, dehydration, immobility
72
Name 4 symptoms of IBS
alternating constipation and diarrhoea abdominal pain pain relief on defecation bloating
73
Why are FBC, TFT and sigmoidoscopy performed in IBS?
To rule out organic disease Anaemia Hyper or hypothyroid IBD, polyps, bowel cancer?
74
Name a psychological disorder associated with IBS
anxiety / depression
75
Name 2 predisposing factors for colonic carcinoma
Low fibre diet UC Crohn's FAP HNPCC
76
Name a site where colorectal cancer may metastasise
Liver Lung Bone
77
Name 2 bacteria that may cause acute diarrhoea
E. coli Salmonella shigella Campylobacter
78
Name a viral cause of gastroenteritis
norovirus, rotavirus, adenovirus
79
Name 3 symptomatic treatments in gastroenteritis
Anti-emetic Analgesia Fluid rehydration (oral or IV)
80
Medication for c.diff
oral vancomycin
81
Opioid induced constipation management
osmotic laxative + stimulant laxative *Bulk-forming laxatives should be avoided*
82
Definition of a hernia
Protrusion of part or whole of an organ or tissue through the wall of the cavity that normally contains it
83
Difference between direct and indirect inguinal hernias in terms of how they enter the canal
Direct: bowel enters the inguinal canal ‘directly’ through a weakness in the posterior wall of the canal Indirect: enters the inguinal canal via the deep inguinal ring
84
Type of inguinal hernia more commonly seen in infants and pathophysiological basis
Indirect because of patent processus vaginalis
85
Which marker gives a direct count of the viral load in Hep B?
HBV DNA
86
What hepatitis B serological marker is a) injected in the hepatitis B vaccine / indicates current infection b) indicates immunity
a) HBsAg b) HBsAb (anti-HBs)
87
Type of viral hepatitis with a vaccine
A and B (they are working their way down the list)
88
Ulcerative colitis biopsy findings
Crypt abscesses Inflammation is present in the mucosa and submucosa only Ulceration
89
2 classes of drugs used to treat UC
Aminosalicylates Corticosteroids
90
UC associated condition presenting with RUQ pain + jaundice and imaging investigation
Primary sclerosing cholangitis MRCP
91
Scoring system used to stratify upper GI bleed and determine further investigation
Glasgow blatchford
92
2 blood tests to consider in upper GI bleed pt
FBC (anaemia 2/2 blood loss) Group & save (matched blood if transfusion is needed) U&Es (urea may be raised in upper GI bleeding)
93
Scoring system used post endoscopy to determine risk of rebleeding
Rockall score
94
3 lifestyle changes for peptic ulcer disease if they don't smoke or drink
Healthy eating (high levels of dietary fibre, fruits and vegetables) Avoid trigger foods Eating smaller meals Raise the head in the bed Eat the evening meal 3-4 hours before bed
95
2 clinical signs of ascites
Shifting dullness Fluid thrill
96
2 blood tests to examine synthetic liver function
INR Albumin
97
3 potential causes of confusion in a cirrhosis pt
Hepatic encephalopathy Alcohol withdrawal (Wernick'es encephalopathy) Sepsis e.g. SBP

SAQ for finals (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions