Gastroenterology Flashcards
Which antibiotics are associated with cholestasis?
flucloxacillin, co-amoxiclav, erythromycin
Which anti-emetic should be avoided in bowel obstruction?
Metoclopramide
What is the preferred laxative in IBS?
Ispaghula husk
Which anti-emetic is best in migraines?
Metoclopramide
Which haematological malignancy is coeliac disease associated with?
enteropathy-associated T cell lymphoma
What is the most common affected site in crohn’s?
The ileum
Which clotting factors are low in liver failure?
In liver failure all clotting factors are low, except for factor VIII which is paradoxically supra-normal. This is because factor VIII is synthesised in endothelial cells throughout the body, unlike the other clotting factors which are synthesised purely in hepatic endothelial cells.
How do you work out how many units in a bottle of alcohol?
multiply the number of millilitres by the ABV and divide by 1,000.
% alcohol on a bottle = number of units if you drank 1 litre of it.
How long before endoscopy do you need to stop a PPI?
2 weeks
Which part of the iron studies are most useful for monitoring haemochromatosis?
Ferritin and transferrin saturation
Which type of imaging for investigating fistuals in crohn’s disease?
MRI
Which medication used in IBD can cause agranulocytosis?
Aminosalicylates are associated with a variety of haematological adverse effects, including agranulocytosis - FBC is a key investigation
Which test is used to see whether H.pylori has resolved?
What medications need to be stopped to make this test reliable?
Urea breath test
No antibiotics in the past 4 weeks, no anti-secretory drugs (e.g. PPI) in past 2 weeks
Which blood group is associated with an increased risk of developing gastric cancer?
Blood group A
What should be given to patients with UGI bleed before endoscopy?
Terlipressin and prophylactic antibiotics
Which type of cancer does achalasia increase the risk of ?
Squamous cell carcinoma of the oesophagus
What medication is used first line in crohn’s to maintain remission?
Azathioprine
What is the ‘double duct’ sign on MRCP suggestive of?
The ‘double duct’ sign on MRCP is when there is dilatation of both the common bile duct and pancreatic duct which is usually indicative of pancreatic cancer (typically the head of the pancreas).
Patients with cirrhosis and low ascitic protein concentraiton (<15) should be given which antibiotic as prophylaxis against SBP?
Ciprofloxacin
Which diabetes medication is associated with cholestasis?
Gliclazide
Which antibodies are tested for to investigate B12 deficiency?
Intrinsic factor antibodies
Which anti-emetic is contra-indicated in GI obstruction and shouldn’t be given to children?
Metoclopramide
Which patients shouldn’t be given H1 receptor antagonists as anti-emetics? (cyclizine, cinnarizine, promethazine)
Hepatic encephalopathy / prostatic hypertrophy
Which anti-emetic should be avoided in diverticulitis, IBD, colitis, megacolon and strictures?
Ondansetron
What is achalasia?
Impaired relaxation of the lower oesophageal sphincter
Which ulcer is worsened by eating?
Gastric ulcers.
What is the most common cause of food poisoning?
Campylobacter
What is fulminant hepatic failure?
Encephalopathy + jaundice in < 2 weeks from a previously normal liver
What causes pre-hepatic jaundice?
Excess haemolysis (haemolytic anaemia) - there is increased bilirubin entering the liver
What causes intra-hepatic jaundice?
Injury of hepatocytes - hepatitis, drugs, cirrhosis
In which condition can you see AST> ALT?
Cirrhosis
