Gastroenterology Flashcards
Jaundice, non-tender palpable enlarged gallblader:
Courvoisier’s sign, think malignancy (cholangiocarcinoma or pancreas)
Middle-aged woman, impaired LFTs, pruritus, Sjogren, AMA positive, diagnosis and management:
Primary biliary cholangitis, Ursodeoxycholic acid
Hereditary pattern of haemochromatosis:
AR
C difficile infection not responding to oral vanc or oral fidaxomicin
Oral vanc + IV metronidazole
Antibiotic that causes cholestasis:
Co-amoxiclav
DM drug that causes cholestasis:
Sulphonylureas (gliclazide)
Management for suspected bleeding varices before endoscopy:
Terlipressin and IV antiniotics (quinolones)
Double duct sign on imaging:
Pancreatic cancer
Long-term disadvantage of PPIs
Osteoporosis and fractures
Treatment and secondary prophylaxis for hepatic encephalopathy:
Lactulose, rifaximin.
Diarrhoea, floating stools, swimming in pools:
Giardia
Most common site affected by Crohn’s and UC:
Ileum, rectum
Patient listed for endoscopy, recommendations on omeprazole?
Stop taking omeprazole 2 weeks before endoscopy
First-line to maintain remission in left-sided or extensive ulcerative colitis:
Oral aminosalicylate (mesalazine)
Incidenctal finding of NAFLD, next step:
Enhanced liver fibrosis blood test (ELF)
Patient with ascitis presents with abdominal pain and fever, investigation and diagnosis:
Paracentesis, spontaneus bacterial peritonitis confirmed by neutrophil count >250 cells/ul
Mild-to-moderate flare of ulcerative colitis (<6 stools/day, no systemic upset) management:
Topical aminosalicylate, if no remission in 4 weeks, add oral aminosalicylate
Severe flare of ulcerative colitis (>6 stools/day + systemic upset) management:
IV steroids
IV ciclosporin 2nd line
Most accurate determinant of acute liver failure as it is a measurement of the liver’s synthetic function:
Prothrombin time
First line for constipation in IBS
Ispaghula husk, lactulose produces gas
Blood film findings in coeliac disease:
Target cells and Howell-Jolly bodies may be seen in coeliac disease → hyposplenism
Watery travellers diarrhoea with stomach cramps and nausea:
Enterotoxigenic E. coli
Treatment for Helicobacter Pylori in allergic to penicillin and non-allergic:
Allergic: PPI + metro + clarithro
Non-allergic: PPI + amoxi + clarithro
