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MHU > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

What is rigler’s sign?

A

On AXR, can see both sides of the bowel wall due to gas inside and outside of the lumen

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2
Q

What is the function of chief cells and what do they look like on histological staining?

A

Vagal stimulation > pepsinogen (converted to pepsin by HCl) + gastric lipase
Eosinophilic (purple) cytoplasm

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3
Q

What is the function of parietal cells and what do they look like on histological staining?

A

Secrete HCl and intrinsic factor (for B12 absorption)

Pale cytoplasm, located in fundus

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4
Q

What do G cells secrete and what is the function of this hormone?

A

Stomach distension > gastrin > HCl secretion

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5
Q

Which hormones stimulate HCl secretion from parietal cells in the stomach?

A

Histamine (most significant contributor)
Gastrin
Acetylcholine

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6
Q

Where are the following nutrients absorbed?

(a) B12
(b) Folate
(c) Iron
(d) Ethanol
(e) Thiamine

A

(a) Ileum
(b) Jejunum
(c) Duodenum
(d) 20% in stomach, 80% in duodenum + jejunum
(e) Jejunum

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7
Q

What factors decrease the absorption of folate from the gut?

A

OCP, vegan diet, alcohol, phenytoin

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8
Q

What is the classic triad of late haemochromatosis?

A

Skin pigmentation, diabetes mellitus, liver cirrhosis

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9
Q

What LFT abnormalities are present in alcoholic liver disease?

A

Elevated GGT, AST:ALT >2

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10
Q

What LFT abnormalities are present in viral hepatitis?

A

Hepatocellular picture: increased ALT, AST > GGT, ALP

AST:ALT <1

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11
Q

What LFT abnormalities indicate a cholestatic picture?

A

Increased GGT, ALP > AST, ALP

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12
Q

What does elevated alpha fetoprotein indicate?

A

Hepatocellular carcinoma
Germ cell tumours
Metastatic cancers of the liver

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13
Q

What blood test findings would indicate immunity and current infection with HBV?

A

Anti-HBsAg present = immune
HBsAg present = current infection
HBcAg present = recent or current infection (not immunity)

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14
Q

What is the Child-Pugh score based on?

A 
Ascites
Encephalopathy
Albumin
INR
Bilirubin
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15
Q

What is the first-line management for portal hypertension?

A

Non-selective beta-blockers (e.g. propanolol)

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16
Q

What are the diagnostic features of coeliac disease?

A

Anti-transglutaminase antibodies (Anti-tTG)
Villous atrophy on biopsy
Antiendomysial IgA antibodies

17
Q

What investigations can be ordered to investigate dysphagia?

A
  1. Endoscopy
  2. Barium Swallow
  3. Manometric Assessment
18
Q

What is achalasia?

A

Disorder of the lower oesophageal sphincter (unable to relax)

19
Q

What is Barrett’s oesophagus?

A

Metaplasia of epithelium in lower oesophagus due to chronic reflux oesophagitis

20
Q

What are the causes of acute blood diarrhoea?

A 
C - Campylobacter
H - Haemorrhagic E. Coli
E - Entamoeba histolytica
S - Salmonella
S - Shigella
21
Q

What foods may contain staph aureus?

A

Unrefrigerated meat + dairy products (e.g. custard, potato salad, mayonaise)

22
Q

Which bacteria is associated with a ‘rose spot’ rash that precedes the onset of diarrhoeal illness?

A

Salmonella Typhi (typhoid fever)

23
Q

What is the most common cause of viral diarrhoea in children < 3 years?

A

Rotavirus

24
Q

What protozoans are known to cause traveller’s diarrhoea?

A

Giardia
Entamoeba histolytica
Cryptosporidium
Cyclospora

25
Q

What is the triple therapy for H. Pylori erradication?

A

Amoxycillin, Clarithromycin, high-dose PPI (e.g. omeprazole)

26
Q

During H. Pylori eradication, should aspirin be ceased?

A

Aspirin can be continued with PPI cover

27
Q

Which organs are retroperitoneal?

A 
S - Suprarenal (adrenal) glands
A - Aorta / IVC
D - Duodenum (parts 2-4)
P - Pancreas
U - Ureters
C - Colon (ascending + descending)
K - Kidneys
E - Oesophagus
R - Rectum
28
Q

What conditions may be associated with autoimmune pancreatitis?

A 
Hashimoto's thyroiditis (hypothyroidism)
Vitiligo
Sjogren's syndrome
Primary sclerosing cholangitis
Inflammatory bowel disease
29
Q

What conditions may cause an isolated rise in ALP?

A 
Bone disease (e.g. Paget's disease, malignancy, fractures)
Severe cardiac disease
Systemic inflammation
Biliary tract / liver disorders
Third trimester of pregnancy
30
Q

What causes an elevation of GGT?

A 
Excessive alcohol intake
Enzyme induction (e.g. anticonvulsants)
Liver disease (in conjunction with other enzymes)
31
Q

Give 3 differential diagnoses for hypoalbuminaemia.

A

Liver cirrhosis
Malnutrition / starvation / coeliac disease
Nephrotic syndrome
Haemodilution in pregnancy
Malignancy (increasing rate of degradation)

32
Q

What key social history information must be gathered from a patient with suspected liver disease?

A

Alcohol consumption
IV drug use, tattoos and piercings
Weight / BMI

33
Q

What is the management for acute alcoholic pancreatitis?

A

Analgesia
IV fluid
Completely rest bowel (NBM) to avoid stimulation
Give thiamine and treat alcohol withdrawal

34
Q

What are the clinical features of cholestasis?

A

Jaundice of skin / icterus of sclera
Pruritis / scratch marks
Dark urine
Pale stools

35
Q

What percentage of people with chronic HCV infection will develop cirrhosis?

A

20%

36
Q

How is hydration status determined?

A 
Urine output (quantity and colour)
HR and BP
Capillary refill
Oral mucosa
Skin turgor

MHU (14 decks)

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