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Medicine Year 4 > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

Score to assess alcohol withdrawal?

A

CIWA scale

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2
Q

Criteria for assess liver transplant feasibility?

A

King’s College Criteria

Looks at pH, PT, bilirubing, creatinine, hep viruses.
Depends on aetiology of liver failure (i.e. paracetamol overdose or not)

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3
Q

Organisms that can cause cholangitis?

A

OPPORTUNISTIC VIRUSES

CMV
Candida
TB
cryptosporidium

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4
Q

LFTs - ALT & AST found in…

A

Hepatocytes

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5
Q

LFTs - gGT & ALP found in…

A

Cholangiocytes

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6
Q

LFTs - INR, why?

A

INR is a measure of prothrombin ACTIVATIN (i.e. a ration) 12 -14 seconds

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7
Q

Albumin and Bilirubin, what do these say?

A

Albumin - synthetic function of the liver

Bili - most useful in assessing if someone is getting better?

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8
Q

Causes of acute liver failure?

A 
PARACETAMOL (90%)
Viral
Autoimmune 
Pregnancy
Cancer
Wilson's (copper accumulation)
Budd-Chiari Syndrome
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9
Q

Schistosomiasis can cause portal HTN

A

just know this…

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10
Q

What is achalasia?

A

Absent oesophogeal mesenteric plexus resulting in no peristalsis, dysphasia and regurgitation

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11
Q

What is the most common side effet of bisphosphenates?

A

Irritation, inflammation and ulceration of the oesophagus

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12
Q

What clinical picture can a pancreatic mass (carcinoma) give you?

A 
Weight loss
Obstructive jaundice (increased bili, ALP, GGT)
Abdo discomfort
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13
Q

What investigation does dypepsia in someone over 55 warrant?

A

Urgent endoscopy

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14
Q

In managing dyspepsia, what are the ALARMS symptoms?

A 
A - anaemia
L - Loss of Weight
A - anorexia
R - recent onset of progressive symptoms 
M - melaena/haematemisis
S - swallowing difficulty
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15
Q

How do you manage suspected H. pylori?

A

If red flag symptoms present then empirical treatment (triple therapy omeprazole, amoxicillin and clarithromycin)

If none, then test with fecal antigen test

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16
Q

What causes peripheral oedema in liver failure?

A

Low levels of serum albumin due to faltering synthetic function of the liver

17
Q

How long should a person not have eaten solid food for before you consider TPN?

A

7 days without eating food

18
Q

How does an anal fissure cause constipation?

A

Profound fear of passing stools

19
Q

What are the complications of Crohn’s disease?

A 
Small bowel obstruction
Fistulae
Osteoperosis
Bowel cancer
Stones

Joints - arthritis
Skin - pyoderma gangrinosum and errythema nodosu
Eyes - uveitis
Liver - Primary Sclerosis Cholangitis (PSC) -> cirrhosis
Oral Ulcers

20
Q

What is tenesmus?

A

Sensation of incomplete passing of stools - indicates possible rectal Ca

21
Q

What is the clinical picture in someone who is suffering from a bleeding ulcer?

A

Hypotension, melaena, long term steroid use

22
Q

What should happen if a patient requires a procedure/operation but they are acutely confused and mentally disorientated that they cannot provide consent?

A

A doctor can sign the consent form as a proxy therefore allow the procedure to happen.

23
Q

How do oesophogeal varices result in a patient with CLD?

A

CLD results in portal HTN and dilated collaterol veins, this leads to oesophogeal varices which can bleed and cause compliactions

24
Q

Before an operation, which drug can be used to discourage bleeding? How does it work?

A

Vasopressin - bleeding reduced via narrowing of blood vessels to small intestine.

25
Q

What is the Child-Pugh score used for?

A

Grading cirrhosis and the risk of variceal bleeding.
Uses:
Bilirubin, albumin, PT
grades of ascites and encephalopathy

26
Q

What investigation should you order in a patient who is struggling to swallow, regurgitating food and is losing weight?

A

Barium swallow

27
Q

What is the sepsis 6?

A 
Give broad spec antibiotics
Give fluids
Monitor UO (catheter)
Serum lactate and Hb
Blood cultures 
High flow oxygen
28
Q

What is the therapy given to eradicate H. pylori?

A

Triple therapy: amoxicillin +clarithrmycin + omeprazole

29
Q

What is an oculogyric crisis?

A

A dystonic reaction of D2 receptor blockage. Notably rolling backwards of eyeballs.

Caused by neuroleptics (metoclopramide, domperidone, halloperidol, levodopa, carbamazepine)

Medicine Year 4 (15 decks)

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