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OSCE > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

What extra vaccines do you need for coeliac?

A

Pneumococcal
Hib
Flu
- same as splenectomy

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2
Q

Risks of coeliac

A

Osteoporosis
Vit D deficiency
Cancer - lymphoma
Anaemia

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3
Q

Where does the inguinal ligament run?

A

ASIS to pubic tubercule

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4
Q

Where does the inguinal canal run?

A

ASIS to pubis symphisis

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5
Q

What are the contents of the inguinal canal?

A

Spermatic cord/Round ligament

Ilioinguinal nerve

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6
Q

What are the borders of the inguinal canal?

MALT

A

Muscle - internal oblique
Aponeurosis (ext oblique)
Ligament (inguinal ligament)
Tendon (transversalis tendon)

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7
Q

Where is the midinguinal point?

A

Halfway between ASIS to pubic symphisis

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8
Q

Where is the midpoint of the inguinal ligament?

A

Midpoint between origins of inguinal ligament (ASIS to pubic tubercle) = deep inguinal ring

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9
Q

Direct inguinal hernia

A

through external inguinal ring

if reduced, can’t be controlled by pressing over deep inguinal ring

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10
Q

Indirect inguinal hernia

A

herniated contents run in inguinal canal
can run right down into scrotum - inguino-scrotal hernia
due to failure of proc

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11
Q

Inguinal vs femoral hernia

A

femoral - below and lateral to pubic tubercule
direct inguinal - above and medial
indirect - anywhere between deep inguinal and scrotum

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12
Q

Differentials for hernias

A 
Psoas abcess
Femoral neurofibroma (hard, painful, lateral to femoral artery)
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13
Q

Features of a colostomy

A

LIF
solid faeces
flush with skin

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14
Q

Features of an ileostomy

A

RIF
liquid faeces
spouted (to protect skin from enzymes)

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15
Q

Features of a urostomy

A

RIF
urine
flush with skin

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16
Q

What is a end colostomy ad what is it for?

A

all of distal bowel removed w/ proximal end brought to surface
e.g for resection of low rectal tumours, Hartmann

17
Q

What a loop colostomy and what is it for?

A

two made in central part of large bowel and brought to surface
e.g to protect distal anastamosis while bowel structures heal
reversed after 6w

18
Q

What is a barrel colostomy and what is it for?

A

segment of bowel removed and both ends brought to surface

e.g for sigmoid volvulus

19
Q

What is an end ileostomy and what is it for?

A

who colon removed

e.g UC, FAP Hirschsprungs

20
Q

What is an ileal conduit and what is it for?

A

urostomy when short segment of ileum removed to act as bladder
e.g after cystectomy

21
Q

What are the early complications of a stoma?

A

high output (dehydration, hypokalaemia), retraction, bowel obstruction, ischaemia of stoma

22
Q

What are the late complications of a stoma?

A

parastomal hernia, prolapse, fistulae, psychological, dermatits

23
Q

Stoma care

A

stoma nurse
empty via tap when 2/3 full, irrigated with water, change 2-4 days/whenever full
diet: lots of full, low fibre to begin with
avoid foods that cause blockage or flatulence
can wear in shower

24
Q

Cuases of hepatosplenomegaly

A

Viral hepatits
Mono
CMV
Haematology; leukaemia, sickle cell, lymphoma

25
Q

Risk factors for Dupetryns

A 
Trauma/ occupational
Genetics
Smoking/alcohol
hypercholesterolaemia
anticonvulsants
26
Q

Questions to ask in Dupetryns

A

How it affects life?
What job they did?
Can you put your hand flat on table?
Feet or Willy?

27
Q

Crohns Barium Enema features

A 
Cobblestone
Transverse stripes
Kantors string sign
Ulcers
Patrial obstruction
28
Q

Inducing remission in UC

A

rectal aminosalicylates or steroids if distal
oral salicyates if no response __>
oral pred
IV steroids (1st line if severe)

29
Q

Causes of ascites

A 
Cirrhosis
Hypoalbuminaemia
Peritoneal mets
Hepatic vein thrombosis
TB
Ovarian Ca
30
Q

Acute Pancreatitis Managemet

A

IV fluids
NBM (enteral fluids)
Analgesia
ABx

31
Q

Causes of Bowel Obstruction

A

Adhesions
Hernias
Tumours
(Gallstones, Crohns, diverticulitis)

32
Q

Symptoms of bowel obstruction

A

Pain
Vomiting
DIstention
Absolute Constipation

33
Q

Volvulus

A 
Loop of bowel twisted on mesentery
Idiopathic/due to faecal loading
Sudden severe abdo pain w/ distention
Unrelieved by opiates
Obstruction then ileus then peritonitis
34
Q

Coffee Bean Sign

A

sigmoid volvulus

35
Q

Acute Pancreatitis Management

A 
FBC, LFTs, U+Es, bHCG
amylase, lipase
BM
ABG
ECG - rule out MI
CXR - pneumoperitoneum
USS - pancreas
CT - pancreas later

OSCE (20 decks)

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