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SMS > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

What cancer can H.Pylori cause?

A

MALToma and gastric lymphoma

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2
Q

Zollinger Ellison Syndrome

  • define
  • presentation
  • investigation
  • management
A

gastrin secreting tumour most commonly found in small intestine or pancreas
- refractory PUD
- abdo pain
- diarrhoea
Inv: fasting serum gastrin
Management- high dose PPI, tumour resection

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3
Q

corkscrew oesophagus in?

A

oesophageal spasm

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4
Q

Plummer Vinson syndrome

A

Oesophageal web

iron def anaemia

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5
Q

Pharyngeal pouch

- presentation

A

dysphagia, regurg, halitosis and gurgling sounds

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6
Q

Oesophageal ca

  • pathophysiology
  • presentation
  • investigation
  • treatment
A

1) Adenocarcinoma (lower 3rd) and SCC (upper and middle 3rd)
2) progressive dysphagia, retrosternal chest pain, hoarseness
3) upper GI endoscopy
BA swallow- apple core stricture
4) oesophagectomy

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7
Q

ALARMS symptoms for OGD

A 
Anaemia
Loss of weight
Anorexia
Recent onset of progressive symptoms
Melaena
Swallowing difficulty
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8
Q

Presentation and classic appearance on barium swallow of achalasia

A
  1. dysphagia to liquids and solids, regurg esp @ night, substernal cramps
  2. bird’s beak
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9
Q

management of achalasia

A

calcium channel blockers

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10
Q

classic complication of UC

A

toxic megacolon

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11
Q

what might you see on small bowel imaging in crohns?

A
  • skip lesions
  • rose thorn ulcers
  • cobble stoning
  • string sign of kantor
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12
Q

inducing remission in UC?

A

if distal colitis use rectal salicyclates
otherwise
first line: oral aminosalicyclates
second line: oral pred

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13
Q

maintaining remission in UC?

A

first line: 5ASAs

second line- azathioprine

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14
Q

inducing remission in crohns?

A

glucocorticoids

5-ASAs second line

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15
Q

maintaining remission

A

first line: azathioprine
second line: methotrexate
use 5-ASAs if previous surgery

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16
Q

what is PSC?

- investigations?

A

inflammation and fibrosis of intra and extra hepatic bile ducts- associated with UC
- ERCP- shows ‘beaded appearance’

17
Q

rash associated with coeliac disease

A

dermatitis herpetiformis

18
Q

Management of varices

A

if stable -> propanolol
if bleeding -> Terlipressin
ligation and banding via urgent endoscopy

19
Q

Kings college hospital criteria in acute hepatitis if paracetamol induced

A 
pH <7.3 24hr after ingestion 
or all of 
- PT >100s
- creat >300
- grade 3/4 encephalopathy
20
Q

Kings college hospital criteria in acute hepatitis if non-paracetamol induced

A 
PT >100s
or 3/5 of
- drug-induced
- age <10 or >40
- >1 week from jaundice to encephalopathy
- PT >50s
- bilirubin >300
21
Q

treatment of PBC

A

ursodeoxycholic acid

22
Q

what is in the child-pugh classification?

A
  1. encephalopathy
  2. bilirubin
  3. ascites
  4. prothrombin time
23
Q

management of encephalopathy

A

lactulose

24
Q

what is SAAG

A

serum albumin ascites gradient

SAAG >=1.1g/dL indicates portal HTN

25
Q

treatment of Hep C

A

PEGinteferon + ribavarin

26
Q

Autoimmune hepatitis

  • epidemiology
  • diagnosis
  • associations
  • management
A
  • young women
  • liver biopsy
  • hashimotos, DM, pernicious anaemia, PSC, UC
  • prednisolone and azathioprine
27
Q

Budd- chiari syndrome

  • define
  • causes
  • presentation
  • management
A

hepatic vein obstruction resulting in ischaemia and liver damage
causes: HCC, congenital, hypercoaguable states
Pres: RUQ pain, hepatomegaly, ascites, jaundice
Rx: anticoagulant and treat ascites

28
Q

Hereditary haemochromatosis

  • inheritance
  • diagnosis
  • management
A
  • autosomal recessive
  • high serum ferritin and genetic testing
  • Rx: venesection
29
Q

Symptoms of hereditary haemochromatosis

A 
Type 1 DM
arthritis
chronic liver disease
slate-grey discolouration 
- dilated cardiomyopathy
30
Q

Wilson’s disease

  • inheritance
  • features
  • diagnosis
  • management
A
  • autosomal recessive
  • kaiser-fleischer rings, liver disease, parkinsonism, renal tubular damage
  • low serum caeruloplasmin and low serum copper
  • penicillamine
31
Q

Presentation of PBC

A

middle aged women with other autoimmune diseases presents with liver fibrosis/cirrhosis, xanthelasma and ascites

32
Q

autoantibodies in PBC

A

AMA (most specific)

ANA

33
Q

Presentation of liver cancer

- tumour markers?

A
  • RUQ pain, nausea, vomiting, jaundice, weight loss

- AFP

34
Q

what is cholangiocarcinoma

  • tumour marker?
  • management?
A

cancer of bile ducts, presents with painless obstructive jaundice

  • CA 19-9
  • resection but usually palliativ care
35
Q 
Vitamin Deficiencies 
A
B1
B3
B6
B12
C
D
K
A 
A- night blindness &amp; total blindness
B1- wet (heart failure) dry (wernickes)
B3- diarrhoea, dermaitis, dementia
B6- sensory neuropathy
B12- glossitis, peripheral neuropathy
C- scurvy
D- osteomalacia
K- bleeding

SMS (5 decks)

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