Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Finals > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

What are the causes of hepatitis? (6)

A 
Hereditary - Wilson's, haemochromatosis, alpha anti-1-deficiency
Viral hepatitis
Autoimmune hepatitis
NAFLD
Drug-induced e.g. paracetamol overdose
Alcoholic hepatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which of the viral hepatitis’ can cause cholestasis?

A

Hepatitis A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which Ig indicates a recent or current infection of hepatitis B?

A

IgM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which two blood tests are initially used to diagnose hepatitis B?

A

HBsAg and anti-HBc

Both of these suggest a current infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which antibody indicates immunity to hepatitis B?

A

anti-HBsAg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which marker indicates hepatitis B is highly infective?

A

HBeAg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What do these results suggest?

———HBsAg + – – + +
——Anti-HBs – + + – –
——–HBeAg + – – +/– –
——Anti-HBe – +/– – +/– +
——Anti-HBc + + – + +
IgM anti-HBc + – – – –
—–HBV DNA + – – + + (low)
————-ALT H N N H N

A
  1. Acute infection
  2. Previous infection and immunity
  3. Vaccination
  4. Chronic infection - active
  5. Chronic infeciton - not active
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which hepatitis marker suggest high risk of chronicity and hepatocellular carcinoma?

A

HBV DNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What type of medication is used to treat hepatitic C?

A

Direct acting antivirals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 3 most common causes of cirrhosis in the UK?

A

Alcohol
Chronic hepatitis B and C
NAFLD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

In which scenario can ELF be used to screen for cirrhosis?

A

NAFLD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What test is used first-line to detect hepatocellular carcinoma in those with cirrhosis?
How often should the test be done?

A

USS

Every 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the MELD score?
How often do NICE recommend doing it?
What is in the MELD score? (5)

A

3 month mortality for those with compensated cirrhosis
Every 6 months
Bilirubin, INR, (i.e. liver) creatinine, sodium, whether they are on dialysis (i.e. kidney)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the complications of cirrhosis? (6)

A 
Malnutrition
Portal hypertension and variceal bleeding
Ascites and SBP
Hepatic encephalopathy
Hepato-renal syndrome 
Hepatocellularcarcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What medication is used for stable varices?

A

Propranolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What options are there for varices via endoscope?

A

Elastic band ligation

Injecting sclerosant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the treatment for bleeding varices? (4)

A

Terlipressin
Correct coagulation e.g. vitamin K, FFP
Prophylactic antibiotics
Urgent endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the management for ascites? (4)

A

Ascitic tap and drainage
Prophylactic antibiotics (e.g. ciprofloxacin)
Aldosterone antagonist
Low sodium diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the antibiotic of choice for spontaneous bacterial peritonitis?

A

IV cephalosporin e.g. cefotaxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Why does hepato-renal syndrome occur?

A

Reduction in circulating blood volume due to portal hypertension means blood flow to kidneys reduced
RAAS activated which vauses vasoconstriction of renal blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How do you manage hepatic encephalopathy? (3)

A

Lactulose - helps to remove ammonia
Antibiotics e.g. rifaximin
Nutritional support

22
Q

Which value of SAAG suggests a transudate and exudate?

A

> 11g/L - transudate i.e. portal hypertension

<11g/l - exudate i.e. malignancy, nephrotic syndrome, infection

23
Q 
What occurs at these times after withdrawing from alcohol?
6-12h:
12-24h:
24-48h:
24-72h:
A
  1. Nausea, sweating, tremors
  2. Hallucinations
  3. Seizures
  4. Delirium tremens
24
Q

Which medication is commonly used to combat the effects of alcohol withdrawal?

A

Chlordiazepoxide (Librium)

25
Q

What are the complications of alcohol abuse? (6)

A 
Alcoholic liver disease
Cirrhosis 
Alcohol dependence and withdrawal 
Wernicke-Korsakoff syndrome
Alcohol cardiomyopathy 
Pancreatitis
26
Q

In what scenario is coeliac disease tested for, even if there are no symptoms?

A

New diagnosis fo type 1 diabetes

27
Q

What signs and symptoms would you expect in someone with coeliac disease?

A

Diarrhoea, weight loss, fatigue, anaemia (e.g. iron, B12, folate), mouth ulcers

28
Q

What special rash do people with coeliac get and where does it tend to present?

A

Dermatitis herpetiformis

Typically occurs on abdomen

29
Q

What are the rare neurological signs of coeliac? (3)

A

Peripheral neuropathy
Cerebellar ataxia
Epilepsy

30
Q

What are the complications of untreated coeliac disease? (6)

A 
Nutritional deficiencies
Anaemia
Hypospenism
Osteoporosis
Malignancy (e.g. lymphoma)
Refractory disease
31
Q

What are the red flags for dyspepsia?

A 
Anorexia
Loss of weight
Anaemia
Recent onset/progressive
Melaena or other GI bleed
Swallowing difficulty
32
Q

Which scoring system can you use if you suspect an upper GI bleed?
What score indicates high risk?

A

Glasgow-Blatchford - a score of more than 0 is high risk

33
Q

Which score can you use to assess the risk of re-bleeding after treating an upper GI bleed?

A

Rockall score

34
Q

What is the management for an upper GI bleed?

A

ABCDE assessment
Bloods
Access i.e. 2 large bore cannulas
Transfuse
Endoscopy - urgent if unstable, otherwise within 24h
Drugs - stop any NSAIDs or anticoagulants

35
Q

What bloods should you order in an upper GI bleed? (6)

A

FBC, U&Es (urea), LFTs, coagulation screen, INR, crossmatch

36
Q

What special tests should you order in suspected dyspepsia or ulcer disease? (2)

A

H pylori

FIT

37
Q

What type of bacteria is H pylori?

A

Gram negative bacilli

38
Q

What is triple therapy for H pylori?

A

PPI, amoxicillin and either clarithromycin or metronidazole

39
Q

What test is used to screen for Zollinger-Ellison disease?

A

Fasting serum gastrin

40
Q

What imaging is available to investigate dysphagia? (4)

A

Endoscopy
Barium swallow
Videofluroscopy (difficulty swallowing vs food sticking)
Oesophageal motility

41
Q

Which medications may precipitate GORD?

A 
CCBs
Bisphosphoates
NSAIDs
Anticholinergics
TCAs
42
Q

What lifestyle advice can you give for GORD? (7)

A 
Smaller, more frequent meals
Avoid caffeinated drinks
Weight loss
Raise bed using blocks
Stay upright after meals
Avoid large meals before bedtime
Avoid smoking
43
Q

What are the features of ulcerative colitis?

A 
Continuous inflammation 
Limited to colon and rectum
Only superficial mucosa
Smoking is protective
Use aminosalicylates first line
Primary sclerosing cholangitis
44
Q

What are the features of Crohn’s disease?

A 
No blood or mucus 
Entire GI tract
Skip lesions
Transmural 
Smoking worsens symptoms
45
Q

What systemic features are used in the scoring of severity for UC? (4)

A

Raised ESR (>30)
Heart rate (>90)
Anaemia
Fever

46
Q

How many stools per day are in the following severity categories for UC?
Mild
Moderate
Severe

A
  1. <4
  2. 4-6
  3. > 6
47
Q

What are the 3 options for inducing remission in UC?

A

Aminosalicylates
Steroids
Calcineurin inhibitors e.g. tacrolimus

48
Q

What are the 3 options for maintaining remission in UC?

A

Aminosalicylates
Immunosuppressants e.g. azathioprine
BIologics

49
Q

What are the 3 options for inducing remission in Crohn’s?

A

Steroids
Immunosupperssants
Biologics

50
Q

What are the 3 options for maintaining remission in Crohn’s?

A

Azathioprine or mercaptopurine
Methotrexate
Biologics

51
Q

What lifestyle changes can help the following symptoms in IBS?

  1. Bloating
  2. Diarrhoea
  3. Constipation
A
  1. Oats and linseeds, avoid beans and pulses
  2. Reduce alcohol and fizzy drinks and sorbitol
  3. Limit high fibre foods
52
Q

What pharmacological options are there for IBS?
Bloating
Diarrhoea
Constipation - what can be used second line?
Other

A

Bloating - buscopan, colpermin
Diarrhoea - loperamide
Constipation - laxatives (apart from lactulose); linaclotide can be used second line
Amitryptiline, SSRIs

Finals (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions