Gastroenterology Flashcards
Spontaneous bacterial peritonitis
Requires long term antibiotic prophylaxis (ciprofloxacin)
Intrinsic factor antibodies
Used to investigate vitamin B12 deficiency
Plummer-Vinson syndrome
Triad of dysphagia, glossitis and iron-deficiency anaemia
Pancreatic cancer
Painless jaundice
Autoimmune hepatitis
Predominantly raised ALT/AST compared to ALP
Ischemic colitis
Most commonly affects the splenic flexure
Haemochromatosis
Raised transferrin saturation and ferritin with low TIBC
Ulcerative colitis
Associated with primary sclerosing cholangitis
C. difficile
First line with metronidazole then second line with oral vancomycin
Coeliac disease
Total IgA and IgA tTG should be assessed
Carcinoid syndrome
- flushing, diarrhoea and abdominal discomfort
- urine 5-HIAA elevated
- can cause pulmonary stenosis and tricuspid insufficiency
Achalasia
Dysphagia affecting both solids and liquids from the start
Clindamycin
Treatment is associated with a high risk of C. diff so warn about diarrhoea
Coeliac diseasse
Offered pneumococcal vaccine due to hyposplenism
Cholestryamine
Used to treat bile-acid malabsorption
Haemochromatosis
Early signs include fatigue, erectile dysfunction and arthralgia
Ulcerative colitis
Lead pipe appearance to colon
Double duct sign
Can indicate pancreatic cancer
Hemochromatosis management
Fist line with venesection and second line with desferrioxamine
Appendicectomy
Requires prophylactic IV antibiotics
Wilson’s disease
A combination of liver and neurological disease that requires copper studies
Rifaximin
Treatment of choice for small bowel bacterial overgrowth syndrome
Isoniazid
Can cause vitamin B6 deficiency leading to peripheral neuropathy
Spontaneous bacterial peritonitis
E. coli is the most common bacteria cultured from ascites tap
Barrett’s oesophagus
If dysplasia is seen then endoscopic intervention is needed
Autoimmune hepatitis
Associated with anti-nuclear and anti-smooth muscle antibodies
TPMT activity
Needs to be assessed before starting azathioprine or mercaptopurine in Crohn’s disease
Appendicitis
Rovsing positive with raised inflammatory markers
Pharyngeal pouch
Treated with surgical repair
Alcoholic ketoacidosis
Metabolic ketoacidosis with a normal or low glucose