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1MRCPCH FOP and TAS > Gastroenterology and Hepatology > Flashcards

Gastroenterology and Hepatology Flashcards

1
Q

Where is the most common site of ulcers in H.pylori infection?

A

Lesser curvature of the stomach

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2
Q

What syndrome is duodenal atresia highly associated with?

A

Down syndrome

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3
Q

Which condition typically causes the “double bubble” sign on AXR?

A

Duodenal atresia

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3
Q

Where is leptin produced?

A

Adipocytes

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4
Q

What is produced by pancreatic acinar cells?

A

Amylase

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4
Q

What conditions is coeliac associated with?

A

IgA deficiency
Dermatitis herpetiformis
AI disorders
Small bowel malignancy

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4
Q

Which RNA virus can sometimes lead to pancreatitis?

A

Mumps

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5
Q

What is produced by pancreatic alpha cells?

A

Glucagon

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5
Q

What is a type A TOF?

A

Oesophageal atresia with no communication with the trachea

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5
Q

What is produced by pancreatic beta cells?

A

Insulin

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5
Q

What is the treatment of lymphangiectasia?

A

Low-fat, high-protein diet with medium chain triglycerides

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6
Q

What is produced by pancreatic delta cells?

A

Somatostatin

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6
Q

What is lymphangiectasia?

A

Protein-losing enteropathy

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6
Q

What is the role of vasoactive intestinal polypeptide with regards to stomach acid secretion?

A

Acts to decrease acid production

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7
Q

What is the role of secretin with regards to stomach acid secretion?

A

S-cells in duodenum detect excess acid and release secretin to reduce stomach acid

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7
Q

How is lymphangiectasia diagnosed?

A

Increased stool alpha-1-antitrypsin levels

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7
Q

What layers of the bowel are affected in UC?

A

Mucosal

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8
Q

What is the role of acetylcholine with regards to stomach acid secretion?

A

Stimulates antral G-cells and partial cells to inhibit somatostatin release.

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8
Q

What layers of the bowel are affected in Crohns?

A

All layers (transmural)

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8
Q

What is the role of somatostatin with regards to stomach acid secretion?

A

D-cells release somatostatin in response to increased acidity - this inhibits gastrin release and decreases acid production

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8
Q

What is the role of cholecystokinin with regards to stomach acid secretion?

A

When partially digested food enters duodenum, entero-endocrine cells release cholecystokinin to reduce acid production in the stomach

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9
Q

What is an H-type TOF?

A

Continuous oesophagus with an anastomosis with the trachea

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9
Q

What is a type C TOF?

A

Oesophageal atresia with distal TOF

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10
Q

What is a type B TOF?

A

Oesophageal atresia with proximal TOF

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11
Q

What is Rovsing’s sign?

A

Increased pain in RLQ on palpation of LLQ in appendicitis

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11
Q

What is a type D TOF?

A

Oesophageal atresia with proximal and distal TOF

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12
Q

Which cells most directly protect the gastric mucosa from autodigestion and how?

A

Mucus neck cells - produce bicarbonate and mucus to form a protective barrier

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12
Q

What is McBurney’s sign?

A

Site of maximal tenderness in appendicitis - typically 2/3 of the way along a line drawn from umbilicus to right anterior superior iliac spine

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13
Q

What is the Psoas sign?

A

Pain in RLQ on passive extension of right thigh with the patient in the left lateral position - common in retrocaecal or retrocolic appendicitis

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14
Q

What is the Obturator sign?

A

Pain in RLQ as a result of passive internal rotation of flexed right thigh in appendicitis

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15
Q

What is Dunphy’s sign?

A

RLQ on coughing in appendicitis

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16
Q

What is the differentiating factor between a gram positive and gram negative bacteria?

A

Presence of a lipopolysaccharide layer - present in gram negative but not positive

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17
Q

What type of virus is rotavirus?

A

Non-enveloped dsDNA

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18
Q

How many serological groups of rotavirus are there?

A

Seven (A-G) - type A most common

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19
Q

What is Crigler Najjar syndrome?

A

Severe, persistent hyperbilirubinemia in first few days of life in the absence of haemolysis

20
Q

What mutation is associated with Crigler Najjar syndrome?

A

UGT1A1 gene mutation

21
Q

What is the treatment for Criger Najjar syndrome?

A

Phototherapy and plasmapheresis

22
Q

What does the Ladd’s procedure aim to fix?

A

Failure of the mid-gut to rotate through 270degrees at 5-10weeks gestation

23
Q

Which factor involved in the homeostasis of the large intestine is most significantly impacted by a lack of dietary fibre?

A

Mucin 2 - protein produced by goblet cells which acts to organise the 2 mucous layers

24
Q

Which type of antibiotic treatment can increase the risk of developing pyloric stenosis?

A

Macrolides e.g. azithromycin

25
Q

What is the most common cause of pancreatitis in children?

A

Idiopathic

25
Q

Deficiency of which enzyme typically causes dark urine, jaundice and hepatomegaly?

A

Glucose 6-phosphatase (or other glycogen storage disorder)

25
Q

With a double bubble sign in duodenal atresia - which part of the duodenum is most likely to be affected?

A

D2

25
Q

What is the most common cause of perianal redness and soreness?

A

Streptococcal infection - area should be swabbed and PO penicillin started

26
Q

If IgA tTG ab level is <10x upper limit of normal in suspected coeliac disease, what is the best next step?

A

Upper GI endoscopy for biopsy

27
Q

What type of bacteria is H.pylori?

A

Gram negative bacilli

27
Q

What occurs in the liver and kidneys in G6P deficiency?

A

Glycogen and fat accumulation

27
Q

What is seen on microscopy in coeliac disease?

A

Crypt hyperplasia and lymphocytosis

28
Q

How does giardiasis infection present?

A

Acute diarrhoeal illness which usually self resolves but may develop into chronic infection with steatorrhea, wasting and stunting as well as nutritional deficiencies.

28
Q

Which vitamins are usually deficient in biliary atresia?

A

Fat soluble vitamins - A, D, E and K

28
Q

Where is ghrelin mostly produced?

A

Fundus of the stomach

29
Q

What are the typical signs seen on endoscopy in UC?

A

Friable mucosa
Ulcers
Areas of regeneration

29
Q

What are the typical signs seen on endoscopy in Crohns?

A

Inflamed mucosa
Aphthous ulcers
Fissures
Cobblestoning
Strictures

29
Q

What is measured doing a H.pylori breath test?

A

Carbon dioxide

29
Q

Which HLA is associated with severe disease in UC?

A

HLA-DRB

30
Q

What is the most common type of oesophageal atresia?

A

Distal tracheo-oesophageal fistula with OA.

30
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30
Q

How is choledochal cyst investigated?

A

AUSS

30
Q

Can buckwheat be used as part of a gluten free diet?

A

Yes

30
Q

How does a choledochal cyst typically present?

A

Conjugated hyperbilirubinaemia
+/- palpable abdominal mass in RUQ
Can present with severe liver dysfunction - ascites and coagulopathy

30
Q

What is the most common type of Kasai classification in biliary atresia?

A

Kasai type III (90%)
- obliteration of left and right hepatic ducts at level of porta hepatis

30
Q

What is the initial eradication therapy for H.pylori?

A

Amoxicillin, Clarithromycin and omeprazole for 1 week

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1MRCPCH FOP and TAS (23 decks)

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