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5 Medicine > Gastroenterology - ASM > Flashcards

Gastroenterology - ASM Flashcards

1
Q

What electrolyte imbalances can cause constipation?

A

Hypocalcaemia

Hypokalaemia

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2
Q

What endocrine cause can cause constipation

A

Hypothyroidism

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3
Q

Commonest age for IBS

A

20-30 y/o

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4
Q

Pathophysiology of achalasia

A

Degeneration of myenteric plexus causing reduced peristalsis in esophagus causing inability to relax lower esophageal sphincter

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5
Q

How to test for H pylori?

A

Breath carbon urea testing or antigen stool test

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6
Q

Erradication therapy for HPylori?

A

7 day, BD course of

1) PPI
2) amoxicillin
3) clarithromycin or metronidazole

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7
Q

What to do with PPI if someone needs OGD for peptic ulcer disease investigation?

A

Stop PPI 2 weeks before

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8
Q

Which type of hiatus hernia should always be treated surgically?

A

Rolling hiatus hernia, due to risk of strangulation

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9
Q

Management for GORD?

A

Full dose ppi for 1-2 months - 30mg lansoprazole/omeprazole OD
If no response - double dose BD
If no response - add H2RA (ranitidine 300mg nocte)

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10
Q

Pathophysiology of GORD

A

LOS dysfunction causing reflux of gastric contents into oesophagus causing oesophagitis.

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11
Q

Differentials for rectal bleeding

A 
Diverticular disease
Rectal haemorrhoids
Infection - bacterial gastroenteritis
Polyps
Inflammation - UC & Crohns
Neoplasia
Gastric upper bleeding
Angio - ischaemic colitic,

Driping arse

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12
Q

What needs to be done in massive upper gi bleeding?

A

ABCDE approach

2x large bore cannulas
1L saline STAT
G&S
Terlipressin
Antibiotics

Endoscopy -> PPI IV after, keep NBM24hrs

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13
Q

What causes dark urine and pale stools?

A

Hepatic or post-hepatic jaundice.

Conjugated + urobillinogen in urine - hepatic
Conjugated bilinogen in urine - post-hepatic

Pale stools - obstruction of bile duct, no stercobilin in stools

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14
Q

why does liver cirrhosis cause gynaecomastia?

A

cause the liver metabolises estrogen, when that fails, estrogen builds up causing gynacomastia,

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15
Q

what are signs of liver cirrhosis associated with estrogen build up

A

gynaecomastia, loss of secondary sexual hair, spider naevi, palmar erythema, hypogonadism,

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16
Q

what can be seen on LFTs in someone with liver cirrhosis

A

increased ALT and AST, decreased albumin

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17
Q

complications of liver cirrhosis

A 
splenomegaly
ascites
variceals
encephalopathy
SBP
HCC
liver failure
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18
Q

what happens to serum glucose in liver failure/cirrhosis

A

hypoglycaemia

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19
Q

what FBC results indicate hypersplenism

A

decreased WCC and Platelets

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20
Q

how to investigate for SBP

A

ascitic tap looking for neutrophils (PMNs)

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21
Q

blood marker for HCC

A

AFP

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22
Q

why do U&Es in liver failure

A

look for hepatorenal syndrome

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23
Q

how to manage ascites in liver cirrhosis

A

fluids, spironolactone, salt restriction, frusemide, ascitic tap, daily weights

24
Q

how to manage hepatorenal syndrome?

A

IV albumin + terlipressin, TIPS

25
Q

in hepatitis B, markers of

1) immunity from vaccine w/o hx of infection
2) current infection
3) chronic infection
4) past resolved infection

A

1) Hepatitis B surface antibody without anything else
2) HBV DNA, HBSAg, Core IgM, Core IgG
3) HBV DNA, HBSAg, Core IgG
4) HBSAb, HBC IgG, HBEAb

26
Q

symptoms of haemochromotosis

A

Iron MEALS

myocardial - dilated cardiomyopathy, arrythmias
endocrine - pituitary hypogonadism, hypoparathyroidism, pancreas: DM
Arthritis
Liver - CLD, hepatomegaly
Skin - grey color

27
Q

what will serum caeruloplasmin be in Wilson’s disease

A

low

28
Q

Which IBD UC or Crohns is associated with skip lesions, crypt abscess, transmural lesions?

A

skip lesions = crohns
crypt absc = UC
transmural lesions = crohns

29
Q

which IBD is more commonly associated with tenesmus?

A

UC

30
Q

what eye conditions are associated with IBD

A

uveitis/iritis/conjunctivitis/episcleritis

31
Q

which IBD is more associated with anal fistulae?

A

crohns

32
Q

what skin/finger conditions are associated with IBD

A

clubbing, erythema nodosum, pyoderma gangrenosum

33
Q

which IBD is associated with malabsorption

A

crohns

34
Q

what bloods to check if suspecting coeliacs

A

FBC, LFTs, INR, VitD, bone panel, folate, serum b12

abs - anti-TTG IgA, Anti-endomysial IgA,

35
Q

what might give a false-negative when investigating coeliacs disease

A

specific IgA deficiency

36
Q

which cancer marker can be used if suspecting pancreatic cancer

A

ca19-9

37
Q

name 3 symptoms found in carcinoid tumour

A 
flushing
diarrhea
wheezing
palpitations
murmur
hepatomegaly
38
Q

what is a Sister Mary Joseph node

A

palpable painful umbilical lymph node associated with advanced metastatic cancer

39
Q

what blood is important to do when suspecting mesenteric ischaemia?

A

lactate

40
Q

what is SAAG used to determine? what values indicate what?

A

if ascites is caused by portal hypertension or not. if >11g/L than more likely to be caused by portal hypertension

41
Q

cancer symptoms with background of coeliac disease - what condition?

A

enteropathy-associated T cell lymphoma

42
Q

what electrolyte imbalance can PPIs cause?

A

hyponatraemia, hypomagnesaemia

43
Q

which IBD is more associated with PSC?

A

UC

44
Q

what investigation to use to check for H Pylori after erradication therapy?

A

urea breath test

45
Q

which antibody should be tested if suspecting primary biliary cholangitis ?

A

AMA

46
Q

what type of carcinoma is seen in barretts?

A

adenocarcinoma

47
Q

what liver pathology is associated in young females with jaundice, tender hepatomegaly and secondary amenorrhea?

A

autoimmune hepatitis

48
Q

what test to use to differentiate IBS from IBD?

A

faecal calprotectin

49
Q

which type of antibiotic is most strongly linked to C diff?

A

cephalosporins and clindamycin

50
Q

why might a young lady with no past medical history and not obese present with cholestasis?

A

COCP

51
Q

what antibiotic is recommended for prophylaxis after SBP?

A

ciproflox

52
Q

what is gallstone ileus

A

gallstone lodged in ileocaecal valve causing obstruction, background of gallstones. might see pneumobilia

53
Q

what are two treatment options for preventing osfgeal varices bleeding?

A

propranalol and endoscopic banding

54
Q

describe type 1 vs type 2 hepato-renal syndrome

A

type 1 = rapid decline (over days)

type 2 = takes longer, with refractory ascites

55
Q

ECG sign seen in hypothermia?

A

J waves

56
Q

2 causes of raised TLCO and KCO?

A

asthma and left-right cardiac shunt

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