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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
in hepatitis B, markers of 1) immunity from vaccine w/o hx of infection 2) current infection 3) chronic infection 4) past resolved infection
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
symptoms of haemochromotosis
Iron MEALS myocardial - dilated cardiomyopathy, arrythmias endocrine - pituitary hypogonadism, hypoparathyroidism, pancreas: DM Arthritis Liver - CLD, hepatomegaly Skin - grey color
27
what will serum caeruloplasmin be in Wilson's disease
low
28
Which IBD UC or Crohns is associated with skip lesions, crypt abscess, transmural lesions?
skip lesions = crohns crypt absc = UC transmural lesions = crohns
29
which IBD is more commonly associated with tenesmus?
UC
30
what eye conditions are associated with IBD
uveitis/iritis/conjunctivitis/episcleritis
31
which IBD is more associated with anal fistulae?
crohns
32
what skin/finger conditions are associated with IBD
clubbing, erythema nodosum, pyoderma gangrenosum
33
which IBD is associated with malabsorption
crohns
34
what bloods to check if suspecting coeliacs
FBC, LFTs, INR, VitD, bone panel, folate, serum b12 abs - anti-TTG IgA, Anti-endomysial IgA,
35
what might give a false-negative when investigating coeliacs disease
specific IgA deficiency
36
which cancer marker can be used if suspecting pancreatic cancer
ca19-9
37
name 3 symptoms found in carcinoid tumour
``` flushing diarrhea wheezing palpitations murmur hepatomegaly ```
38
what is a Sister Mary Joseph node
palpable painful umbilical lymph node associated with advanced metastatic cancer
39
what blood is important to do when suspecting mesenteric ischaemia?
lactate
40
what is SAAG used to determine? what values indicate what?
if ascites is caused by portal hypertension or not. if >11g/L than more likely to be caused by portal hypertension
41
cancer symptoms with background of coeliac disease - what condition?
enteropathy-associated T cell lymphoma
42
what electrolyte imbalance can PPIs cause?
hyponatraemia, hypomagnesaemia
43
which IBD is more associated with PSC?
UC
44
what investigation to use to check for H Pylori after erradication therapy?
urea breath test
45
which antibody should be tested if suspecting primary biliary cholangitis ?
AMA
46
what type of carcinoma is seen in barretts?
adenocarcinoma
47
what liver pathology is associated in young females with jaundice, tender hepatomegaly and secondary amenorrhea?
autoimmune hepatitis
48
what test to use to differentiate IBS from IBD?
faecal calprotectin
49
which type of antibiotic is most strongly linked to C diff?
cephalosporins and clindamycin
50
why might a young lady with no past medical history and not obese present with cholestasis?
COCP
51
what antibiotic is recommended for prophylaxis after SBP?
ciproflox
52
what is gallstone ileus
gallstone lodged in ileocaecal valve causing obstruction, background of gallstones. might see pneumobilia
53
what are two treatment options for preventing osfgeal varices bleeding?
propranalol and endoscopic banding
54
describe type 1 vs type 2 hepato-renal syndrome
type 1 = rapid decline (over days) type 2 = takes longer, with refractory ascites
55
ECG sign seen in hypothermia?
J waves
56
2 causes of raised TLCO and KCO?
asthma and left-right cardiac shunt

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