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4th Year Exam > Gastroenterology ILOs > Flashcards

Gastroenterology ILOs Flashcards

1
Q

Define GORD and give it’s main cause

A

Reflux of gastric contents into oesophagus or beyond, into the oral cavity or lung

LOS incompetence

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2
Q

Give 3 red flag symptoms in GORD

A

Weight loss
Dysphagia
Odynophagia

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3
Q

What is the treatment plan for GORD?

A
  • Trial PPI for 8 weeks
  • GP follow up
  • Consider endoscopy
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4
Q

Give 2 complications of GORD

A

Haemorrhage

Oesophageal stricture

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5
Q

Define hiatus hernia

A

Protrusion of intra-abdominal contents through enlarged oesophageal hiatus of diaphragm

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6
Q

Outline the difference between a rolling hernia and a sliding hernia

A

Rolling: Fundus moves up and bulges into chest cavity

Sliding: Gastric fundus in and out of chest through hiatus

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7
Q

Give 2 symptoms of hiatus hernia/GORD

A

Heartburn

Acid regurgitation

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8
Q

What surgery can repair a hiatus hernia?

A

Fundoplication (wrap fundus around distal oesophagus to allow LOS to be correctly positioned)

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9
Q

Give 4 causes of an Upper GI bleed

A
  • Peptic Ulcer
  • Oesophageal varices
  • Mallory Weiss tear
  • Oesophagitis/gastritis
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10
Q

Give 3 symptoms of upper GI bleed

A

Haematemesis – coffee ground vomit

Malena

Epigastric pain

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11
Q

Give 2 risks of an upper GI bleed

A

NSAID use

Bleeding disorders

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12
Q

Which scoring system stratifies low and high risk upper GI bleed patients?

A

Glasgow Blatchford score

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13
Q

Which scoring system is done pre-endoscopy to estimate post-endoscopy mortality?

A

Rockall score

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14
Q

What additional management should be carried out in bleeding oesophageal varices?

A

ABX as prophylaxis

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15
Q

Define acute liver failure

A

Rapid decline in hepatic function characterised by jaundice, coagulopathy and hepatic encephalopathy in pt. with no prior evidence of liver disease

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16
Q

Give 2 causes of acute liver failure

A

Paracetamol overdose

Acute hepatitis

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17
Q

Give 3 features of acute liver failure

A

Jaundice
Hepatic encephalopathy
Abdominal pain

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18
Q

Give 3 lab tests for acute liver failure

A

LFTs (high bilirubin and enzymes)
INR >1.5
ABG (metabolic acidosis)

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19
Q

What drug is used in the treatment of paracetamol overdose?

A

Acetylcysteine

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20
Q

Give 2 complications of acute liver failure

A

Coagulopathy

Renal failure

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21
Q

Define acute alcohol withdrawal

A

Abstinence from alcohol in an alcohol dependent characterised by signs of overactivity by sympathetic nervous system

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22
Q

Give 3 features of acute alcohol withdrawal

A

Tachycardia
Sweating
DTs

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23
Q

Give 3 investigations for acute alcohol withdrawal

A

VBG (resp. alkalosis)
BM (hypoglycaemia common)
FBC (thrombocytopenia, folate deficiency)

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24
Q

Give 3 pharmacological treatments for acute alcohol withdrawal

A
  • Diazepam
  • Pabrinex (thiamine)
  • Haloperidol
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25
Q

Give 2 complications of acute alcohol withdrawal

A
  • Over-sedation

- Status epilepticus

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26
Q

Give 4 symptoms of IBD

A

Abdominal pain
Diarrhoea
PR blood
Weight loss

27
Q

Give 4 investigations of IBD

A

Bloods
Faecal calprotectin
Stool culture
Colonoscopy

28
Q

Give 4 pathological features of Crohn’s disease

A
  • Patchy inflammation
  • Skip lesions
  • Granulomas
  • Inflammatory cell infiltrate
29
Q

Give 3 risks for Crohn’s

A
  • White
  • Cigarette smoking
  • 15-40 then 60-80 y/o
30
Q

Give 4 treatments for Crohn’s

A
  • Glucocorticoids
  • Azothioprine
  • Methotrexate
  • Anti-TNF
31
Q

Give 3 complications of Crohn’s

A

Colorectal cancer
Strictures
Fistulae

32
Q

Give 4 pathological features of UC

A
  • Erosions
  • Crypt abcesses
  • Inflammatory cell infiltrate
  • Goblet cell loss
33
Q

Give 4 treatments for UC

A

Aminosalicylates (Remission)
Corticosteroids
Thiopurines
Ciclosporin (salvage in refractory)

34
Q

Give 3 complications of UC

A

Colorectal cancer
Toxic megacolon
Osteoporosis

35
Q

Define gastritis

A

Histological presence of gastric mucosal inflammation

36
Q

Give 2 acute and 2 chronic causes of gastritis

A

A: Alcohol + NSAIDs

C: AI + H pylori

37
Q

Give 2 lab tests used in the diagnosis of gastritis

A

H pylori urea breath test

H pylori faecal antigen test

38
Q

What is the general H pylori eradication therapy?

A 
Triple ABX (Clarithromycin, metronidazole + amoxicillin)
\+ PPI
39
Q

Give 2 complications of gastritis

A
  • Gastric cancer

- B12 Deficiency

40
Q

Define peptic ulcer disease and give the 2 main causes

A

Break in mucosal lining of stomach or duodenum more than 5mm in diameter with depth to submucosa

H pylori (duodenal)
NSAIDs (gastric)
41
Q

Broadly, how does peptic ulcer disease occur?

A

Imbalance between damaging and protective factors causing mucosal damage

42
Q

Give 2 investigations of peptic ulcer disease

A

H pylori testing

Upper GI endoscopy

43
Q

Give 2 risks for peptic ulcer disease

A

Older age

Developing world

44
Q

Define oesophageal varices

A

Dilated collateral blood vessels as a consequence of portal hypertension

45
Q

Outline the pathophysiology of oesophageal varices

A

Increased hepatic resistance and increased portal flow combine to increase portal pressure, causing systemic collaterals

46
Q

Give 4 treatment options for oesophageal varices

A
  • ABX
  • Terlipressin
  • Endoscopy band ligation
  • Rescue TIPS
47
Q

Give 2 complications of oesophageal varices

A

SBP

Encephalopathy

48
Q

Define cirrhosis and give 2 causes

A

End-stage liver failure

  • Chronic hepatitis
  • ALD
49
Q

Give 2 risks of cirrhosis

A

Alcohol misuse

IVDU

50
Q

Outline the main pathological changes seen in cirrhosis

A

Diffuse with:

Fibrosis + nodules

51
Q

Name three blood tests which may be abnormal in cirrhosis

A 
Deranged LFTs (raised GGT)
Raised albumin
Prolonged PTT
52
Q

Give 2 complications of cirrhosis

A

Ascites

Varices

53
Q

Define Barret’s oesophagus

A

Mucosal metaplasia in response to mucosal injury, Squamous to glandular, usually with intestinal goblet cells

54
Q

Give the main cause of Barret’s oesophagus

A

Gastro-oesophageal reflux

55
Q

Give 2 symptoms and 1 investigation of Barret’s oesophagus

A

Heartburn + regurgitation

Upper GI endoscopy

56
Q

Give 2 treatments for Barret’s oesophagus

A

PPI

Radiofrequency ablation

57
Q

Define coeliac disease

A

Gluten-sensitive enteropathy involving small intestinal villous atrophy that resolves when gluten (wheat, barley) is withdrawn from diet

58
Q

What causes coeliac disease?

A

AI disease triggered by gluten peptides from grain, associated with HLA-DQ2 gene

59
Q

Give 3 symptoms of coeliac disease

A

Bloating
Diarrhoea
Abdominal pain

60
Q

Outline the pathology of coeliac disease

A

Alpha gliadin deaminated due to TTG, making it more immunogenic

HLA-DQ2 bonds and causes T cell inflammatory response

Sub-total villous atrophy

61
Q

Give 4 blood tests for coeliac disease

A
  • FBC (anaemia)
  • IgA serology
  • TTG serology
  • IgA EMA serology
62
Q

Give 3 features seen on endoscopy of coeliac disease

A

Scalloping of folds
Mosaic pattern
Nodular pattern of mucosa

63
Q

Define irritable bowel syndrome and give 2 symptoms

A

Chronic condition characterised by abdominal pain associated with bowel dysfunction

  • Abdominal pain
  • Altered bowel habit
64
Q

Give 3 tests in diagnosis of IBS

A

FBC (anaemia suggests something else)

Faecal occult blood (normal)

Coeliac serology

4th Year Exam (20 decks)

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