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Year 6 > Gastroenterology (surgery) > Flashcards

Gastroenterology (surgery) Flashcards

1
Q

What bowel obstruction do adhesions and cancer likely cause?

A

Adhesions - small bowel
Cancer - large bowel

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2
Q

Bowel obstruction imaging

A

1) AXR
2) CT abdo pelvis

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3
Q

Small bowel obstruction management

A

1) Fluid resus, NG bowel decompression, analgesia
2) If peritonitic, strangulation - laparoscopic surgery

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4
Q

Large bowel obstruction management if sigmoid volvulus and caecal volvulus

A

SV: Decompression with sigmoidoscope, insert flatus tube

CV: laparotomy + right hemicolectomy

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5
Q

FIT cancer screening programme time

A

60-74
Every 2 years

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6
Q

Bowel cancer first 2 investigations

A

Sigmoidoscopy
Colonoscopy

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7
Q

What medication should be given for 28 days after bowel cancer sugery?

A

Heparin

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8
Q

Syndrome causing hamartomas, and risk of breast, ovarian, cervical, pancreatic and bowel tumours

A

Peutz-Jegher’s syndrome

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9
Q

Syndrome with right sided colonic, endometrial, and gastric tumours

A

Lynch syndrome
aka Hereditary non-polyposis colorectal cancer

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10
Q

Where are inguinal and femoral hernias found

A

Inguinal: above + medial to pubic tubercle
Femoral: below + lateral to puboc tibercle

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11
Q

Biggest risk factor for cholangiocarcinoma

A

PSC

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12
Q

Imaging for cholangiocarcinoma

A

1) Abdo USS
2) Abdo CT
3) ERCP (gold standard) + MRCP for staging

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13
Q

Cholangiocarcinoma management

A

Cholecystectomy or partial liver resection if intrahepatic

Chemo/radio

Liver transplant

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14
Q

Bacterium causing acute cholangitis

A

E. coli

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15
Q

Imaging for acute cholangitis

A

1) Abdo USS - dilated bile duct
2) ERCP - find cause and therapeutic if stone

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16
Q

Acute cholangitis management

A

1) IV abx (broad spectrum until blood culture results)
2) ERCP and stent

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17
Q

Condition with Murphy’s sign

A

Cholecystitis

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18
Q

Imaging for cholecystitis

A

Sepsis not suspected - abdo USS
Sepsis suspected - abdo CT

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19
Q

Cholecystitis management

A

Fluids
Analgesia
IV abx
Laparoscopic cholecystectomy within 1 week

20
Q

Imaging in biliary colic

A

Abdo USS
MRCP if not detected

21
Q

Biliary colic management

A

Elective laparoscopic cholecystectomy
Analgesia

22
Q

2 causes of pre-hepatic jaundice

A

Haemolytic anaemia
Gilbert’s syndrome

23
Q

3 mechanisms of hepatic jaundice

A

1) Hepatic cell dysfunction - can’t conjugate
2) Leakage of conjugated bile
3) Compression of biliary tree e.g. in cirrhosis

24
Q

Mechanism of post-hepatic jaundice

A

Obstruction of bile ducts causing leakage of conjugated bile

25
Q

Why does jaundice cause pale stool and dark urine?

A

No conjugated bilirubin or urobilinogen to form stercobilinogen - pale stool

More bilirubin in blood, which is excreted by kidneys

26
Q

Dyspepsia urgent red flag referral

A

Age >= 55 with weight loss
Dysphagia
Upper abdominal mass

27
Q

Signet ring cells on biopsy from OGD

A

Gastric cancer

28
Q

Surgery for gastric cancer

A

Endoscopic mucosal resection or gastrectomy (partial or total)

29
Q

Most common cause of hepatocellular carcinoma

A

Chronic hep B (world)
Chronic hep C (Europe)

30
Q

First investigation for hepatocellular carcinoma

A

Liver USS

31
Q

Regional staging imaging for oeseophageal cancer

A

Endoscopic USS

32
Q

What is Ivor-Lewis type oesophagostomy a treatment for?

A

Oesophageal cancer

33
Q

Most common site of pancreatic cancer

A

Head of pancreas

34
Q

Investigation if pancreatic cance suspected, and the sign seen

A

CT
Double duct (dilatation of CBD and pancreatic duct)

35
Q

Pancreatic cancer management

A

Whipple’s resection (pancreaticoduodenectomy)
Adjuvant chemo
ERCP with stenting

36
Q

Main investigation for acute pancreatitis

A

Amylase

37
Q

How to find cause of acute pancreatitis

A

USS

38
Q

Acute pancreatitis management

A

Fluids
Analgesia (IV morphine, STAT boluses)

If necrotising: abx

Maintain enteral feeding

39
Q

Most common cause of chronic pancreatitis

A

Alcohol

40
Q

When is pain worse in chronic pancreatitis and when does steatorrhoea occur?

A

15-30 mins after meal

Steatorrhoea 5-25 years after pain

41
Q

Chronic pancreatitis investigations

A

Faecal elastase - low
T2DM scnreening
CT - calcification

42
Q

Chronic pancreatitis management

A

Alcohol and smoking cessation
Analgesia
Pancreatic enzymes

43
Q

Arterial supply of oesophagus

A

Thoracic: thoracic aorta and inferior thyroid artery
Abdominal: left gastric artery (from coeliac trunk)

44
Q

Arterial supply of duodenum

A

Gastroduodenal artry and inferior pancreatoduodenal artery (from superior mesenteric)

45
Q

Arterial supply of jejunum and ileum

A

Superior mesenteric artery

Year 6 (19 decks)

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