Gastrointestinal Flashcards
Signs of acute porphyria
Intermittent worsening abdo pain, nausea, lethargy
Recent course of nitrofuratoin (UTI)
Treatment of acute alc withdrawal
Reducing regimen of chlordiazepoxide and Pabrinex
Vit defic causing Wernicke’s encephalopathy
B1
High/Low SAAG caused by…
High - Portal HT
Low - Peritoneal cancers
First line ascites treatment
Spironolactone
Absolute contraindications to ascitic tap
Disseminated intravasc coag (bleeding gums, raised D-dimer, low fibrinogen)
First line for AI hepatitis
Immunosuppressants (azathioprine!!!!!!)
Management for Barrett’s w high-grade dysplasia
Endoscopic ablation/resection
Oeso cancer most assoc w Barrett’s
Adenocarcinoma
Treatment of carcinoid crisis
Octreotide
Abrupt onset watery diarrhoea
Cholera
Cholera treatment
Doxycycline or co-trimoxazole
Chronic pancreatitis on AXR/CT
Pancreatic calcification
Name for scratches from constant itching
Excoriations
First line for C.diff
Oral vancomycin
Colonoscopy appearance of pseudomembraneus colitis from C. diff
Raised yellow plaques across mucosa
What type of cancer are Coeliacs most at risk of?
Small bowel lymphoma
In which disease must you also test for Coeliac?
Grave’s (thyroid)
What can you see on buttocks in Coeliac?
Pruritic papulovesicular lesions
What is alpha-feto protein a marker of?
Hepatocellular cancer
Also testicular/germ cell cancer
Management of fistulae
Trans-sphincteric - drainage seton
Low/submucosal - fistulotomy
Perianal - insertion of fistula plug
Crohn’s on endoscopic biopsy
Non-caseating granulomas
Test to definitively distinguish Crohn’s and UC
Ileocolonoscopy and biopsy
Investigation for sepsis in Crohn’s
Urgent MRI pelvis
What drugs can commonly cause dyspepsia?
Clarithromycin
Risedronate
New onset dyspepsi + WL + >55 + H.pylori pos = which investigation?
Endoscopy within 2w
Liver foci and bloody diarrhoea from gastroenteritis?
Entamoeba histolytica
Campylobactor (gm- rod) treated w…
Erythromycin (macrolide)
What gastroenteritis pathogen is GBS associated with?
Campylobacter jejuni
What is the cause of abdo discomfort, bloating and flatulence after giardia treatment?
Lactose intolerance
Hep B serology seen w previous vaccination?
HbSAg negative, Anti-HbS positive, Anti-HbC negative
Pharma treatment for haemochromatosis
Desferrioxamine
Diag of hernia
Barium swallow !!!!!!
Endoscopy
Oeso manometry
Management of hernia
Conservative (WL, raise bed head, avoid large meals before sleep, avoid alc/acid foods/smoking/spec drugs etc)
Meds (PPI for 4-8w then review)
Surgery (Nissen’s fundiplication if med-resistance, urgent is haem/necrosis/volvulus/obs)
What drugs can affect hernia?
Calcium channel blockers e.g. amlodipine
Beta blockers
Drugs causing diarrhoea
Magnesium Antibiotics - penicillins Chemotherapy Omeprazole Cimetidine Ranitidine NSAIDs Metformin
Drugs causing constipation
Anti-depressant agents Anti-psychotic agents Levodopa Aluminium Iron Opiates
Inv for flow over diarrhoea
Rectal exam
Indication for TIPSS
Secondary prophylaxis for oesophageal variceal bleeding
Treatment of refractory ascites
Treating portal hypertension in Budd-Chiari syndrome
How can TIPSS cause hepatic encephalopathy?
Diverts blood flow away from liver and reduces ammonia breakdown
When is pain relieved in IBS?
After defaecation
Mirrizi’s disease
Causes obs jundice due to compression of common bile duct secondary to gallstones
Produces conjugated hyperbilirubinaemia
Features of primary sclerosing cholangitis
Fatigue, itch etc
Deranged LFTs
AMA +ve
Hepatic jaundice LFTs…
Raised bilirubin
Raised AST and ALT
Maybe slightly raised ALP
Low albumin
Classification of cirrhosis w Child-Pugh score
A <7 points
B 7-9 points
C >9 points
Cirrhosis complications
Ascites SBP Liver failure Hepatocellular carcinoma Oeso varices +/- haemorrhage Renal failure