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MCQ Review > Gastrointestinal system > Flashcards

Gastrointestinal system Flashcards

1
Q

Criteria used for prognosticating chronic liver disease and cirrhosis

A

Child-Pugh classification

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2
Q

The 5 clinical features of Child-Pugh classification

A
  1. Total bilirubin
  2. Serum albumin
  3. Prothrombin time or INR
  4. Ascites
  5. Hepatic encephalopathy
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3
Q

Complication of reflux esophagitis that can lead to progressive obstruction

A

peptic esophageal stricture

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4
Q

Antibiotic given in preparation for emergency appendectomy

A

single dose 3rd gen cephalosporin

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5
Q

Risk factor in patients with primary jejunal lymphoma

A

coeliac disease

(particularly tumors in proximal jejunum)

Crohn - usually in the distal ileum
FAP - duodenal

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6
Q

Most common cause of early postoperative fever, particularly in heavy smokers

A

pulmonary atelectasis

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7
Q

Virus associated with hepatocellular carcinoma

A

Hep B

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8
Q

DOC for chronic hep B

A

Lamivudine over 12 months

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9
Q

Sudden passage of large amount of blood, with or without fecal material is characteristic of

A

Diverticular disease

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10
Q

systemic venous circulation develops around the umbilicus due to shunting of obstructed portal circulation

A

caput medusae

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11
Q

Bleeding from esophageal varices in the australian community is most commonly due to _____

A

alcoholic liver disease

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12
Q

Uncommon condition where thrombosis of larger hepatic veins, sometimes secondary to polycythemia can cause hepatic venous congestion, marked ascites and progression to hepatic cirrhosis and liver failure

A

Budd-Chiari syndrome

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13
Q

Classic tetrad of intestinal obstruction

A

Abdominal colic, vomiting, constipation, distention

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14
Q

Xray appearance: large bowel gaseous dilatation cut off at the sigmoid without rectal gas.

A

Colon CA with obstruction

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15
Q

Xray findings: Inverted U loop of dilated gas-filled signmoid colon

A

sigmoid volvulus

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16
Q

Xray findings: luminal boluses with accompanying colonic dilatation

A

fecal impaction

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17
Q

Xray findings: diffuse distention of small and large bowel

A

drug-induced pseudo obstruction

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18
Q

Xray findings: markedly dilated small bowel loops with fluid levels in the absence of distal large bowel gas

A

Adhesion-obstruction

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19
Q

Meckel diverticulum rule of 2s

A

2% of individuals
2 feet from ileocecal valve
2 inches long
2 inches wide

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20
Q

Most important factor contributing to postoperative wound disruption/subcutaneous dehiscence of deep wound layers

A

paralytic ileus - increases intra-abdominal pressure with abdominal distention

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21
Q

predisposes to intusussception in ADULTS

A

metastatic melanoma deposit

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22
Q

predisposes to intusussception in CHILDREN

A

enlarged peyer patches

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23
Q

Life-threatening complication of ulcerative colitis

A

toxic megacolon

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24
Q

Clinical features: Vomiting, polyhydramnios, abdominal distention, aspiration

A

Tracheoesophageal fistula

25
Q

Congenital malformation of abdominal wall leading to exposure of abdominal contents

A

gastroschisis

26
Q

Persistent herniation of bowel into umbilical cord due to failure of herniated intestines to return to body cavity during devt

A

omphalocele

27
Q

Covering in omphalocoele

A

peritoneum, amnion of umbilical cord

28
Q

Congenital hypertrophy of pyloric smooth muscle

A

pyloric stenosis

29
Q

When does pyloric stenosis present/develop?

A

2 weeks after birth ==>projectile non-bilious vomiting d/t buildup of stomach pressure

30
Q

Olive like mass on palpation of abdomen (pediatric)

A

Pyloric stenosis

31
Q

treatment of pyloric stenosis

A

myotomy

32
Q

Acid damage to gastric mucosa d/t imbalance between acid environment and mucosal defenses

A

Acute gastritis

33
Q

Ulcers caused by hypovolemia and subsequent decreased stomach blood flow due to Severe burns

A

Curling ulcer

34
Q

Ulcers formed by increased vagal stimulation and increased Ach due to Increased intracranial pressure

A

Cushing ulcer

35
Q

Gastric ulcer vs erosion

A

erosion - epithelial loss

ulcer- mucosal

36
Q

most common cause of vitamin B12 deficiency

A

Chronic autoimmune gastritis (d/t lack of intrinsic factor, which is needed for VB12 absorption)

37
Q

Chronic gastritis Autoimmune vs h. Pylori based on location

A

autoimmune - fundus and body

Hpylori - antrum

38
Q

Mechanism of injury in H pylori gastritis

A

H pylori sits on top of the epithelium (no invasion) and produces damage via ureases and proteases

39
Q

CA Risk in chronic h pylori gastritis

A

Gastric adenocarcinoma, MALT lymphoma (due to production of germinal centers)

40
Q

Treatment in chronic h pylori gastritis

A

Triple therapy: PPI + Clarithromycin* + Amoxicillin*

*may be replaced with metronidazole if with contraindication

For 14 days

41
Q

Epigastric pain that improves with meals

A

Peptic ulcer disease

42
Q

solitary mucosal ulcer in proximal duodenum or distal stomach

A

Peptic ulcer disease

43
Q

2 complications of PUD on the POSTERIOR wall

A

1) rupture and bleeding from gastroduodenal artery

2) acute pancreatitis

44
Q

Epigastric pain that worsens with meals

A

Gastric ulcer

45
Q

Most common location of gastric ulcer

A

Lesser curvature

46
Q

Risk of bleeding in gastric ulcer from which artery?

A

Left Gastric artery

47
Q

Features of benign gastric ulcer on endoscopy

A

Small, punched out appearance, margins flat

48
Q

Features of malignant gastric ulcer on endoscopy

A

Large, with irregular ”heaped-up” margins

49
Q

Subtypes of gastric CA

A

1) intestinal type

2) diffuse type

50
Q

CA in which Signet ring cells infiltrate gastric wall producing desmoplasia (lintis plastica)

A

Diffuse type gastric adenocarcinoma

51
Q

Bilateral ovarian metastases of gastric CA diffuse type

A

Krukenburg tumor

52
Q

GI congenital disorder highly associated with Down Syndrome

A

Duodenal atresia

53
Q

hernia most likely to strangulate

A

femoral hernia - obliquely tortous track and narrow rigid neck

54
Q

Typical march of symptoms in acute appendicitis

A 
mild bowel upset 
abdominal pain
anorexia 
nausea and vomiting 
moderate fever
focal peritonitis
55
Q

Colorectal CA screening for patients with NO risk factors

A

annual FOBT or sigmoidoscopy in patients over 50 years old

56
Q

Colorectal CA screening for those with above average risk (no personal history, with 1st or 2nd degree relative)

A

5 yearly colonoscopy and annual FOBT in intervening years

57
Q

Colorectal CA in patients with familirs with FAP or HNPCC

A

Annual or biennial colonoscopy, commencing at 25 yo (HNPCC); annual sigmoidoscopy from the age of 10 then every 3 years from the age of 35 (FAP)

58
Q

Double bubble sign on xray

A

duodenal atresia

MCQ Review (12 decks)

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