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GI Flashcards

1
Q

amylase level greater than what is considered to be diagnostic of pancreatitis

A

1000u/l

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2
Q

can raised serum amylase levels diagnose pancreatitis

A

no but can suggest it as other things also raise it and in severe pancratitis serum amylase can be normal

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3
Q

sudden osnet abdo pain, vomitting profusely and pain in epigastric region that radiates to back , drank alot of alcohol

A

pancreatitis

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4
Q

symptoms of exacerbation of crohns

A

bloody bowel motions, fatigue, tachycardia, elevated inflammatory markers

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5
Q

chrons disease exacerbation and acutely unwell treatment?

A

IV hydration, electrolyte replacement and corticosteriods

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6
Q

macrocytic anaemia results from

A

increased utilisation of vitamin B12 by colonised bacteria

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7
Q

steatorrhoea is caused by

A

reduced conc. of conjugated bile acids

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8
Q

— can convert conjugated bile acids to unconjugated bile acids, which results in impaired micelle formation

A

bacteriodes

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9
Q

diarrhoe is due to

A

steatorrhea

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10
Q

Bacterial overgrowth syndrome constitutes a group of disorders characterised by

A

diarrhoea, steatorrhoea and macrocytic anaemia

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11
Q

anatomic stasis due to duodenal or jejunal diverticula can result in the development of

A

bacterial overgrowth syndrome

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12
Q

acquired deficiency of intrinsic factor is seen in

A

pernicious anaemia

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13
Q

pernicious anaemia does not have

A

diarrhoea or steatorrhoea

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14
Q

calcification of the pancreas

A

chronic pancreatitis

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15
Q

chronic pancreatic insufficiency is most commonly associated with chronic pancreatitis caused by

A

high alcohol intake or cystic fibrosis

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16
Q

Fish tapeworm infestation cause

A

vitamin b12 deficiency,but steatorrhoea, diarrhoea, jejuna diverticula make bacterial overgrowth syndrome more likely

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17
Q

history of HIV, white mass on lateral aspect of tongue which cannot be scraped off

A

oral hairy leukplakia

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18
Q

first line treatment for oral hairy leukoplakia

A

antivirals

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19
Q

oral hairy leukplakia

A

a non- premaliganant Epstein-barr virus manifestation

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20
Q

oral candiasis can typically be

A

scraped off with a tongue blade

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21
Q

white lacy patches

A

oral lichen planus

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22
Q

what deficincey is common in alcoholics

A

B1 (thiamine)

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23
Q

thiamine deficiency causes

A

Wernicke’e encephalopathy - confusion, coma, ataxia, nystagmus, with the preservation of pupillary responses

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24
Q

vitamin b3 deficiency (niacin) causes

A

pellagra characterised by diarrhoea, dermatitis and dementia

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25
Q

vitamin A deficiency causes

A

photophobia, dry conjunctiva, dry cornea, dry scaly skin, anaemia and growth retardation- it is essential for retinal pigments, epithelial maturation and bone development

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26
Q

Vitamin — deficincy may present in patients with alcholic cirrhosis

A

K

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27
Q

acute abdo pain, rapidly developing asictes, elevated liver enzymes, enlarged caudate lobe,

A

hepatous venous outflow obstruction or Budd Chairi syndrome

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28
Q

In Budd -chairi syndrome, venous thrombosis forms anywhere from the hepatic venules up to the entrance of the

A

Inferior vena cava

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29
Q

Most commonly in budd-chiari syndrome, the venous thrombosis is with the

A

hepatic vein

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30
Q

firts line diagnostic investigation for hepatic venous obstruction

A

Ultrasound doppler

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31
Q

Management steps for budd-chairi syndrome

A

initially- anticoagulation

secondly- angioplasty with/out stenting or thromlysis

third line- Transjugular intrahepatic portosystemic shunt ( TIPSS)

  • liver transplant
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32
Q

treatment for Budd chairi syndrome , if AST >1000

A

liver transplantation

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33
Q

features of crohns disease

A

anorexia, fatigue, perianal and perioral ulceration, joint pain, rashes such as erythema nodosum

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34
Q

typically presents with bloody diarrhoea and mucus

A

ulcerative colitis

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35
Q

epigastric pain and heartburn symptoms

A

peptic ulcer disease

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36
Q

right upper quadrant pain and symptoms may be aggravated bu eating foods high in fat

A

gall stones

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37
Q

left iliac fossa abdominal pain - common in elderly

A

diverticulitis

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38
Q

corkscrew appearance on oesophagus

A

oesophageal spasm

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39
Q

barium swallow- post cricoid web , iron deficiency anaemia and dysphagia

A

Plummer vinson syndrome

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40
Q

spontaneous rupture of the oesophagus after forceful and severe vomitting. classically occur after excessive overeating and alcohol consumption. left sided pleural effusions is often an early finding on a CXR

A

boerhaave syndrome

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41
Q

bloody diarrhoea, tenesmus (feeling as though he needs to empty his bowels) and left lower quadrant tenderness point to

A

inflammatory bowel disease (Uc or crohns)

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42
Q

flu-like illness, anorexia, nausea and vomitting, general malaise followed by acute hepatitis with __ tenderness, jaundice pale stools and dark urine if cholestasis develops and on palpatation hepatomegaly will likely be present

= acute hepatitis A infection ]-common in north africa

A

RUQ

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43
Q

is there a significant risk of acute hepatitis A infection progressing to cirrhosis

A

NO!

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44
Q

HEP A and E transmitted by the

A

fAEcal -oral route

hep b and c by blood products and sexual intercourse and other ways

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45
Q

raised neutrophil count in ascites fluidin patient with cirrhosis of the liver and asictes

A

Spontaneous bacterial peritonitis

  • serious complicatio and occur in approx 8% of cases of cirrhosis with ascites
  • high mortality rate and high recurrence rate
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46
Q

most reflective of synthetic liver function

A
  • pro-thrombin time and albumin

(pro-thrombin timw increases and is an indicator of acute sythetic function, albumin gives an indication of synthetic liver function over a longer period, given the half life 20 days in serum)

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47
Q

ALP would be raised in

A

cholestatic disease

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48
Q

ALT and AST represent liver

A

parenchymal function

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49
Q

hepatic portal vein is formed by the union of the

A

superior mesenteric and spenic veins

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50
Q

liver in patient is cirrhotic and and — vein is obstructed, this is the cause of caput medusae

A

hepatic portal

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51
Q

tropical sprue presents with

A

chronic dirarrhoea, weight loss, vitamin b12 and folate deficiencies- seen in tropical countires like india

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52
Q

predominant mononuclear cell infiltration and less villous atrophy throughout the intestine

A

tropical sprue

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53
Q

treatment of tropical sprue

A

broad spectrum antibiotics

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54
Q

presentation of somatostatinoma

A

gallstones, weight loss, diarrhoea and diabetes mellitus

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55
Q

Glucagonoma typically presents with

A

diabetes mellitus, weight loss, anaemia, and classical rash is necrolytic migratory erythema

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56
Q

insulinoma presents with

A

sweating, weight gain, light-headedness and loss of consciousness- exacerbated by exercise or fasting

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57
Q

gastrinoma characterised by

A

peptic ulceration, gastric acid hypersecretion, non B cell islet tumour of the pancreas

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58
Q

VIPoma presents with

A

severe watery diarrhoea, which therefore gives significant hypokalemia, and achlorhydria

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59
Q

abdo pain which radiates to the back, significant elevation in amylase levels following endoscopic retrograde cholangiopancreatography (ERCP)

A

Post ERCP pancreatitis

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60
Q

vomitted bright red blood twice, palpable spleen tip, spider naevi over the check neck and arms

A

oesophageal varices

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61
Q

spleonmegaly and spider narvi are suggestive of

A

chronic liver failure with portal hypertension

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62
Q

immediate management of oesophageal varices

A

resuscitation, PPI, urgent endoscopy to diagnose and treat teh source of bleeding

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63
Q

Mallory-weiss tear classicaly occurs after severe

A

retching and vomitting or coughing

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64
Q

red flags for malignancy

A

appetite and anaemia

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65
Q

red flags for malignancy and luminal obstruction what investigation

A

colonoscopy

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66
Q

most common causes of exudative ascites are

A

infection or malignancy

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67
Q

causes of transudative ascites

A

-cardiac failure, portal hypertension, fulminant hepatic failure, budd-chairi syndrome

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68
Q

relatively common in elderly, muscle and joint pain, fatigue, red dots on the skin (perifollicular heamorrhages), bleeding and inflammation of the gums (gingivitis) ,easy brusing

A

scurvy (VITAMI C DEFICIENCY)

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69
Q

hypothyroidism is more likely to do what to weight

A

weight gain

and dry, coarse skin

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70
Q

lead posioning

A

abdo pain, confusion, headaches

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71
Q

while vitamin K deficiency may cause bleeding and easy brusing, it is much less common than

A

vitamin C defiency

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72
Q

you would expect a raised plasma urea level in

A

gastric ulcer

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73
Q

urea is produced as a by-product from the digestion of

A

blood

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74
Q

epigastric pain, which ususally occurs before meals or at night, relieved by eating or drinking milk

A

duodenal ulcer

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75
Q

duodenal ulcers usually occur in the presence of oversecretion of gastric acid

A
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76
Q

causes of duodenal ulcer:

A

HELICOBACTER PYLORI,NSAIDS, STERIODS AND ASPIRIN

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77
Q

GASTRIC ULCERS ARE LESS COMMON THAN DUODENAL ULCERS AND PATIETNS WITH GASTRIC ULCERS TEND TO HAVE

A

NORMAL OR LOW SECRETION OF GASTRIC ACID

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78
Q

solitary, well defined painful lesion in mouth

A

aphthous ulcer - benign oral lesion found in approx 20% of the population

  • common triggers coffee and chocolate
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79
Q

first line management of aphthous ulcer

A

topical steriods and topical lidocaine for pain control

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80
Q

shaggy, white patch on the lateral aspect of the tongue

A

oral hairy leukoplakia

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81
Q

oral steriods should eb used cautiously in patietns with daiebets as they can cause

A

hyperglycaemia

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82
Q

treatment for oesophageal varices in patient with known alcoholic liver disease

A

non-specific beta blockers- nadolol and propanolol

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83
Q

blood and tender iliac fossa hint

A

UC

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84
Q

Ulcerative colitis is strongly associated with

A

primary sclerosing cholangitis

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85
Q

UC raised

A

ALP, ASMA, isolated ALP is often observed

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86
Q

what reduces surface mucus secretion

A

Aspirin

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87
Q

taking aspirin with — has been shown to reduce the risk of GI bleeding and peptic ulceration

A

PPI

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88
Q

aspirin causes increased acid production from gastric parietal cells as — normally inhibit acid secretion

A

prostaglandins

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89
Q

first line treatment for Hep C

A

Direct acting antivirals

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90
Q

diarrhoea, wheezing, flushing, weight loss

A

Neuroendocrine tumour

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91
Q

most common site for gastrin secreting tumours that cause zollinger- ellison syndrome

A

First/ second parts of duodenum

92
Q

what is infectious mononucleosis

A

glandular fever

93
Q

20y/o student w fever, sore throat, tender cervical lymphadenopathy and enlarged tender liver

A

glandular fever - enlarged over or spleen in 10% of cases - causative organism - epstein barr virus

94
Q

glandular fever patients should avoid what in the first month

A

contact sports or heavy lifting

95
Q

diagnosis for glandular fever

A

MONOSPOT TEST( PAUL BUNNELL)

96
Q

Altered bowel habit and has lost weight recently

A

colorectal cancer with liver metastasis

97
Q

liver metastases commonly arise from

A

bowel and breast cancer

98
Q

abdominal swelling, hepatomegaly, lower limb oedema, SOB, past history of rheumatic fever and has hypertension

A

Congestive cardiac failure

(right heart failure is often a forgotten cause of ascites and hepatomegaly)

In tric regurg the enlarged liver may be pulsatile

99
Q

feeling tired and diarrheoa, brusing tendency, large beefy tongue, lymphadenopathy and hepatomegaly

A

Amyloidosis

100
Q

lumps and generalised symptoms- unintentional weight loss, fever, night sweats, involvement of liver, spleen, bone marrow

A
101
Q

lymph node pain on drinking alcohol is said to be a feature of

A

hodgkin’s disease

102
Q

around 70-90% of patients with PSC (primary sclerosing cholangitis) have

A

inflammatory bowel disease

103
Q

gold invstigation for PSC

A

ERCP

104
Q

beaded appearance of biliary ducts, and liver biopsy showing – skin appearance

A

onion

105
Q

PSC - posive

PBS-positive

(antibody)

A

ANCA

AMA

106
Q

ascending cholangitis triad

A

jaundice, abdo pain and fever

107
Q

High serum amylase and serum lipase levels may indicate — -induced pancreatitis

A

hypertriglyceridaemia

108
Q

invstigation to check if a peptic ulcer has perforated

A

erect CXR

(show air under the diaphragm if a peptic ulcer has perforated)

109
Q

hyper/hypocalcaemia in acute pancreatitis

A

HypOcalcaemia

110
Q

symptoms that change at different points in the menstrual cycle is not an unusual finding in

A

IBS

111
Q

much older than 26, acute onset lower abdo pain, altered bowel habit, rectal bleeding and fever

A

diverticulitis

112
Q

advacned disease of chronic pancreatitis has

A

steatorrhoea

113
Q

upper abdominal discomfort related to eating, without any consistent disturbance of bowel habit

A

peptic ulcer disease

114
Q

what needs to be avoided ebefore doing the hydrogen breath test

A

smoking

avoid carbs the night before

115
Q

post partum, on the pil, RUQ painn, nausea and vomiting, hepatosplenomegaly, ascites

A

Budd-chairi syndrome

116
Q

budd-chiarai syndrome commonly results in

A

hepatosplenomegaly and ascities

-associated with pregnancy and being post partum- use of pill can increase risk

117
Q

rise in bilirubin, young, no liver disease, jaundiced

A

gilberts syndrome

118
Q

death or jaundice in neonate

A

Crigler Najjar

119
Q

accumulate copper

A

wilsons disease

120
Q

recurrent episodes of cholangitis

A

caroli’s syndrome

121
Q

elevated ferritin points towards a diagnosis of

A

Haemochromatosis

122
Q

bronze diabetes

A

haemochromatosis

123
Q

low ceruloplasmin, along with high urinary copper is typical of

A

Wilson’s disease

124
Q

positive AMA

A

PBC

125
Q

high transferrin saturation

A

haemochromatosis- iron overload leading to liver cirrhosis, bronze colour to the skin

126
Q

positive ANA or anti-SMA

A

autoimmune hepatitis

127
Q

history of travel, lack of drug use, blood transfusion and unprotected sex , what hep

A

A

  • eating shellfish, water contaminated by sewage, crowded, poor sanitation
128
Q

hep B and – are cotransmitted

A

D

129
Q

hep C is contacted by

A

saliva and blood

130
Q

Hep B is contracted by

A

blood, saliva, sexual contact

131
Q

yellow fever assoiated with travel to

A

tropical rainforests

132
Q

young person, flu like symptoms, mild janudice, raised bilirubin

A

gilberts syndrome

133
Q

RUQ pain and fever, but no jaundice

A

Cholecystitis

134
Q

HIV patient, pain affectid right side of face and got a rash affecting right cheek and right side of his palate

A

Shingles (herpes zoster)

135
Q

most common cause of mouth ulcers particularly in young people

A

recurrent apthous stomatitis

136
Q

behcet disease is common in asian and mediterranean countries eg

A

turkey

137
Q

recurrent orogenital ulceration plus any no. of systemic manifestations eg joint pain, acne like lesions

A

behcets disease

138
Q

associated with HLA-B51

A

behcets disease

139
Q

common drugs that cause stevens johnson sydrome

A

allopurinol, antiepileptics, trimethoprim

140
Q

lesions on skin, oral ulceration, crusting of the lips

A

stevens johnson sydrome

141
Q

small pale papule on upper lip which develops into a large, painless indurated ulcer

A

syphillis

142
Q

spleonmegaly and spider naevi are suggestive of chronic liver failure with portal hypertension. portal hypertension can lead to —- which can rupture, causing severe bleeding, manifested as heamatemesis.

A

oesophageal varices

143
Q

occurs in patients after severe coughing, vomitting or retching

A

mallory weiss tear

144
Q

sudden onset large volume of blood

A

oesophageal varices

145
Q

oesophagitis is very

A

painful

146
Q

symptoms of delirium tremens

A

agitation, hyperthermia, visual hallucinations

147
Q

first line therapy for delirium tremens

A

Lorazepam

148
Q

– lies at the severe end of the alcohol withdrawl spectrum

A

delirium tremens

149
Q

histology shows acive inflammation

A

Helicobacter pylori gastritis

150
Q

progressive painless jaundice. more common in men over 50, gives rise to hepatomegaly, stools paler than normal and urine darker,

A

cholangiocarcinoma

151
Q

in acute cholecystitis you would expect

A

marked abdominal pain and pyrexia

152
Q

haemolytic anaemia gives rise to

A

pre-hepatic jaundice, colour of urine and stool remains unchanged

153
Q

if suspect obstruction , first line investigation is — of the abdomen

A

ultrasound

154
Q

LFTs of an obstructive/ cholestatic

A

ALP and GGT raised more than AST or ALT

155
Q

common causes of obstructive jaundice

A

gallstones within the comon bile duct

cancer within the head of the pancreas

certain autoimmune liver diseases (PSC or PBC)

156
Q

what investigation after upper GI endoscopy, colonscopy and small bowel contrast study

A

capsule endoscopy- not if got swallowing disorder, stricture or fistula, suspected small bowel stenosis

157
Q

malaena is due to GI bleeding so what investigation

A

endoscopy

158
Q

what would you inject a bleeding ulcer withbefore it is clipped to prevent re-bleed

A

adrenaline

159
Q

hepatocytes differentiate from the

A

endoderm

160
Q

Mallory bodies are seen in

A

injured hepatocytes

161
Q

what is the precursor of cirrhosis

A

bridging fibrosis

162
Q

small dilated blood vessels on face and trunk, palmar erythema, dilation of the superificial abdominal veisn

A

cirrhosis or irreversible liver injury

163
Q

triple therapy for H.pylor (common cause of peptic ulceration)

A

PPI including omeprazole, clarithromycin and amoxicillin

164
Q

treatment for h.pylori if allergic to pencillin

A

PPI, clarithromycin and metronidazole

165
Q

second line eradication fro h.pylori

A

Metronidazole or clarithromycin, bismuth, tetracycline and PPI

166
Q

investigatio for non alcoholic fatty liver disease

A

ultrasound liver

167
Q

-raised ALT, impaired glucose regulation referenced by teh thickened folds of skin in the axilla, high BMI

A
168
Q

HBsAg indicates

A

current infection

169
Q

HBeAg indicates

A

current infection (suggests highly active HBV)

170
Q

if patients had HBeAb and not HBeAG this would suggest

A

chronic carrier state of low infectivity

171
Q

presence of — would indicates immunity to HBV

A

HBV surface antibody

172
Q

what region of the stomach is closest to the oesophagogastric junction

A

cardia

The cardia of the stomach surrounds the opening of the oesophagus into the stomach

173
Q

duodenal ulcer is a type of

A

peptic ulcer disease

174
Q

risk factors for peptic ucler disease

A

smoking, H.pylori infection, NSAIS, zollinger ellison syndrome

175
Q

appendicitis

A

central abdominal pain that localises to the right iliac fossa with associated anorexia, fevers and peritonism

176
Q

chronic mesenteric ischaemia

A

severe, colicky, post prandial abdo pain, weight loss, abdominal bruit

177
Q

diverticulitis

A

left iliac fossa pain with rectal bleeding, fevers and tachycardia

178
Q

pancreatitis

A

central abdominal pain radiating to the back in patients who have a history of gallstones, alcoholism, or abdominal trauma

179
Q

hip pain more common in – than crohns

A

UC

180
Q

Primary sclerosing cholangitis is a condition in which

A

inflammation, fibrosis and strictures of the intra and extra hepatic bile ducts occur

(MRCP shows multiple strictures in the biliary tree adn a characteristic ‘beaded’ appearance. Around 80% of patients with PSC will have UC)

181
Q

cholangitis is

A

ascending infection of the biliary tree

182
Q

cholecystitis refers to

A

inflammation of the gallbladder, most commonly caused by gallstones

183
Q

findings of strictures on MRCP is more suggestive of

A

Primary sclerosing cholangitis

184
Q

Primary biliary cholangitis is an

A

autoimmune disorder causing destruction of the small interlobular bile ducts, subsequent intrahepatic choleostasis causes fibrosis and ultimately cirrhosis of the liver

185
Q

glasgow severity score is used for

A

severity stratification (within 48hrs of admission)

score of 3 or above indicates intensive care unit

186
Q

not a parameter in glasgow severity scoring

A

serum amylase

  • may be normal in severe pancreatitis and may be elevated in many other conditions.
187
Q

first line method to confirm safe placement of NG tube before commencing feeding

A

Aspirate 10ml and check the pH

if less than 5.5 then NG tube can be safely used

188
Q

red flag of cancer

A

subacute first onset dysphagia which is limited to solids

189
Q

painless jaundice, weight loss, epigastric discomfort, development of diabetes

A

pancreatic carcinoma

painless jaundice is significantly associated with pancreatic carcinoma

190
Q

progressively worsening jaundice, weight loss, strong alcohol history

A

pancreatic cancer

191
Q

presenting symptoms of cholangiocarcinoma

A

jaundice, abdominal pain, itching

192
Q

nail clubbing, palmar erythema, spider naevi- no jaundice

A

chronic liver disease

193
Q

first line treatments for autoimmune hepatitis

A

Azathioprine and prednisolone

194
Q

deranged liver function tests, jaundice, itching and chronic fatigue

A

PSC

195
Q

white lesion in mouth that can be easily scraped off treatment

A

Oral candidiasis - nystatin suspension- like mouth wash

196
Q

RUQ pain, fever, elevated white cell count

A

acute cholecystitis

197
Q

RUQ pain, fever, elevated white cell count

A

acute cholecystitis

198
Q

management of acute cholecystitis

A

laparoscopic cholecystectomy

199
Q

— classicaly presents gradually with difficulty swallowing both solids and liquids over time as the lower oesophageal sphincter fails to relax

A

achalasia

200
Q

Long term reflux causes damage to the oesophageal epithelium, which is replaced by fibrosis and results in a stricture. This in itself leads to dysphagia but can also predispose to malignancy through a pre-malignant stage known as

A

Barret’s metaplasia

201
Q

previously investigated for anaemia and now complains of dysphagia

A

Plummer-vinson sydrome

-occurs in pre-menopausal women

202
Q

fibrosis resulting in disruption of normal liver architecture

A

alcoholic cirrhosis

203
Q

deposition of excess lipids in hepatocytes

A

NAFLD

204
Q

increase in portal blood pressure

A

portal hypertension - sequelae of alcoholic liver disease.

205
Q

sclerosis of the intra and extrahepatic bile ducts

A

PSC- causes inflammation, fibrosis, and strictures of the bile ducts. Strong association with UC

206
Q

investigations would best distinguish pernicious anaemia from otehr causes of malabsorption as the cause of low b12

A

intrinsic factor antibodies

207
Q

PERNICIOUS ANAEMIA IS CAUSED BY

A

ANTIBODIES WHICH TARGET EITHER INTRINSIC FACTOR OR THE GASTRIC PARIETAL CELLS

208
Q

C14 BREATH TESTS ARE USED IN THE IDENTIFICATION OF

A

H.PYLORI, A CAUSE OF PEPTIC ULCERS

209
Q

TREATMENT FOR SEVERE TREATMENT RESISTANT C. DIFFICILE

A

IV METRONIDAZOLE OR FACEAL TRANSPLANT

NEEDS TO BE IV METRONIDAZOLE

210
Q

CLASSIC SYMPTOMS OF HAEMORRHOIDS

A

fresh red blood and mucous after passing stool, pruritic anusm soreness around anus

211
Q

risk factors for heamorrhoids

A

obesity, chronic constipation, coughing

212
Q

Diverticulitis is characterised by passing fresh red blood per rectum, other associated symptoms are

A

nausea and vomitting, pyrexia and abdo pain

213
Q

anal fissures associated with

A

sharp anal pain when stools are passed

214
Q

blood supply to the stomach originates from the

A

coeliac trunk

215
Q

coeliac trunk 3 main divisions:

A

Left gastric artery(oesophageal and stomach branch), common hepatic arery (proper hepatic artery, right gastric artery, gastroduodenal artery), splenic artery (short gastric arteries, branches to the pancreas)

216
Q

In haemochromatosis there is increased risk of

A

hepatocellular carcinoma

217
Q

is associated with haemochromatosis

A

arthropathy

218
Q

p-ANCA is elevated in patients with

A

UC and or PSC

219
Q

ASMA are markers for

A

autoimmune hepaitis

220
Q

increased ASCA is associated with

A

crohns disease

221
Q

elevated levels of Anti-dsDNA is found in

A

SLE

222
Q

what nerves supply the muscularis externa of the oesophagus

A

vagus nerve

223
Q

vagus nerve has a parasympathetic action and stimulate — and supply teh smooth muscle

A

peristalsis

224
Q

At the gastro-oesophageal junction there is the lower oesophageal sphincter, that under the influence of the vagus nerve, relaxes to allow food to enter the stomach. In —- , there is increased tone of the lower oesophageal sphincter, incomplete relaxation ans lack of peristalsis. as a result has dysphagia and regurg

A

oesophageal achalasia

225
Q

greater splanchnic nerves supply

A

enteric nervous system and the adrenals

226
Q

— nerves supply msucles for swallowing

A

glossopharyngeal (parasympathetic)

227
Q

are rice and potatoes gluten free

A

yes

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