GI Flashcards

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1
Q

Thumb-printing sign

  1. Sign
  2. Differentials
A

Thumb-printing sign

  1. Thumb imprints along bowel wall
    • Oedematous large bowel
    • Enlarged haustrae
  2. Inflammatory process
    • IBD
    • Infection eg. Pseudomembranous colitis
    • Ischaemia
    • Diverticulitis
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2
Q

Bowel Habit

- Five questions

A

Bowel habit

  1. How often?
  2. Change in frequency or form?
  3. Waking overnight?
  4. Blood or mucous?
  5. Tenesmus, urgency, or incontinence?
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3
Q

Which IBD has:

  1. Transmural inflammation
  2. Crypt abscesses
  3. Decreased incidence in smokers
  4. Lymphoid and neutrophil aggregates
A

IBD

  1. Transmural inflammation
    • Crohn’s
  2. Crypt abscesses
    • UC
  3. Decreased incidence in smokers
    • UC
  4. Lymphoid and neutrophil aggregates
    • Crohn’s
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4
Q

Which endoscopy test for:

  1. Bloody diarrhoea
  2. Small bowel mucosa
  3. Proximal disease
A

Which endoscopy test for:

  1. Bloody diarrhoea
    • Flexible sigmoid
  2. Small bowel mucosa
    • Capsule
  3. Proximal disease
    • Colonoscopy
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5
Q

IBD

- Mainstay Treatment

A

IBD Steroids

  1. Oral prednisolone
  2. Oral Budesonide in SB disease
  3. IV Hydrocortisone
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6
Q

IBD Rescue Therapy

  1. UC
  2. Crohn’s
A

IBD Rescue

UC

  1. Ciclosporin and biological
  2. Surgery

Crohn’s

  1. Biological
  2. Surgery
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7
Q

UC

- Maintaining Remission

A

UC - Remission

-	Mesalazine
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8
Q

Crohn’s

- Maintenance therapy

A

Crohn’s
- Maintenance therapy

  1. Azathioprine
  2. Biological (especially peri-anal or fistulating)
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9
Q

Coeliac disease

- Untreated progression

A

Untreated coeliac disease

  1. SB lymphoma
  2. SB cancer
  3. Osteoporosis
  4. Gluten ataxia and neuropathy
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10
Q

Coeliac disease

- Diagnosis

A

Coeliac Dx

  1. tTG
    • Tissue transglutaminase
  2. OGD and duodenal biopsies
    • Villous atrophy
    • Intra-epithelial lymphocytosis
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11
Q

Dyspepsia history

- Five questions

A

Dyspepsia history

  1. Abdo or retrosternal
  2. Waterbrash
  3. Vomitting
  4. Upper GI wind
  5. Weight-loss, Dysphagia, older age
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12
Q

Dysphagia

  1. Phases
  2. DDx
A

Dysphagia

  1. Oro-pharyngeal
    • Neurological
  2. Oesophageal
    • Neuromuscular
    • Obstruction
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13
Q

Liver disease

- History risk factors

A

Liver risk factors

  1. Family history
  2. Sexual history
  3. Medication history
    • Prescribed/self-prescribed
  4. IVDU or dubious sterile procedures
  5. 1990 blood transfusion
  6. Alcohol/metabolic syndrome
  7. Travel
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14
Q

Liver disease

- Five self-resolving acute disease

A

Liver disease

  1. Hep A
  2. Hep E
  3. CMV
  4. EBV
  5. Drug induced DILI
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15
Q

Liver disease

- Five chronic conditions

A

Liver disease

  1. ETOH
  2. Hep C
  3. NASH (non alcoholic steatohepatitis)
  4. AIH (autoimmune hepatitis)
  5. PBC, PSC
    • Biliary cirrhosis
    • Sclerosing cholangitis
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16
Q

Hepatic Encephalopathy

-	Four grades
A

Hepatic Encephalopathy

  1. Psychomotor slowing
  2. Lethargy, disorientation
  3. Drowsy
  4. Coma
17
Q

ALP increase

- Test to confirm liver pathology?

A

ALP Increase

-	Gamma GT will confirm liver origin
18
Q

Hepatic synthetic function

- Three markers

A

Hepatic synthetic function

- Three markers: 1. Bilirubin 2. Albumin 3. INR
19
Q

ALT>500

- Four hepatic causes

A

ALT > 500 (more acute)

- Hepatic causes 1. Viral 2. Ischaemia 3. Toxic 4. Autoimmune
20
Q

ALT 100-200

- Four hepatic causes

A

ALT 100-200

- Four hepatic causes 1. NASH 2. Autoimmune hepatitis 3. Chronic viral hepatitis 4. Drug induced liver injury
21
Q

Dilated bile ducts

- Two cholestatic pathologies

A

Dilated bile ducts
- Cholestatic causes

  1. Gallstones
  2. Malignancy
22
Q

Non-dilated bile ducts

- Three cholestatic pathologies

A

Non-dilated bile ducts
- Three cholestatic pathologies

  1. Alcoholic hepatitis
  2. Cirrhosis
    • PBC/PSC
    • Alcohol
  3. Drug induced liver injury
    • ABx
23
Q

Liver diseases

- More common in women

A

Liver diseases (F)

  1. Autoimmune hepatitis
  2. PBC
24
Q

Liver diseases

- More common in men

A

Liver diseases (M)

  1. PSC (with IBD)
  2. Haemachromatosis (earlier in men)
25
Q

Liver diseases in young people

A

Youth liver diseases

1. Wilsons
2. Anti LKM autoimmune hepatitis
Liver kidney microsomal antibodies

26
Q

Liver cirrhosis

- Imaging

A

Liver cirrhosis

  1. Fibroscan
  2. Varices on endoscopy
27
Q

Liver cirrhosis

- Important screening

A

Liver cirrhosis

- OGD for varices

28
Q

Ascites

- Treatment

A

Ascites

- Treatment 1. Spironolactone 2. Paracentesis if tense
29
Q

Cirrhosis

- Long term complications

A

Cirrhosis complications

  1. Osteoporosis (DEXA)
  2. HCC (Alpha-fetoprotein +USS 6/12)
30
Q

MUST elements

A

MUST

  1. BMI (<20, <18.5)
  2. Weight loss 3 - 6/12 (5%, 10%)
  3. No intake >5days and ill
31
Q

NG Tube

- Drugs effecting needle aspirate

A

NG Tube
- Drugs and aspirate

  1. PPIs effect pH
32
Q

PEG vs RIG

A
  1. PEG
    Percutaneous endoscopic gastrostomy
  2. Radiologically inserted gastrostomy
33
Q

PN feeding

  1. Indications
  2. Risks
  3. Requirements
A

PN Feeding

  1. Indications
    • GI Blockage
    • GI failure
  2. Risks
    • Sepsis
    • Liver dysfunction
  3. Requirements
    • Central line
    • eg. PICC/Hickman
34
Q

GI Bleeding

- Two risk assessments

A

GI Bleeding Assessments

  1. Rockall (Rebleed/death)
  2. Blatchford (Need for intervention)
35
Q

Variceal Bleed

- Management

A

Variceal Bleed
- Management

  1. IV access and fluids
  2. IV Terlipressin
  3. Endoscopy
    (Banding, Linton/Sengstaken tube)
  4. TIPSS
    (Trans-jugular intrahepatic porto-stystemic shunt)
36
Q

Upper GI bleed

- Non variceal Mx

A

Non-variceal UGI Bleed Mx:

  1. IV access and fluids
  2. PPI post-OGD
  3. Endoscopy