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Z2F/Comprehensive Flashcards > GI > Flashcards

GI Flashcards

1
Q

phases of alcoholic liver disease (3)

A

1- alcoholic fatty liver
2- alcoholic hepatitis
3- cirrhosis

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2
Q

medical emergency caused by alcohol withdrawal (& Treatment)

A

Delirium tremens- treat with Chloridazepoxide (or other long acting bentos e.g. Diazepam. Lorazepam can be used in patients with hepatic failure)

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3
Q

vitamin deficiency caused by alcohol?
Which disorders can this cause?

A

Alcohol can cause B1 (Thiamine deficiency)

Wernicke’s encephalopathy, which can progress to Korsakoff’s syndrome

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4
Q

Features of Wernicke’s encephalopathy

A
  • nystagmus
  • ophthalmoplegia
  • ataxia
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5
Q

Additional features in Korsaoff’s syndrome

A
  • Amnesia (anterograde and retrograde)
  • Confabulation
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6
Q

most common causes of liver cirrhosis (4)

A
  • alcoholic liver disease
  • non-alcoholic fatty liver disease
  • Hep B
  • Hep C
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7
Q

What causes splenomegaly in liver cirrhosis?

A

Portal hypertension

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8
Q

What is lactulose used for in connection to liver cirrhosis?

A

Lactulose is used to treat hepatic encephalopathy

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9
Q

Features of hepatic encephalopathy?

A
  • confusion and altered GCS
  • asterix (liver flap)
  • constructional apraxia (inability to draw a 5-pointed star)
  • raised ammonia level
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10
Q

complication of cirrhosis: patient with cirrhosis, ascites and a fever?

A

Spontaneous bacterial peritonitis

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11
Q

stages of non-alcoholic fatty liver disease (4)

A

1- non alcoholic fatty liver disease
2- non-alcoholic steatohepatitis (NASH)
3- fibrosis
4- cirrhosis

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12
Q

full non-invasive liver screen for someone with unexplained abnormal LFTs (7)

A
  • Liver ultrasound
  • Hep B and C serology
  • Autoantibodies (ANA, SMA, AMA, LKM-1)
  • Immunoglobulins
  • Caeruloplasmin
  • Alpha-1 Antitrypsin
  • Ferritin and Transferrin saturations
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13
Q

First line test for assessing fibrosis in NAFLD

A

enhanced liver fibrosis (ELF) test

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14
Q

Causes of hepatitis (5)

A

1- Viral
2- Alcohol
3- Autoimmune
4- fatty liver
5- Drug induced (e.g. paracetamol overdose)

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15
Q

Patterns with LFTs in hepatitis

A

Raised transaminases (AST/ALT)

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16
Q

Hep A:
1. DNA/RNA?
2. Mode of transmission?

A
  1. RNA
  2. Faecal-oral
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17
Q

Hep B :
1. DNA/RNA?
2. Mode of transmission?

A
  1. DNA
  2. Bloods/Fluids
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18
Q

Hep C:
1. DNA/RNA?
2. Mode of transmission?

A
  1. RNA
  2. Bloods/Fluids
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19
Q

Hep D:
1. DNA/RNA?
2. Mode of transmission?

A
  1. RNA
  2. With Hep B
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20
Q

Hep E:
1. DNA/RNA?
2. Mode of transmission?

A
  1. RNA
  2. Faecal-oral
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21
Q

Treatment for Hep C (and prognosis?)

A

Tx: Direct acting antivirals
>90% cure

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22
Q

typical demographic for type I autoimmune hepatitis?

A

women aged 40-50

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23
Q

Hep B serology:
HBsAg
1. What is it?
2. If it is positive?

A
  1. Surface antigen
  2. There is Hep B infection
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24
Q

Hep B serology:
HBeAg
1. What is it?
2. If it is positive?

A
  1. Hep B E Antigen
  2. The patient is in acute phase of Hep B infection
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25
Q

Hep B serology:
HBeAb
1. What is it?
2. If it is positive?

A
  1. Hep B E Antibody
  2. The patient is past the acute phase of infection
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26
Q

Levels of which marker should be checked four months after Hep B vaccination to ensure an adequate response to immunisation?

A

Anti-HBs

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27
Q

treatment for ascites secondary to liver cirrhosis

A

Aldosterone antagonist e.g. Spironolactone

28
Q

patient with hair loss, mood changes, fatigue, bronze skin, erectile dysfunction, joint pain
- Diagnosis?
- what is the underlying issue?

A

Haemochromatosis

-Build-up/excess absorption of iron in the body

29
Q

gene mutations in haemachromatosis

A

HFE gene on chromosome 6

30
Q

serum results for haemachromatosis:

A
  • Raised ferritin
  • Raised transferrin saturation
  • Low Iron binding capacity
31
Q

treatment for haemachromatosis

A

venesection

32
Q

Complications of haemachromatosis (7)

A
  • T1DM
  • Cardiomyopathy
  • liver cirrhosis
  • hepatocellular carcinoma
  • hypogonadism
  • chondrocalcinosis
  • hepatocellular carcinoma
33
Q

symptoms associated with Wilson’s disease

A

dysarthria, dystonia and tremor

34
Q

Cause of Wilson’s disease

A

‘Wilson’s disease protein’ gene mutation on chromosome 13

35
Q

Eye sign with Wilson’s disease

A

Kayser Fleischer rings (copper deposit on iris)

36
Q

initial investigation for Wilson’s disease

A

Serum caeruloplasmin

37
Q

Gold standard test for Wilson’s disease

A

Liver biopsy

38
Q

management of Wilson’s disease

A
  • Copper chelation
  • Penicillamine
  • Trientene
39
Q

Genetic condition associated with bronchiectasis, emphysema and liver cirrhosis

A

Alpha-1-Antitrypsin Deficiency

40
Q

genetic defect in A1AT Deficiency

A

Autosomal recessive defect in the Alpha 1 Antitrypsin gene on Chromosome 14

41
Q

64 year old woman with generalised itching and pale, greasy stools

A

Primary Biliary Cirrhosis

42
Q

antibodies associated with PBC

A
  • Anti Mitochondrial Antibodies (AMA)
  • Anti-Nuclear Antibodies (ANA)
43
Q

First abnormal LFT in PBC

A

Alkaline Phosphatase

44
Q

Diagnostic test for PBC

A

Liver Biopsy

45
Q

Medication to reduce cholesterol absorption in PBC

A

Ursodeoxycholic Acid

46
Q

bile acid sequestrate used in PBC

A

Colestyramine

47
Q

types of primary liver cancer

A
  • Hepatocellular Carcinoma (HCC)
  • Cholangiocarcinoma
48
Q

Main risk factor for Hepatocellular carcinoma

A

Liver cirrhosis

49
Q

main risk factor for cholangiocarcinoma

A

primary sclerosing cholangitis

50
Q

treatment for peptic and duodenal ulcers

A

PPIs

51
Q

ulcer which causes epigastric pain when hungry and is relieved by eating

A

duodenal ulcers

52
Q

ulcer which causes epigastric pain worsened by eating

A

gastric ulcers

53
Q

raised blood marker in upper GI bleed

A

raised urea

54
Q

management of upper GI bleed

A

ABATED
ABDCE Resus
Bloods
IV Access
Transfusion
Endoscopy
Drugs (stop anticoagulants)

55
Q

type of IBD which effects the entire GI tract

A

Crohn’s

56
Q

type of IBD with skip lesions

A

Crohn’s

57
Q

type of IBD where smoking is protective

A

Ulcerative Colitis

58
Q

type of IBD where fistulas often form

A

Crohn’s

59
Q

type of IBD which affects only the superficial mucosa

A

Ulcerative Colitis

60
Q

type of IBD which is treated with Aminosalicyclates

A

Ulcerative Colitis

61
Q

type of IBD which is treated with Aminosalicyclates

A

Ulcerative Colitis

62
Q

type of IBD which is associated with Primary Sclerosing Cholangitis

A

Ulcerative Colitis

63
Q

Screening test for IBD (both types)

A

Faecal caprotectin

64
Q

First line for diarrhoea from IBD

A

Loperamide

65
Q

Laxative to avoid in IBD

A

Lactulose (causes bloating)

66
Q

Rash associated with coeliac disease

A

Dermatitis herpetiformis

67
Q

Gene associated with Coeliac disease

A

HLA-DQ2

Z2F/Comprehensive Flashcards (7 decks)

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