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PTS sessions > GI > Flashcards

GI Flashcards

1
Q

Red flags for GI Ca

A

ALARMS:
anaemia
loss of weight
anorexia
recent onset of progressive sx
masses/ melena
swallowing difficulties

> 55y/o

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2
Q

oesophageal disease differentials: haematemesis

A

Mallory Weiss
oesophageal varices
oesophageal Ca

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3
Q

oesophageal disease differentials: swallowing difficulties

A

achalasia
oesophageal Ca
Zenker’s diverticulum
systemic sclerosis
strictures

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4
Q

oesophageal disease differentials: pain

A

Mallory Weiss
oesophageal varices
GORD

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5
Q

Exam technique: difference between Mallory Weiss and oesophageal varices

A

MW: ‘continuously retching’, ‘vomiting blood’
OV: PMH liver, ‘coughing up blood’

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6
Q

What is Zenker’s diverticulum?

A

outpouching of pharynx causing pseudo-choking, bad breath and infection

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7
Q

Exam technique: difference between oesophageal ca and achalasia?

A

oesophageal ca: can’t swallow solids, then liquids
achalasia: can’t swallow either (occurs at the same time)

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8
Q

ix and result for achalasia

A

endoscopy
barium swallow- bird’s beak sign
manometry (gold)

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9
Q

histological change in Barrett’s oesophagus

A

stratified squamous to simple columnar epithelium

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10
Q

potential bacterial cause of gastritis

A

helicobacter pylori infection- gram -ve spiral bacterium
oral-oral or faecal-oral transmission

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11
Q

where is vit B12 absorbed

A

terminal ileum

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12
Q

how do NSAIDs cause acute gastritis?

A

COX-inhibitor -> inhibits prostaglandin synthesis -> less mucus secretion

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13
Q

helicobacter pylori infection gastritis ix

A

urea breath test
stool antigen test

stop PPI for 2 weeks, abx for 4 weeks before

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14
Q

How does eating affect gastric/ duodenal ulcer pain?

A

duodenal: gets better as duodenal sphincter closes
gastric: gets worse as increased stomach acid production

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15
Q

What is triple therapy for h pylori?

A

PPI, clarithromycin, amoxicillin/ metronidazole

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16
Q

Which artery could a gastric/ duodenal ulcer perforate?

A

gastric: gastroduodenal
duodenal: left gastric

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17
Q

Signs of gastric ulcer perforation

A

haematemesis + melena

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18
Q

Signs of duodenal ulcer perforation

A

hematochezia + melena

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19
Q

IBS s+s

A

ABC

abdominal pain (relieved by defecation)
bloating
change in bowel habits

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20
Q

path of UC inflammation

A

rectum to ileum

so abdo pain starts in left lower quadrant

21
Q

IBD extraintestinal signs

A

A PIE SAC

Ankylosing spondylitis
Pyoderma gangrenosum
Iritis
Erythema nodosum
Sclerosing cholangitis
Aphthous ulcers/ amyloidosis
Clubbing

22
Q

flow chart of diagnostic markers for UC and Crohn’s

A

+ve faecal calprotectin for IBD (-ve for IBS)

pANCA is +ve for UC, -ve for Crohn’s

23
Q

mild UC tx

A
  1. mesalazine (to maintain remission)
    • steroid (prednisolone)
24
Q

moderate/ severe UC tx

A
  1. fluid resus
  2. IV steroid (hydrocortisone)
    • TNF-alpha inhibitor (infliximab)
25
Q

UC gold tx

A

colectomy

26
Q

location of Crohn’s abdo pain

A

right lower quadrant (mostly affects ileum)

27
Q

tropical sprue GOLD ix

A

jejunal tissue biopsy

28
Q

difference between tropical sprue and Crohn’s

A

tropical sprue: incomplete villous atrophy
Crohn’s: complete villous atrophy

29
Q

3 histological changes in coeliac disease

A

villous atrophy
crypt hyperplasia
intraepithelial lymphocytes

30
Q

skin sx present in coeliac

A

dermatitis herpetiformis
angular stomatitis

31
Q

dude is just feeling ill bro

A

duodenum: iron
jejunum: folate
ileum: B12

32
Q

1st and 2nd line and gold ix for coeliac

A

raised anti-tTG
raised anti-EMA
endoscopy and duodenal biopsy (villous atrophy, crypt hyperplasia, intraepithelial lymphocytes)

33
Q

chronic mesenteric ischaemia s+s (classic triad)

A

central colicky abdo pain after eating
weight loss
abdominal bruit (due to turbulent blood flow)

34
Q

diverticular disease sx

A

BBL

bowel habits change
bloating/ flatulence
left lower quadrant pain

N+V

35
Q

diverticulitis sx

A

diverticular disease sx

+ fever + blood in stool

36
Q

what is Rovsing’s sign?

A

sign of acute appendicitis- palpation of LIF causes pain in the RIF

37
Q

most common viral causes of diarrhoea

A

rotavirus: leading cause in children
norovirus: leading cause in adults

Traveller’s diarrhoea

38
Q

most common bacterial cause of diarrhoea

A

campylobacter jejuni

E coli
salmonella enterica
shigella

39
Q

difference between salmonella and shigella on XLD plate

A

salmonella: pink w black centre
shigella: pink

40
Q

how is diarrhoea caused by c diff treated?

A

metronidazole, vancomycin, stop abx

41
Q

mc cause + tx for parasitic diarrhoea

A

giardia lamblia

metronidazole

42
Q

where does oesophageal adenocarcinoma affect?

A

lower 1/3 of the oesophagus

43
Q

where does oesophageal squamous cell carcinoma affect?

A

upper 2/3 of the oesophagus

44
Q

What is CA19-9 a marker for?

A

cholangiocarcinoma and pancreatic cancer

45
Q

what is alpha fetoprotein (AFP) a marker for?

A

HCC and testicular cancer

46
Q

what is beta-hCG a marker for?

A

pregnancy

47
Q

what is CA-125 a marker for?

A

ovarian cancer

48
Q

what is carcinoembryonic antigen (CEA) a marker for?

A

colorectal cancer

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