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#passmed 2023 > GI > Flashcards

GI Flashcards

1
Q

How do you calculate Anion gap?

A

(Sodium + Potassium) – (Bicarbonate + Chloride)

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2
Q

What is the most common cause of abnormal LFTs in T2DM pt?

A

Non-alcohol fatty liver disease

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3
Q

What are the causes of transient non-visible haematuria? (4 things)

A
  1. UTI
  2. Exercise (settles after 3 days)
  3. Menstruation
  4. Sexual intercourse
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4
Q

What procedure can be used to treat Portal Hypertension?

A

TIPS (transjugular intrahepatic portosystemic shunt)

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5
Q

What 2 vessels does TIPS (transjugular intrahepatic portosystemic shunt) connect?

A
  • Hepatic vein
  • Portal vein
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6
Q

What blood results will make you sus macrocytic anaemia (aka low B12 aka pernicious anaemia)?

A
  • Low Hb
  • High MCV
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7
Q

What investigation should you do when you sus Macrocytic anaemia?

A

Intrinsic factor antibodies

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8
Q

In UC, what is better, oral or rectal mesalazine?

A

Rectal

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9
Q

If you have LOA and WL, is it still unexplained WL?

A

Yes

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10
Q

How can Nephrotic syndrome lead to DVT? (3 steps)

A
  1. Nephrotic syndrome
  2. Increased LOSS of antithrombin III from kidneys
  3. Antithrombin III deficiency –> DVT
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11
Q

What is the M rule for Primary Biliary Cholangitis (PBC)? (3 things)

A
  1. igM
  2. anti-Mitochondrial antibodies (M2 subtype)
  3. Middle aged females
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12
Q

What are the side fx of Erythropoetin aka EPO (given for CKD anaemia)? (3 things)

A
  1. Flu-like sympoms
  2. Skin rashes
  3. Bone aches
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13
Q

What are Elderly ppl at risk of after critical illness / major surgery?

A

Refeeding syndrome

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14
Q

What are the CF of Refeeding syndrome? (5 things)

A

Arthymias n Electrolye dysf:
1. Arrhythmias (AF)
2. Low K
3. High Na
4. Low Mg
5. Low P

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15
Q

We said renal dialysis is indicated when 4 aki complications are not treated by meds, so what is the one you should look out for in bloods / UnEs?

A

High urea, suggests uraemia (encephalopathy / pericarditis)

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16
Q

What urea levels suggest UPPER GI bleed more likely than lower?

A

High Urea
(high like upper innit)

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17
Q

What is the GOLD standard investigation for Primary Sclerosing Cholangitis (PSC) (assoc w UC)?

A

MRCP/ERCP

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18
Q

What will a MRCP / ERCP show you in PSC?

A

Inflamm / fibrosis / stricture of intra and extra-hepatic bile ducts

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19
Q

What is a complication of PSC?

A

Cholangiocarcinoma

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20
Q

How do you differentiate between Alcohol cause and Drug induced Cholestasis cause of deranged LFTs?

A
  • GGT raised by itself = Alcohol
  • GGT + ALP both raised = Drug induced Cholestasis
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21
Q

Apart from GGT how can you check if abnormal LFTs are caused by Alcohol? (2 things)

A
  • Calculate AST / ALT ratio
  • Normal = 0.8, but if 2+ then its Alcohol nigga
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22
Q

What causes Liver failure following MI?

A

Ischaemic hepatitis
(ischaemia coz like they had an infarction innit)

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23
Q

What are you at increased risk of with Nephrotic syndrome?

A

VTE (so give LMWH)

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24
Q

What works to remove Potassium from body?

A

Calcium RESONIUM

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25
Q

How do you differentiate between Achalasia and Oesophageal cancer? (3 things)

A

Achalasia:
1. Both solids AND liquids affected
2. NOT progressive
3. Bird beak appearance in barium swallow

26
Q

What will you see in Barium swallow of Oesophageal cancer?

A

Apple core sign

27
Q

How do you differentiate between PSGN and igA nephropathy?

A
  • PSGN: Develops 1-2 weeks after URTI
  • igA nephropathy: Develops 1-2 days after URTI
28
Q

What should make you sus PSGN? (2 things)

A
  1. Nephritic syndrome
  2. Recent lung / skin infection (e.g cellulitis)
29
Q

How do you confirm PSGN dx?

A

Raised anti-streptolysin O titres
(confirm dx of recent strep inf)

30
Q

When prescribing fluids, what is the glucose requirement per day?

A

50-100g / day (regardless of pt weight)

31
Q

What is the Triad you will see in Mesenteric ischaemia? (3 things)

A
  1. CVD
  2. High lactate (obv bc ischaemia)
  3. Soft but tender abdomen
32
Q

What type of anion gap and acidosis / alkalosis do you get in DKA?

A

Raised anion gap metabolic acidosis
(excess ketones causes raised anion gap)

33
Q

If C difficile doesn’t respond to vancomycin or fidaxomicin, what should you try?

A

Oral vancomycin + IV metronidazole

34
Q

What medication should you avoid in bowel obstruction?

A

Metoclopramide
(pro-kinetic)

35
Q

How Hyperparathyroidism, what do you give to correct vit D deficiency?

A

Alfacalcidol

36
Q

How Hyperparathyroidism, what do you give to correct hyperphosophataemia?

A

Calcium carbonate (Phosphate binder)

37
Q

How Hyperparathyroidism, what do you give to correct hyperphosophataemia?

A

Calcium carbonate (Phosphate binder)

38
Q

What is the first line Mx of Barrets oesophagus becoming high grade dysplasia?

A

Endoscopic intervention
(preffered over oesophagectomy)

39
Q

What do you assess if you sus Diabetic nephropathy?

A

Albumin : Creatinine ratio (ACR) early morning specimen

40
Q

What is an early sign of Diabetic nephropathy?

A

Enlarged kidneys

41
Q

What serology shows someone has been immunised against Hep B but hasn’t had an infection before?

A
  • HBsAg: Negative
  • IgG anti-HBc: Negative
  • anti-HBs: Positive
    (HBsAg and igG being negative show no active / chronic infection
    Anti-HB positive means been immunised)
42
Q

What are the guidelines for investigating AKI when cause is unclear?

A

Renal US within 24 hours of diagnosing AKI if cause unclear
(checking for intrinsic or post-renal aka obstructive causes)

43
Q

When preparing for dialysis, how long does it take for AV fistula to be ready?

A

2 months

44
Q

What investigations do you need to do before doing Fundoplication surgery on GORD pt?

A
  1. Oesophageal pH
  2. Manometry
45
Q

Where are the cysts in Autosomal Dominant Polcystic Kidney Disease (ADPKD)?

A
  1. Cysts in kidney
  2. Cysts in liver
  3. Cysts in brain
    (quite literally “polycystic” kidney disease)
46
Q

How do you prevent against contrast-induced nephropathy? (lets say you need to do a CT on a pt w CKD)

A

1L 0.9% saline

47
Q

How do you stage eGFR / AKI?

A
  • Stage 1: all the 1s (1.5-1.99x increase in creatinine)
  • Stage 2: al the 2s (2-2.99x increase in creatinine)
  • Stage 3: all the 3s (3x or more increase in creatinine)
48
Q

When should you start meds in CKD and what meds?

A

ACEi if ACR (albumin:creatinine ratio) is more than 30

49
Q

How should you change Levothyroxine dose in pregnancy for Hypothyroid pt?

A

Increase dose by upto 50%

50
Q

What can happen to thyroid levels in sickness?

A

Free t4 can drop, called Sick Euthyroid
NEEDS NO MX

51
Q

What is a CF of Graves disease that needs urgent referral?

A

Losing colour vision –> urgent referral to eye ppl

52
Q

What can give falsely low HbA1c results?

A

Haemodialysis

53
Q

What should you give a post menopausal woman with hip fracture?

A

Bisphosphonates + calcium supplements
NO NEED FOR DEXA SCAN

54
Q

What gynae conditions are Hyper / Hypothyroidism assco w?

A

HYPER = Oligomenorrhea / Amenorrhoea
HYPO = Menorrhagia (HMB)
(hyperActive so they don’t have periods)

55
Q

Why is Pioglitazone CI in HF?

A

Causes fluid retention –> worsens HF

56
Q

What is the difference in Tx for Addisons and Addisonian crisis?

A

Addisons = Hydrocortisone + Fludrocortisone
Addisonian crisis = IV Hydrocortisone

57
Q

If Low dose Dexamethasone suppression test gives low (aka suppressed) cortisol, what is the Dx?

A

Normal

58
Q

If Low dose Dexamethasone suppression test gives high (aka not suppressed) cortisol, what is the Dx?

A

Cushings syndrome –> dose high dose to find cause

59
Q

If High dose Dexamethasone suppression test gives low (aka suppressed) cortisol, what is the Dx?

A

Cuhsings disease

60
Q

If High dose Dexamethasone suppression test gives high (aka not suppressed) cortisol, what is the Dx?

A
  • High ACTH = Pituitary (higher up in body) (aka Ectopic ACTH)
  • Low ACTH = Adrenal (lower down in body)

#passmed 2023 (39 decks)

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