Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FINALS: Passmed > GI > Flashcards

GI Flashcards

1
Q

Ascites: a high SAAG gradient (> 11g/L) indicates _______.

A

portal HTN

Serum ascites albumin ratio: shows proportion of protein in serum vs. in ascites. Bc serum protein is still high, we know that ascitic fluid is transudate- fluid thats leaked from altered hydrostatic forces across an INTACT membrane. most common cause is portal HTN secondary to liver cirrhosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

jaundice and a painful, distended abdomen that exhibits tympanic resonance in the periumbilical area and dullness in the flanks - what does pt have?

A

ascites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

jaundiced woman with ascities has ‘ tortuous, palpable swelling is present in the paraumbilical region’ - what is it?

A

caput medusae—a swollen network of paraumbilical veins—indicates abdominal wall vein distension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ascitic tap: which conditions have SAAG > 11 and which have SAAG < 11?

A

SAAG > 11
- cirrhosis/alcoholic liver disease
- liver failure
- liver mets
(all cause portal HTN)
- HF
- pericarditis

SAAG < 11
- hypoalbuminaemia: nephrotic syndrome, malnutriion
- malignancy
- infetion
- pancreatitis
- bowel obstruction
- post-operative
basically inflammation causes increased cappillary permeability and causes proteins to leak

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Vitamin deficiencies:
- B1
- B2
- C
- D

A
  • B1 (thiamine): linked to Wernicke’s
  • B2 (riboflavin): anguar cheilitis (cracked skin around mouth)
  • C (ascorbic acid): scurvy (bleeding gums, loosened teeth)
  • D (colecalciferol): teeth strength
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

firstline to maintain remission in Crohn’s

A

azathiopurine/mercatopurine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

early signs of _______ are fatigue, erectil dysfunction and arthralgia. Which marker is raised?
What is the pattern of iheritance

A

haemochromatosis due to iron deposition in different tissues.

AST

autosomal recessive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

wilsons and haemochromatosis - what is the diff?

A

copper in ilsons is deposited in basal ganglia, causing chorea, speech problems, parkinsons etc.

iron in haemochromatosis is deposited in liver, joints, pituitary gland. bronze skin pigmentation, DM.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

which features of haemochromatosis are reversible with Tx?

A

cardiomyopathy
skin pigmenation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what parameteres to monitor when checking effectiveness of haemochromatosis tx?

A

transferrng saturation + serum ferritin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

1st line therapy for C diff. infection
2nd line

A

oral vancomycin
oral fidaxomicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

asymptomatic gallstones - tx?

A

observation, esp if located in gallblader. If i commob bile duct consider surgical Mx.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

__________ can be a useful diagnostic marker for HCC

A

Raised AFP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pt on PPI waiting to get endoscpy - advice?

A

stop PPI 2 weeks before endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Stopping medications before OGD (1-4):
1 day =
2 weeks =
3 days =
4 weeks =

A

1 day = gaviscon
2 weeks = PPIs
3 days = ranitidine
4 weeks = antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

B12 deficiency - what do you investigate? what is an early sign on blood flim?

A

intrinsic factor antibodies

hyperegmented polymorphs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Patients suffering from C. difficile need isolation for at least ________

A

48 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Wilson’s disease - _______ total serum copper

A

reduced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

_______artery is at risk with duodenal ulcers on the posterior wall

A

Gastroduodenal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the M rule for PBC?

A

IgM
anti-Mitochondrial antibodies, M2 subtype
Middle aged females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how does PBC typically present? What condition is it frequently associated with?

A

typically presents in middle-aged women with jaundice, itch and fatigue. Bloods show cholestatic LFTs with raised IgM and anti-mitochondrial antibodies

Sjogrens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what will bloods show in autoimmune hepatitis?

A

IgG and ANA (anti-nuclear) or SMA (anti-smooth muscle) antibodies. ALT is also typically raised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how does PSC present? what ab are positive?

A

PSC typically presents in 20-40-year-old males with jaundice, itch and fatigue. It is strongly associated with ulcerative colitis. Bloods show P-ANCA antibodies.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

tx for PBC?

A
  • urodeoxycholic acid (helps move bile through your liver, preventing damage)
  • pruritus: cholestyramine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is diagnostic for portal HTN?

A

A raised SAAG (>11g/L)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

sudden onset abdominal pain, ascites, and tender hepatomegaly –> ?

A

Budd-Chiari syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is Budd-Chiari syndrome?
RFs?
Ix

A

hepatic vein thrombosis, is usually seen in the context of underlying haematological disease or another procoagulant condition.

RFs: polycythaemia rubra vera, thrombophilia, pregnancy, COCP

Ix: doppler US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Patients with haemochromatosis are at an increased risk of __________ (check with US)

A

hepatocellular carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

A 41-year-old man with cerebral palsy is admitted with abdominal pain and diarrhoea. His carers report him passing 5-6 watery stools per day for the past four days. On examination he has a mass in the left side of the abdomen.

Dx?

A

Constipation causing overflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

A 37-year-old woman presents with a three week history of diarrhoea and crampy abdominal pains. On examination she is noted to have a number of perianal skin tags.

Dx?

A

Crohn’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Acute causes of diarrhoea:

1.May be accompanied by abdominal pain or nausea/vomiting:

2.Classically causes left lower quadrant pain, diarrhoea and fever:

3.More common with broad spectrum antibiotics, Clostridioides difficile is also seen with antibiotic use:

  1. A history of alternating diarrhoea and constipation may be given
A
  1. gastroenteritis
  2. diverticulitis
  3. abx therapy
  4. constipation causing overdlow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Chronic causes of diarrhoea:

  1. A history of alternating diarrhoea and constipation may be given:
  2. Crampy abdominal pain and weight loss are also common. Faecal urgency and tenesmus may be seen:
  3. Crampy abdominal pains and non-bloody diarrhoea. Other features include malabsorption, mouth ulcers, perianal disease and intestinal obstruction
  4. Symptoms depend on the site of the lesion but include diarrhoea, rectal bleeding, anaemia and constitutional symptoms e.g. Weight loss and anorexia:
  5. In children may present with failure to thrive, diarrhoea and abdominal distension. In adults lethargy, anaemia, diarrhoea and weight loss are seen. Other autoimmune conditions may coexist
A
  1. IBS
  2. UC
  3. Crohn’s
  4. Colorectal cancer
  5. Coeliac disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

A recurrent episode of C. difficile within 12 weeks of symptom resolution should be treated with oral __________

A

fidaxomicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

A 28-year-old pregnant lady presents to the Emergency Department in a confused and agitated state. She is itching her arms vigorously and on examination, the patient complains of right side abdominal pain during palpation. As she tries to speak, the doctor notes her breath has a sweet, fecal smell. Which of the following is the most likely diagnosis?

A

Fetor hepaticus, sweet and fecal breath, is a sign of liver failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Phaeochromocytoma removal: what drug do you give before betablocker?

A

phenoxybenzamine (alpha-blocker)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Coeliac disease increases the risk of developing this malignancy:

A

T-cell lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

longterm omeprazole use increases your risk of

A
  • osteoporosis
  • C diff. infrction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what finding on barium swallow is consistent with oesophageal cancer?

A

irregular narrowing of mid-thoracic oesophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

__________is the most sensitive and specific lab finding for diagnosis of liver cirrhosis in those with chronic liver disease

A

Thrombocytopenia (platelet count <150,000 mm^3) is the most sensitive and specific lab finding for diagnosis of liver cirrhosis in those with chronic liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Coeliac’s disease: blood film abnormality?

A

Coeliac’s is associated with hyposplenism.
Hyposplenism is associated with Howell-Jolly body, target cells and acanthocytes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

painless jaundice + sudden weight loss =

A

NAFLD (acute on chronic)

Weight loss triggers catabolism of peripheral adipose reserves and importation of toxic lipids to the liver which trigger steatosis, inflammation and hepatocyte cell death. This manifests with deranged serum liver enzymes and raised bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

A _____________ may be used to stop an uncontrolled variceal haemorrhage

A

Sengstaken-Blakemore tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

diarrhoea, palpitations, flushing + weight loss + hepatomegaly =

A

carcinoid tumour

The secretion of serotonin by this cancer causes diarrhoea, flushing and palpitations (which can be accompanied by tachycardia).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Carcinoid Syndrome:
FIVE HT

A

Flushing
Intestinal (Diarrhoea)
Valve Fibrosis (Tricuspid Regurg & Pulmonary Stenosis)
whEEze: Bronchoconstriction
Hepatic Involvement (1st pass metabolism bypassed)
Tryptophan Deficiency (Pellagra)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

1st line to induce remission in Crohns disease

A

glucocorticoids only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Obesity with abnormal LFTs - ?

A

NAFLD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

________ are used in the management of severe alcoholic hepatitis

A

Corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

A severe flare of ulcerative colitis should be treated in hospital with ________

A

IV corticosteroids
IV ciclosporin if steroids C/I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

stop taking PPIs_____ weeks before endoscopy

A

2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

1st line Mx of ascities

A

spironolactone

fluid restriction is sometimes recommended if the sodium is < 125 mmol/L

drainage if tense ascites

Offer prophylactic oral ciprofloxacin or norfloxacin for people with cirrhosis and ascites with an ascitic protein of 15 g/litre or less, until the ascites has resolved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

In patients with severe colitis, _______should be avoided due to the risk of perforation - a ____________is preferred

A

colonoscopy
flexible sigmoidoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

__________________________________ is used to screen patients for malnutrition

A

The Malnutrition Universal Screening Tool (MUST)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Screening Tools for:
1. Acute appendicitis
2. Liver Cirrhosis
3. Upper GI Bleed
4. Acute pancreatitis

A
  1. Alvardo
  2. Child-Pugh
  3. Glasgow-Blatchford
  4. Glasgow-Imrie criteria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Early signs of ________________are fatigue, erectile dysfunction and arthralgia

A

haemochromatosis

Iron MAN:
Metacarphpphalangeal
Arthralgia
No energy
erectile dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Mesalazine > sulfasalazine in terms of

A

pancreatitis risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

_____________ is the only test recommended for H. pylori post-eradication therapy

A

Urea breath test

This test should be conducted at least four weeks after completing antibiotic treatment or two weeks following the discontinuation of antisecretory medications such as omeprazole.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

most common cause of inherited colorectal cancer

A

HNPCC (Lynch syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Red flag symptoms for gastric cancer includes

A

new-onset dyspepsia in a patient aged >55 years
unexplained persistent vomiting
unexplained weight-loss
progressively worsening dysphagia/
odynophagia
epigastric pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

signet ring vells on OGD

A

gastric cancer

Higher numbers of signet ring cells are associated with a worse prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

_________________is key in determining the severity of C. difficile infection

A

The white cell count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Bleeding gums and receding, think ________

A

scurvy

62
Q

What must be administered before endoscopy in pt with variceal haemorrhage?

A

Terlipressin + IV Abx

63
Q

A combination of liver and neurological disease points towards

A

Wilson’s disease

64
Q

___________________________ are the characteristic electrolyte disturbances seen in patients with refeeding syndrome.

______________ is the hallmark of refeeding syndrome.

A

Hypophosphataemia, hypokalaemia and hypomagnesaemia

hypophosphataemia: musckle weakness, cardiac and respiratory failure

65
Q

oeliac disease increases the risk of developing what malignancy?

A

enteropathy-associated T cell lymphoma

66
Q

A 32-year-old lady presents with dysphagia. She has a 10 year history of anaemia secondary to menorrhagia and has been strongly resistant to treatment.

A

Plummer Vinson syndrome (oesophageal web) may occur in association with iron deficiency anaemia (although rare).

67
Q

In a mild-moderate flare of ulcerative colitis extending past the left-sided colon, ________________ should be added

A

oral aminosalicylates should be added to rectal aminosalicylates, as enemas only reach so far

68
Q

UC with severe relapse or >=2 exacerbations in the past year

A

oral azathioprine or oral mercaptopurine

69
Q

we look for _________ in all suspected irritable bowel syndrome (IBS) patients to rule it out

A

coeliac antibodies

70
Q

____________is indicated in patients with ongoing acute bleeding despite repeated endoscopic therapy

A

Surgery

71
Q

Courvoisier’s law states that a palpable mass in the RUQ is more likely to be

A

a malignant obstruction of the common bile duct rather than obstruction due to stones

72
Q

A 56-year-old man is admitted with a profuse upper gastro intestinal haemorrhage. He is relatively malnourished and has evidence of gynaecomastia.

A

Patients presenting with gastrointestinal bleeding and evidence of established liver disease may have portal hypertension and develop variceal haemorrhage. The patient may have evidence of jaundice, gynaecomastia, spider naevia, caput medusae and ascites. The bleeding is usually profuse and painless.

73
Q

Which condition is associated with gallstone development

A

Crohn’s

Crohn’s disease can result in terminal ileitis, this is the section of the bowel where bile salts are reabsorbed. When this area is inflamed and the bile salts are not absorbed and people are prone to development of gallstones.

Other risk factors for the development of gallstones include;

Increasing age
Family history.
Sudden weight loss - eg, after obesity surgery.
Loss of bile salts - eg, ileal resection, terminal ileitis.
Diabetes - as part of the metabolic syndrome.
Oral contraception - particularly in young women

74
Q

what is Maddrey’s discriminant function?

A

Calculation used to determine whether gluccocorticoid therapy should be commenced in patient with alcoholic hepatitis.

Used bilirubin + prothrombin time

75
Q

Antinuclear antibodies, anti-smooth muscle antibodies and raised IgG levels are characteristic of

A

autoimmune hepatitis

76
Q

________________ is the mainstay of treatment in haemochromatosis

A

Regular venesection

77
Q

A 42-year-old man presents to the GP with a 2 year history of watery diarrhoea which is green in colour, associated with abdominal bloating and cramping. He reports no blood in his stool, and denies fevers or weight loss. Other than a previous cholecystectomy he is fit and well, and takes no regular medications. His doctor suspects the diarrhoea is a complication following his cholecystectomy.

What is next most appropriate step in his management?

A

Bile-acid malabsorption may be treated with cholestyramine

78
Q

NICE advise the use of______________ to help differentiate between IBS and IBD in primary care

A

faecal calprotectin

79
Q

If a patient with ulcerative colitis has had a severe relapse or >=2 exacerbations in the past year they should be given

A

either oral azathioprine or oral mercaptopurine to maintain remission

80
Q

mescenteric ischaemia vs ischaemic colitis

A
81
Q

A 76-year-old woman presents with abdominal pain, distension and vomiting. She recently had an episode of acute cholecystitis and is awaiting a cholecystectomy. She feels her symptoms have returned over the past few days. On examination her abdomen is distended.

A

This patient has developed small bowel obstruction secondary to an impacted gallstone.

82
Q

__________is the treatment of choice for small bowel bacterial overgrowth syndrome

A

Rifaximin

83
Q

raised amylase + low calcium =

A

acute pancreatitis

84
Q

acute pancreatitis Ix

A

US

85
Q

_____________ gastroenteritis is characterised by a short incubation period and severe vomiting

A

Staphylococcus aureus

86
Q

________is an indicator of pancreatitis severity

A

hypocalcaemia

87
Q

Ix for achalasia

A
  1. oesophageal manometry
  2. barium swallow - birds beak apperance
  3. chest xray - wide mediastinum
88
Q

tx for achalasia

A
  1. pneumatic balloon dilation
89
Q

how does mesenteric ischemia present

A
  1. Hx of Afib or CVD
  2. Diarrhoea, rectal bleeding
  3. Metabolic acidosis (dying tissue)
90
Q

Causes and features of acute LF

A

causes: paracetamol OD, alcohol, viral hep (A and B), acute fatty liver of pregnancy

features: jaundice, coagulopathy (raised PT), hypoalbuminaemia, hepatic encephalopathy, renal failure

91
Q

Tx for alcoholic ketoacidosis?

A

infusion of saline & thiamine

92
Q

Tx of acute alcoholic hepatitis? Scoring system?

A

glucocorticoids - Maddrey’s discriminant function

93
Q

SEs of sulfasalazine

A

rashes, oligospermia, headache, Heinz body anaemia, megaloblastic anaemia, lung fibrosis

94
Q

SE of mesalazine

A

GI upset, headache, agranulocytosis, pancreatitis*, interstitial nephritis

95
Q

how to diagnose C.diff infection? What is characteristic of it?

A

C.diff toxin in stool (antigen positivity only shows exposure to bacteria, not infection)

WCC raised

96
Q

genetic associations of colorectal cancer

A

HNPCC (Lynch syndrome), familial adenomatous polyposis (FAP)

97
Q

Crohn’s: 1st line to induce remission, 1st line to maintain remission

A
  1. gluccocorticoids
  2. azathioprine/mercaptopurine
98
Q

Who needs URGENT (2 week wait) referral for suspected GI cancer

A
  1. all pts with dysphagia
  2. all pts with upper abdominal mass (consistent with cancer)
  3. all pts aged >55 years who have weight loss AND
    - upper abdo pain
    - reflux
    - or dyspepsia
99
Q

Tx for cholangitis?

A

ERCP

100
Q

lymphatic spread in gastric cancer

A

left supraclavicular lymph node (Virchow’s node)
periumbilical nodule (Sister Mary Joseph’s node)

101
Q

what cells are seen in OGD for gastric cancer

A

signet cells

102
Q

gold standard Ix for GORD

A

24-hr oesophageal pH monitoring

103
Q

___________ is the most likely area to be affected by ischaemic colitis

A

The splenic flexure

104
Q

difference between mesenteric ischaemia and IC

A
105
Q

Tx for hepatic encephalopathy

A
  1. lactulose
  2. rifaximin
106
Q

a palpable mass in RQ and perimbilical lymphadenopathy

A

cholangiocarcinoma: A palpable mass in the right upper quadrant (Courvoisier sign), periumbilical lymphadenopathy (Sister Mary Joseph nodes) and left supraclavicular adenopathy (Virchow node) may be seen

107
Q

what is raised in hepatocellualar cancer

A

AFP

108
Q

liver cirrhosis - what scans?

A
  1. fibroscan to Dx
  2. endoscopy to check for varcies
  3. liver US every 6m with AFP for cancer
109
Q

what is commonly associated with pancreatic cancer

A

migratory thrombophlebitis (Trousseau sign) is more common than with other cancers

110
Q

Ix finding for pancreatic cancer

A

double duct sign on CT

111
Q

pernicious anaemia increases your risk of

A

gastric cancer

112
Q

‘is an appropriate first line test for diagnosis of small bowel overgrowth syndrome’ and Tx

A

Hydrogen breath testing
rifaximin

113
Q

A 72-year-old man is admitted with an episode of brisk haematemesis. Following resuscitation an upper GI endoscopy is performed and a prominent blood vessel is identified in the mucosa approximately 6 cm from the O-G junction on the lesser curve of the stomach.

A

Dieulafoy lesion

These small arterial lesions are a rare cause of bleeding and are characterised by a single large tortuous arteriole in the sub mucosa. Extra gastric lesions may occur.

114
Q

Acute pancreatitis may cause what e- abnormality

A

hypocalcemia

other signs: raised haematocrit, neutrophilia

115
Q

Macrolides can cause ___________ on ECG

A

torsades de pointes

116
Q

a-1 antitrypsin defiency
- which genetic defect?
- pattern of inheritance?
- test for liver cirrhosis?
- test for lung disease?
- which enzyme is damaging the tissues?

A
  • which genetic defect? alpha-1 antitrypsin gene on chromosome 4
  • pattern of inheritance? AR
  • test for liver cirrhosis? liver biospy shows cirrhosis and acid-schiff positive globules
  • test for lung disease? high res CT thorax
  • which enzyme is damaging the tissues? neutrophil elastase
117
Q

Blockage of the ________ (billiary tree) does NOT cause jaundice

A

cystic duct or gallbladder

118
Q

In patients with severe colitis, __________should be avoided due to the risk of perforation - a _______________ is preferred

A

colonoscopy
flexible sigmoidoscopy

119
Q

___________ should be offered to anyone with moderately severe or severe acute pancreatitis

A

Enteral nutrition

120
Q

Surgical treatment of achalasia -

A

Heller cardiomyotomy

121
Q

how are severe UC exacerbations characterised

A

evere exacerbations are categorised by > 6 bloody stools per day with features of systemic upset (pyrexia, tachycardia, anaemia, raised inflammatory markers).

122
Q

Ongoing diarrhoea in Crohn’s patient post-resection with normal CRP →

A

cholestyramine

123
Q

________ are part of the first-line recommended treatment for severe autoimmune hepatitis

A

Steroids

124
Q

liver transplant criteria

A

Liver transplantation criteria in paracetamol overdose: pH < 7.3 more than 24 hours after ingestion

Or all of the following
- Prothrombin time > 100 seconds
- Creatinine > 300 µmol/L
- Grade III or IV encephalopathy

125
Q

HNPCC is associated with

A

colorectal cancer
pancreatic cancer
endometrial cancer

126
Q

double duct sign on Ct abdomen =

A

pancreatic cancer

127
Q

__________ is the definitive diagnostic investigation for small bowel obstruction

A

CT abdo

128
Q

pt presents 2 days after acute pancreatitis Sx start - what do you test?

A

lipase

129
Q

Campylobacter infection is often self-limiting but if severe then treatment with

A

clarithromycin may be indicated

130
Q

This patient is presenting with typical features of hepatitis: flu-like symptoms, right upper quadrant pain with tender hepatomegaly and hepatocellular liver function tests which show:
Raised bilirubin
Raised ALT/ AST
Normal or slightly raised ALP

A

Hep A

131
Q

Men of any age with a Hb below 110g/L

A

should be referred for upper and lower GI endoscopy as a 2ww

132
Q

Whilst Barrett’s oesophagus increases the risk of______________, achalasia increases the risk of ________________.

A

oesophageal adenocarcinoma
squamous cell carcinoma of the oesophagus

133
Q

In an emergency setting, if a colonic tumour is associated with perforation the risk of an anastomosis is greater →

A

end colostomy

134
Q

__________________causing ongoing jaundice and pain after cholecystectomy

A

Gallstones may be present in the CBD

135
Q

Liver failure = triad of

A

encephalopathy, jaundice and coagulopathy

136
Q

Total parenteral nutrition should be administered via

A

a central vein as it is strongly phlebitic

137
Q

___________ can be used to assess the presence of fluid in the abdomen and thorax in trauma

A

FAST scans

138
Q

_______ is the intervention of choice in patients with malignant distal obstructive jaundice due to unresectable pancreatic carcinoma

A

Biliary stenting

139
Q

When testing for coeliac disease, the correct investigations are .

A

a paired tissue transglutaminase (TTG) and IgA

140
Q

Patients with diverticulitis flares can be managed with oral antibiotics at home.

A

If they do not improve within 72 hours, admission to hospital for IV ceftriaxone + metronidazole is indicated

141
Q

Fe/transferrin in haemochromatosis?

A

raised ferritin, raised transferrin
low TIBC

142
Q

Large-volume paracentesis for the treatment of ascites requires

A

albumin ‘cover’. Evidence suggests this reduces paracentesis-induced circulatory dysfunction and mortality

143
Q

spontaenous bacterial peritonitis
1. acute Tx?
2. Longterm Tx?

A

acute: IV cefotaxime
long-term: ciprofloxacin

Patients who have previously suffered an episode of spontaneous bacterial peritonitis and who have a fluid protein <15 g/l require antibiotic prophylaxis, this is most commonly ciprofloxacin or norfloxacin.

144
Q

Nasogastric tubes are ________ if pH <5.5 on aspirate

A

safe to use
if more >5.5, do CXR to confirm position of tube

145
Q

PANCREAS mnemonic for prognostic factors in acute pancreatitis

A

P - PaO2 <8kPa

A - Age >55-years-old

N - Neutrophilia: WCC >15x10(9)/L

C - Calcium <2 mmol/L

R - Renal function: Urea >16 mmol/L

E - Enzymes: LDH >600iu/L; AST >200iu/L

A - Albumin <32g/L (serum)

S - Sugar: blood glucose >10 mmol/L

146
Q

Travel Hx + no organomegaly + jaundice–>

A

Hep A

147
Q

A 29-year-old man who is known to have ulcerative colitis is admitted to hospital with a flare of his disease. For the past three days he has been passing up to five bloody stools per day. Over the past 24 hours he has also developed abdominal pain and a low grade pyrexia.

What is the most important next investigation to perform?

A

Abdo XRA (toxic megacolon)

148
Q

Which anal fissures are a result of constipation and which suggest IBD?

A

constipation: anterior, posterior to midle
IBD: lateral

149
Q

1st line Ix for Budd Chiari?

A

US with doppler flow

150
Q

Colon cancer features but colonoscopy too difficult - Ix?

A

Computed tomography (CT) colonography (“virtual colonoscopy”)

151
Q

Common cause of galbladder cancer?

A

UC

152
Q

smoking + oesophageal cancer - what type?

A

squamous

FINALS: Passmed (40 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions