GI Flashcards
Mx of a mild to moderate flare of UC that does not respond to topical or oral aminosalicylates?
Add oral steroids (note, do NOT stop oral ASAs)
What condition has the strongest association with H. pylori infection?
Duodenal ulceration
What is used 1st line for Mx of hepatic encephalopathy
Lactulose
Which scoring system would be used to determine the severity of an upper GI bleed and whether or not they could be managed safely as an outpatient?
Glasgow Blatchford score
What is Budd Chiari syndrome?
Hepatic vein thrombosis.
Usually seen in the context of underlying haematological disease or another procoagulant condition e.g. polycythaemia vera, thrombophilia, pregnancy, COCP
What classic triad of features is seen in Budd Chiari syndrome?
1) Abdo pain: sudden onset, severe
2) Ascites –> abdo distension
3) Tender hepatomegaly
1st line investigation in Budd Chiari syndrome?
US with Doppler flow studies
If a patient with UC colitis had a severe relapse or >=2 exacerbations in the past year, what should they should be given to maintain remission?
either oral azathioprine or oral mercaptopurine
What is the 1st line laxative indicated in acute constipation that is not associated with opioid use? (after diet)
Bulk forming e.g. ispaghula husk
Which laxative is often given for opioid-induced constipation?
Docusate
2nd line laxative indicated in acute constipation that is not associated with opioid use? (after ispaghula husk)
Osmotic laxative e.g. macrogol
What is the diagnostic investigation of choice in pancreatic cancer?
High resolution CT
Mx of pharyngeal pouch?
Surgical repair and resection
Mx options in perianal fistula?
1) Oral metronidazole (if symptomatic)
2) Draining seton (for complex fistulae)
What is a seton used in perianal fistula?
A seton is a piece of surgical thread that is run through the fistula to allow continuous drainage while the fistula is healing.
This ensures that the fistula doesn’t heal containing pus within, which would result in further abscess formation.
What should patients with ascites 2ary to liver cirrhosis be given?
Aldosterone antagonist e.g. spironolactone
Stepwise Mx of achalasia?
1) pneumatic (balloon) dilation (less invasive and quicker recovery time than surgery)
2) Heller cardiomyotomy (if recurrent or persistent symptoms)
What does a Heller cardiomyotomy involve?
Involves cutting of the thick muscle around the lower oesophagus and upper stomach to allow for passage of food and drink.
Give 4 causes of acute liver failure
1) paracetamol OD
2) alcohol
3) hepatitis (usually A or B)
4) acute fatty liver of pregnancy
What are the 2 best ways to measure acute liver failure?
1) prothrombin time (best) i.e. INR
2) albumin level
How can PPIs affect sodium level?
Can cause hyponatraemia through SIADH
Where is biopsy taken from for diagnosis of coeliac?
Jejunal biopsy
Or duodenal biopsy
What are the 2 areas most affected in coeliac?
Jejunum & duodenum
What 2 factors are used to monitor treatment in haemochromatosis?
1) ferritin
2) transferrin saturation