GI 3 Flashcards
Associated features of haemochromatosis
Hyperpigmentation, diabetes, cirrhosis and later possible hepatocellular carcinoma, dilated and restrictive cardiomyopathy, athralgia, rarely hypothryoidism
Treatment for haemochromatosis
Weekly venesection
Treatment in Primary Biliary Cirrhosis
Ursodeoxycholic acid
Treatment for Pseudomonas colitis
PO Vancomycin
Been abroad, diarrhoea, fever, sweats, rash suggestive of “rose spots”
Typhoid fever
Treatment for Typhoid fever?
Ciprofloxacin for 14 days
Traveller returning from Indian subcontinent, diarrhoea, fever, sweats, rash suggestive of “rose spots”
Typhoid fever
Management options for oesophageal spasm?
Medical therapy with Ca antagonists, nitrates and triclyclide antidepressants
Post-cricoid web, iron deficiency anaemia and dysphagia
Plummer-Vinson Syndrome
Treatment for a pregnant patient with gallstones in a non dilated bile duct
Conservative treatment with antibiotics and hydration
Farmer with vague abdominal symptoms affecting upper right quadrant. AXR shows multiple calcified cysts within the liver
Hydatid disease
What is the most appropriate long treat treatment for varies apart from abstaining from alcohol?
Band Ligation
Why should patients with a history of variceal bleeding not be monitored with repeat endoscopy?
Risk of further variceal bleeding
What should be given in the short term acute management of variceal bleeding?
Terlipressin
-Reduces mortality
Why is band ligation favoured over TIPPS in the long term management of variceal bleeding?
There is an increased risk of hepatic encephalopathy with TIPPS
Why should IgA levels of antibody be checked when checking for anti-tTG
anti-TTG is a type of IgA antibody which may be raised in the presence of IgA deficiency
Which is the preferred test for diagnosing coeliac disease?
anti-TTG as it is more specific than anti-gliandin
Treatment for Hepatitis C in an IV drug user
PEG-interferon alpha with ribavirin
-Only requires weekly dosing
Patient returns from Far East with symptoms similar to coeliac disease, including chronic diarrhoea, weight loss, tiredness and fevers. He develops chronic leg oedema. Diagnosis and treatment?
Tropical Sprue
-Treat with Tetracycline for 3-6months
What is diclofenac?
NSAID
What is vitamin B1?
Thiamine deficiency
Name some causes behind delayed vomiting
Peptic ulcer, gastric carcinoma, gall bladder disease and intestinal obstruction
Which can constipation occur in Crohn’s
Due to partial strictures in the intestines
In terms of bowel habit, what does hypothyroidism and hypercalcaemia cause?
Constipation
Difficulty swallowing, iron deficiency anaemia and oesophageal web
Plummer-Vinson Syndrome
What kind of pulse is associated with cardiac tamponade?
Paradoxical pulse
What kind of pulse is found in patients with severe heart failure?
Alternans
Causes of a wide pulse pressure
atherosclerosis, fever, anaemia, thyroxitosis, heart block, anxiety, aortic dissection, endcarditis
What type of malignancies are patients with coeliac disease at risk of?
Small bowel lymphoma and oesophageal carcinoma
Where is Meckel’s Diverticulum commonly found and when is it diagnosed?
Diagnosis of exclusion after upper and lower GI blood loss have been excluded. 60cm away from ileocaecal valve
Diagnosis: depression, fatigue, constipation and bone pain
Hypercalcaemia
Patient in shock and lying still
Peritonitis
What type of stones are associated with bacterial in the bile duct?
Pigment stones
What is Duke’s staging?
1) Limited to mucosa
2) Through wall
3) Lymph Node involvement
4) Distal metastases
Where is the most common site of mesenteric ischaemia?
Splenic flexure
What is the rule of twos for Meckel’s diverticulum?
2 inches in length, 2 feet proximal to ileocaecal junction, 2% of population, 2 types of Heretrophic epithelium (gastric and pancreatic)
Pseudopolyps
UC
An 83 year old man presents following a collapse. He is not tachycardic but has a postural drop in bp. He has mild epigastric discomfort. You not he has a history of arthritis and hypertension
Bleeding peptic ulcer
-He is taking NSAIDs because of his arthritis. Not tachycardic because he is using alpha blockers for hypertension
Inguinal hernia
Above and medial to the pubic tubercle
Femoral hernia
Below and lateral to the pubic tubercle
Hernia lying medially to the epigastric vessels
Direct- more common in older male
Hernia lying laterally to the epigastric vessels
Indirect- more common in young male
Raised serum amylase
Pancreatitis
Murphy’s sign positive
Cholecystitis
