GI Flashcards
What are the characteristics of HepB:
How many become chronic
Who gets treated?
What are the serological tests?
5% chronic
Treat if signs of liver disease
What are the characteristics of HepC:
How many become chronic
Who gets treated?
70% become chronic
Everyone tends to get treated and success depends on genotype
Tazocin:
What is it?
When is it used?
How is it used?
Adverse reactions?
- Mixture of Piperacillin sodium (PENICILLIN)/Tazobactam sodium (B LACTAMASE INHIBITOR)
- Broad spectrum antibiotic used for pneumonia or abdo infections
- It is given IV
- Diarrhoea is most common
Chlordiazepoxide hydrochloride:
When is it used?
Acute alcohol withdrawal syndrome* - Acts as a GABA agonist
*Delirium tremens (confusion, hypertension, tremors, sweating) seizures and agitation due to hyper arousal of CNS due to downregulation of GABA activity.
What is the GDH toxin?
Produced by C.Diff.
Is also produced by other bacteria so not enough for diagnosis
What is Courvesiers law?
Jaundice plus non painful cholecystitis = ?Pancreatic Ca
If it is non enlarged but is painful then probably gall stones
What can cause hepatic Bruits?
HCC
ALD
When is a fecal calprotectin used?
What can cause a positive result?
It is a test using the faeces and it distinguishes between a functional and inflammatory process.
Causes of raised levels:
IBD
Infection
Cancer
NSAIDS and tissue damage
NB - IBD WEEKS
What can cause PR bleeding?
- IBD
- Fissure
- Polyps
- Rectal carcinoma
- Haemorrhoids
- Fistula
- Gasteroentiritis
- Diverticuli causing weakened and subsequent bursting of vessels
What is hepatorenal syndrome and what is used to treat it?
Renal failure as a result of liver disease
Splanchic vasodilation causes renal vasoconstriction
Tx - Telepressin - causes vasoconstriction of splanchic vessels
What are the signs of Hypoalbuminemia?
What causes it
Signs -
- Leukonychia
- oedema
Causes -
- Liver failure
- Renal failure (nephrotic syndrome)
What is hepatic encephalopathy?
What is the pathophysiology?
What is the treatment?
Liver failure causes condusion and coma due to a build up ammonia in the blood causes cerebral swelling via bacterial production of glutamine.
Tx - Lactulose to suppress toxic substances in blood from gut bacteria
What commonly causes DIC?
What blood results do you get?
E.coli septicaemia
Clotting and bleeding together
Bloods:
- Increase APTT, INR, PT, bleeding time
- Decreased fibrinogen
- Increased FDP
- Schistocytes
What is gilberts disease?
Increase in unconjugated bilirubin and subsequent transient jaundice in times of stress or illness
LIVER ICM DECK
ANAEMIA DECK
What are the ECG changes for hyperkalaemia?
- Peaked T waves
- Small P waves
- Wide QRS
What are the three stages of hyperkalamia management?
- Stabilise myocardium if ECG changes - 10ml calcium gluconate IV 3-5 min. Can repeat 5 mins later
- Shift potassium intracellularly - Insulin and glucose. Nebulised salbutamol
- Remove K from body - Calcium resonium to bind it in gut
NB - may need to treat hypoglycaemia
What are the symptoms and signs of anaemia?
Symptoms
- SOB
- Tiredness
- Palpitations/Angina
- Dyspnoea
- Headache
- Tinnitus
Signs
- Conjuctival pallor
- Leuconychia
- Glossitis in (IDA atrophic, bald and shiny with pallow or B12 deficiency)
- Angular stomatitis (IDA IDA or B12 deficiency)
What are the three catagories of anaemia and what are the blood results?
Microcytic (High MCV)
- Low Hb, low MCV, Low ferritin, High TIBC
Normocytic (Normal MCV)
- Low Hb, Normal MCV, Low TIBC, Low Ferritin
Macrocytic (Low MCV)
- Low Hb, High MCV,
What terms do you use to describe the anaemia?
Anaemia - Low Hb
Macro/Normo/Microcytic - Size of MCV
Macro/Normo/Microchromic - MCH
What are the common causes of microcytic anaemia?
IDA
Thallasemia
Lead poisoning
Sideroblastic
Anaemia of chronic disease (also normocytic)
What are the common causes of iron deficiency?
Menorrhagia
GI bleed eg cancer
No absorption eg coeliac
What can cause normocytic anaemia?
Blood loss
Anaemia of chronic disease (also microcytic)
Sickle Cell
Haemolytic
Hypothyroidism
What are the causes of macrocytic anaemia?
Megaloblastic - Low B12 or folate
Non megaloblastic - Alcohol, hypothyroid (also normo)
Why do you get peripheral neuropathy with macrocytic anaemia?
Loss of myelin
What are the causes of b12/folate deficieny?
Coeliac
IBD
Poor diet (folate = green, b12 = meat and poultry)
What can cause relative polycythaemia i.e low plasma volume?
Acute dehydration
Chronic - obesity, smoking, alcohol
What can cause absolute polycythaemia
Increased EPO
Chronic hypoxia eg Altitude. COPD
What cause cause B12 to rise?
Any inflammatory reaction
What causes both normo and mirocytic anaemia?
Anaemia of chronic diesease
What causes both macro and normocytic anaemia?
Hypothyroid
What do you treat B12 and folate deficiency?
B12 injections first to stop
subacute combined degeneration of the spinal cord (dorsal columns and corticospinal)
What is Kussmaul breathing?
Shallow and rapid and then deep and laboured breathing associated with metabolic acidosis
