GI Flashcards
Name 2 causes of pre-hepatic jaundice?
Thalassaemia, Malaria, Sickle Cell Disease
Which 3 components make up charcot’s traid?
Fever, Right Upper Qudarant pain and jaundice
What is Leukonchyia?
White discolouration on nails due to hypoalbuminaemia
Name 4 clinical presentations of cirrhosis?
LACS - Leuconchyia, ascites, clubbing, spider naevi
Name the two most common intra-hepatic causes of portal hypertension?
Cirrhosis
Schistomiasis
Name 3 post-hepatic causes of portal hypertension?
IVC obstruction
Constrictive pericarditis
Right heart failure
Where are the most common sites for varices to form?
Gastro-oesaphgeal junction, rectum, left renal vein, diaphram, anterior abdominal wall via umbilical vein
At what pressure do varices tend to rupture?
About 12mmHg
What is the clinical presentation of a ruptures varicies?
Shock
Fresh Rectal bleeding
Vomitting fresh blood
What is given to treat G-O varices and how does this drug work?
Banding OR IV Terlipressin (causes splanchnic vasoconstriction)
Name a sign that can be seen in a patient with portal hypertension?
Splenomegaly
Name two methods to treat alcohol withdrawal ?
Lorazepam
Diazepam
IV thiamine prevent werknickes encephalopathy
Name 4 reasons why patients with chronic liver disease are vulnerable to infections?
- Impaired reticula-endothelial function
- Reduced opsonic activity
- Leucocyte function
- Permeable gut wall
Which drugs should you avoid in prescribing in liver damage?
ACE- Inhibitors
Aminoglycosides
Short acting benzodiazepines with care
Name a treatment method for encephalopathy caused by liver disease?
Lactulose
Name 5 causes of peritonitis?
- Spontaneous bacterial peritonitis
- Surgical
- Secondary to peritoneal dialysis
- TB
- Pelvic inflammatory disease
Name 3 organisms which cause peritonitis?
Staph aureus, E.coli and klebsiella
Name 3 complications of peritonitis?
Septicaemia
Toxaemia
Paralytic Ileus
What does serum amalayse -ve exclude?
Pancreatitis
What are the main causes of chronic liver disease?
Alcohol Non alcoholic steatohepatitis Metabolic (wilsons, alpha q , haemachromatosis) Vascular (budd-chiari) Immune (autoimune hepaitis, PBC, PSC)
Which drug do you used to prevent Wernicke- Korsakoff?
IV thiamine
Name an exudate cause of ascites?
Peritonitis, surgery, TB, neoplasia, sepsis
Name a transudate cause of ascites?
Hypoalbuminaemia, nephrotic syndrome and malnutrition
Name a cause of ascites associated with low flow due to obstruction?
Budd-Chiari
Name 3 management strategies in a patient with ascites?
Paracentesis
Spironalactone
Trans-jugular portosytemic shunts
Which serum antibody is found in almost all patients with PBC?
AMA
Name the three most common symptoms of PBC?
Pruritis, lethargy and fatigue, jaundice
How do you treat pruritits?
Cholestyramine
How do you treat fatigue?
Modafinil
How do you reduce rate of vatical development?
Ursodeoxycholic acid
Which auto-antibodies are present in autoimmune hepatitis?
ANA and ASMA
Where is the gene mutation in haemachromatosis?
Chromosome 6
Name the diagnosis and treatment of haemachromatosis?
Raised serum ferritin and transferrin saturation
Treated with regular removal of blood and desferoxamine
In Wilson’s Disease, what is the name of the rings that encircle the iris of the eye?
Kayser-Fleischer
What is the difference in presentation between adults and children in wilsons disease?
Children = hepatic problems eg cirrhosis
Adults present with CNS problems eg tremor and dysphasia
What is the difference in presentation between adults and children in alpha-1-antitrypsin deficiency?
Children present with liver disease eg jaundice
Adults present with respiratory problems eg dyspnoea
Which is the only DNA virus in viral hepatitis?
Hepatitis B
Name 2 organisms which cause chronic diarrhoea?
Giardiasis
Cryptosporidiosis
Which organism is the most common cause of bacterial diarrhoea?
Camplylobacter jejuni
What is the definition of travellers diarrhoea?
3 or more unformed stool per day and at least one of pain/cramps/nausea/vomiting/dysentry
Name 3 organism causes of bloody diarrhoea?
E.coli, salmonella, shigella
Name 3 protozoa that cause diarrhoea?
Giardia, cryptosporidium and microsporidiea and entamoeba histolytica
Name 2 helminths causes of diarrhoea?
Schistosomiasis
Strongyloides
Which 4 antibiotics commonly cause C. difficle?
Clindamycin, co-amoxiclav, cephalosporin, ciprofloxacin
What is the treatment of c. difficile?
Oral vancomycin and metronidazole
What is Hirschprungs disease?
Neonates born without complete innervation of colon to rectum
What are the 4 main symptoms of bowel obstruction?
- Pain -colicky -poorly localised
- Billous vomitting
- Constipation
- Abdominal distension
What are the main causes of small bowel obstruction in a) adults and b) children?
a) Adhesions, hernia, malignancy
b) Appendicitis, intersussuption, volvulus