GI Flashcards
Which type of ulcers (gastric or duodenal are more common)?
Duodenal
What is the most common gram negative cause of acute cholangitis?
E.coli
What is the most common gram positive cause of acute cholangitis?
Enterococci
How is Wilson’s disease treated?
Oral zinc therapy
What impact does SIBO have on vitamin B12 and folate?
Decreased B12
Increased folate
What may fenofibrate lead to (and how)?
Causes increased cholesterol secretion, so may cause cholesterol gallstone formation
Which type of glands are usually preserved in Crohn’s?
Mucin glands
ZE tumours are commonly located where?
Proximal duodenal wall and the head of the pancreas
What is melanosis coli and how is it caused?
Darkening of the mucosal lining due to prolonged laxative use
How are duodenal ulcers relieved?
Eating or drinking milk
Which test is mandatory to diagnose Coeliac?
Duodenal biopsy
What do high serum amylase and serum lipase indicate?
Hypertriglyceridaemia induced pancreatitis
What three factors stimulate gastric acid secretion?
ACh
Gastrin
Histamine
What three factors inhibit gastric acid secretion?
Somatostatin
Secretin
CCK
How is giardiasis diagnosed?
Stool sample
What are three characteristics of haemolytic jaundice?
Splenomegaly
Reticulocytosis (increase in immature RBCs)
Anaemia
If the large bowel has a diameter of over x, it is considered dilated. What is x?
5.5cm
If the small bowel has a diameter of over x, it is considered dilated. What is x?
3cm
How is hydatid disease treated (2)?
Drainage and albendazole
Which type of fibre intake should be increased in diverticular disease?
Soluble
What three symptoms/signs are associated with Budd-Chiari?
Abdominal pain
Ascites
Hepatomegaly
How is TB diagnosed?
Ileal biopsy
What are three most common bacterial causes of ascending cholangitis?
E.coli
Klebsiella
Enterobacter
What type of vomiting is caused by pyloric stenosis?
Projectile
Which type of inheritance is haemachromatosis?
Autosomal recessive
Which two types of antibodies are important in autoimmune gastritis?
Anti-parietal and anti-intrinsic factor
What is removal of the sigmoid colon called?
Hartmann’s procedure
What faecal test is used to investigate pancreatitis?
Faecal elastase
Are fistulae more common in Crohn’s or UC?
Crohn’s
FAP is a mutation in which gene?
APC tumour suppressor
HNPCC is a mutation in which gene?
DNA mismatch repair
Which type of inheritance do FAP and HNPCC show?
Autosomal dominant
When does CVID become apparent?
Adulthood
What is the treatment for life-threatening C.diff infection?
Oral vancomycin + IV metronidazole
Which two disease are associated with alpha1-antitrypsin deficiency?
COPD and liver disease
Of Crohn’s and UC, which is TH1 mediated and which is mediated by TH1 and TH2?
Crohn's = TH1 UC = TH1 and TH2
What % of people with Hep C will become chronic carriers?
80%
GISTs are what type of tumours?
Mesenchymal
In which populations are squamous carcinomas in the oesophagus most common?
Eastern/developing countries
Where in the oesophagus is squamous carcinoma usually found?
Upper 2/3rds
When is vomiting due to gastroperesis worst?
In the evening
When in life is H.pylori usually contracted?
Under 5s
What does H.pylori do to the pH of its environment?
Increases it
What is the floor of the inguinal canal formed of?
Inguinal and lacunar ligaments
What is the medial border of the femoral canal formed from?
Lacunar ligament
How are small bowel lymphomas treated?
Surgery and chemotherapy
What is the average lifespan of an enterocyte?
72 hours
Which IL is important in H.pylori chronic gastritis?
IL-8
What are the two causes of small bowel ischaemia?
Arterial occlusion or perfusion insufficiency
What effect does coeliac disease have on the risk of gallstones?
Increases the risk
Is adenocarcinoma of the oesophagus more common in males or females?
Males
Is toxic megacolon more associated with Crohn’s or UC?
UC
Which GI disease is associated with childhood onset diabetes?
Coeliac
What type of tumour are most oral cancers?
Squamous
Which type of bowel infarct causes stricturing?
Mural
Which gene is important in Crohn’s?
NOD2
What are the three layers of a peptic ulcer?
Floor of necrosis
Base of granulation tissue
Deep layer of fibrosis
Inflammation in UC involves which layers?
Mucosa and submucosa
Autoimmune gastritis shows which two things?
Atrophy and intestinal metaplasia
UC causes which electrolyte imbalance?
Hypokalaemia
Are adenomas of the liver more common in males or females?
Females
Perl’s stain detects what?
Iron
Proteases in pancreatitis cause what (2)?
Tissue destruction and haemorrhage
Which type of cirrhosis is seen in alcoholics?
Micronodular
What is bile released in response to?
CCK
The liver has how many acinar zones?
3
Acute pancreatitis may cause which two electrolyte imbalances?
Hypocalcaemia
Hyperglycaemia
Does Hep B or C have a longer incubation period?
B
What is the main treatment for haemachromatosis?
Venesection
PBC is associated with which antibodies?
AMA
Which two places does copper accumulate in in Wilson’s?
Brain and liver
Acutely, which form of hepatitis (B or C) is more likely to kill you?
B
Bizarre stromal cells and vessels are a sign of what?
Radiological colitis
All adenomas of the colon are what?
Dysplastic
C.diff overgrowth causes which type of colitis?
Pseudomembranous
Less than 100 polyps suggests which (FAP/HNPCC)?
HPNCC
Does HNPCC have an early or late onset?
Late
Small bowel ischaemia is usually located where?
Left sided
Do all colonic adenomas need removed?
Yes
What is the treatment for Hep B?
PEG IFNalpha + tenofovir + entecavir
What is the treatment for Hep C?
PEG IFNalpha + ribavirin
Which form of hepatitis is most common in the tropics?
Hep E
Which hepatitis drug can cause haemolytic anaemia?
Ribavirin
What is the main route of spread of Hep E in the UK?
Zoonosis
Which is the most common form of hepatitis amongst PWIDs?
C
Which form of hepatitis may be asymptomatic in young children?
A
Which drug is used for sedation in hepatic encephalopathy?
Lorazepam
What are the three drugs used in H.pylori eradication?
Amoxicillin + omperazole + clarithromycin
Which drug can replace amoxicillin in H.pylori eradication if there is a pencillin allergy?
Metronidazole
Which deficiency causes agammaglobulinaemia?
XLA
In autoimmune hepatitis, what do HLA DR3/4 mean in terms of onset and severity?
HLA DR3 = early onset and severe
HLA DR4 = late onset and severe
What is gluconeogenesis?
The non-specific breakdown of non-carbohydrate precursors to form new glucose
What does AST stand for?
Aspartate transaminase
Is UC or Crohn’s associated with granulomas?
Crohn’s
Do RBCs appear macro/microcytic in autoimmune gastritis?
Macrocytic
Food poisoning associated with shellfish is usually due to?
Norovirus
What is schistosomiasis caused by?
Trematodes
Salmonella presents which two antigens?
O and H
Which infection is associated with lactose intolerance for a few weeks after?
Giardia intestinalis
Which drug is used to treat recurring C.diff?
Fidaxomicin
Which type of jaundice may be caused by E.coli 0157?
Pre-hepatic
Which bacteria is part of the normal gut flora of some reptiles?
Salmonella
On which type of agar is enterohaemorrhagic E.coli grown on?
Sorbitol MacConkey
Which impact to E.coli toxins have on intracellular cAMP?
Increases
How is enteric fever treated?
Azithromycin
Cestodes are associated with…
Pork and beef
What is the mortality rate for acute pancreatitis?
10%
Are pancreatic acinar cells endo/exocrine?
Exocrine
High coffee intake is a risk factor for which type of pancreatic tumours?
Exocrine
Necrosis occurs how many days post-illness in pancreatitis?
3-5
What are the causes of chronic pancreatitis?
CAT And PIG Congenital/acquired Alcohol Tropical countries Autoimmune Pancreatic duct obstruction Idiopathic Genetics (CF)
Does somatostatin suppress or inhance the release of pancreatic hormones?
Suppress
Which criteria is used to assess the severity of pancreatitis?
Glasgow criteria
Alpha amylase produces what?
Oligoaccharides
How can the secretions of the parotid, submandibular and sublingual glands be described?
Parotid = serous Submandibular = more viscous Sublingual = mucous
What are three side effects of orlistat?
Abdominal cramps
Diarrhoea
Vitamin deficiency
What do NSAIDs block to cause peptic ulcers?
COX 1
Which drugs need to be stopped before doing a faecal antigen test for H.pylori?
PPI 2 weeks before
H2 antagonist 1 day before
What is the operation for appendicitis?
Laparoscopic appendectomy
What is the first investigation for rectal bleeding?
PR exam
What is the investigation for diverticulitis?
CT colonography
What medications are given for diverticulitis?
Metronidazole + co-trimoxazole
What is pneumoperitoneum?
Free gas under the diaphragm
What is the treatment for PSC?
Liver transplant
What is the treatment for PBC?
Ursodeoxycholic acid
What are the conditions for severe UC?
6+ bloody stools in 24 hours \+1 of... -fever -HR >90bpm -anemia -elevated ESR