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Phase 3b/finals > GI > Flashcards

GI Flashcards

1
Q

HIgh urea + anaemia = ?

A

Upper GI bleed

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2
Q

What is the treeatment of Wilson’s disease?

A

Penicillamine

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3
Q

LFTs in cholestatic diesease?

A

ALT normal
ALP raised
ALT/ALP < 2

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4
Q

LFTs in hepatocellular disease?

A

ALT raised
ALP normal
ALT/ALP 5+

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5
Q

Causes of acute pancreatitis

A

Gallstones
Ethanol
Trauma
Steroids
Mumps (other viruses include Coxsackie B)
Autoimmune (e.g. polyarteritis nodosa), Ascaris infection
Scorpion venom
Hypertriglyceridaemia, Hyperchylomicronaemia, Hypercalcaemia, Hypothermia
ERCP
Drugs

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6
Q

What do you see on endoscopy in Crohn’s disease?

A

Cobblestone appearance

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7
Q

Painless jaundice is classically associated with what kind of cancer?

A

Pancreatic cancer

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8
Q

What is Murphy’s sign?

A

Patient stops breathing when you palpate the right costal margin due to acute cholecystitis

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9
Q

What is Virchow’s node associated with?

A

Gastric cancer

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10
Q

What kind of ulcer is alleviated by eating?

A

Duodenal ulcer

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11
Q

What condition is associated with primary sclerosing cholangitis?

A

Ulcerative colitis

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12
Q

What is the gold standard investigation for primary sclerosing cholangitis?

A

ERCP/MRCP

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13
Q

What is the worrying complication of primary sclerosing cholangitis?

A

cholangiocarcinoma

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14
Q

Where is the pain felt indiverticulitis?

A

Left lower quadrant

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15
Q

What is Haemochromatosis?

A

disorder of iron metabolism resulting in accumulation of iron

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16
Q

Liver disease + neurological signs points to…

A

Wilson’s Disease

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17
Q

What metabolic picture is seen in vomiting?

A

Metabolic alkalosis

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18
Q

Where does ulcerative colitis stop?

A

Ileocaecal valve

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19
Q

What does metoclopramide treat?

A

Nausea

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20
Q

Metabolic change associated with ACE inhibitora?

A

hyperkalaemia

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21
Q

Metabolic change associated with vitamin D deficiency?

A

Hypocalcaemia

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22
Q

Crypt abscesses are seen in..

A

Ulverative colitis

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23
Q

Small bowel lymphoma is a complication of…

A

Coeliac disease

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24
Q

Medical management of variceal haemorrhage?

A

terlipressin

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25
Q

Prophylaxis of variceal haemorrhage?

A

Propranolol

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26
Q

Anti-mitochondrial antibodies seen in…

A

primary biliary cirrhosis

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27
Q

Most common cuase of Hepatocellular carcinoma worldwide

A

Chronic Hepatitis B

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28
Q

Anti endomyseal antibody is associated with…

A

coeliac disease

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29
Q

What is the triad of Budd-Chiari syndrome?

A

sudden onset abdo pain
ascites
tender hepatomegaly

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30
Q

Investigation of of Budd-Chiari syndrome?

A

Doppler ultrasound

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31
Q

What is Barrett’s oesophagus?

A

Squamous epithelium replaced by columnar epithelium

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32
Q

What cancer is associated with h..pylori?

A

B cell lymphoma of MALT tissue

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33
Q

First line antibiotic treatment for c.diff infection

A

Oral metronidazole

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34
Q

First line anti motility agent for IBS?

A

loperamide

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35
Q

Triad of Mesenteric ischaemia

A

CVD, high lactate and soft but tender abdomen

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36
Q

Management of a liver absess

A

drainage and antibiotics

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37
Q

Treatment of h,pylori infection

A

PPI + amoxicillin + clarithromycin

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38
Q

1st line test for coeliac disease

A

Tissue transglutaminase antiboties /anti TTG

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39
Q

Test for H.pylori post eradication therapy

A

Urea breath test

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40
Q

Complication of ERCP

A

pancreatitis

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41
Q

Describe the classic history of achalasia

A

Dysphagia to solids and liquids from the start

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42
Q

What is visible on barium swallow in achalasia?

A

Beak like deformity

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43
Q

What is the cause of coeliac disease?

A

HLA DQ2 or DQ8

44
Q

If there is no FHx of coeliacs disease, what antibody blood tests can confirm diagnosis?

A

Anti TTG and anti endomysial

45
Q

What would you see on duodenal biopsy in coeliac disease?

A

Villous atrophy
Crypt hyperplasia
Lymphocyte infiltration

46
Q

What antibodies are positive in ulcerative colitis?

A

pANCA

47
Q

Name 2 anti inflammatory drugs used in the treatment of ulcerative colitis?

A

Sulfasalazine and mesalamine

48
Q

What can you hear on examination of bowel obstruction?

A

Tinkling bowel sounds

49
Q

Most common site of intussusception?

A

Ileocaecal calve

50
Q

What typically causes mesenteric ischaemia?

A

embolus

51
Q

Name a key risk factor for mesenteric ischaemia?

A

Atrial fibrillation

smoking, vascular disease

52
Q

What area of the bowel is most commonly affected in ischaemic colitis?

A

Splenic flexure

53
Q

Severe abdo pain out of proportion to physical findings with a history of a fib points to…

A

Mesenteric ischaemia

54
Q

Where is diverticular disease most likely to occur?

A

The sigmoid colon

55
Q

What is the gold standard diagnositc test for diverticulitis?

A

Abdominal CT (not colonoscopy)

56
Q

Left lower quadrant pain in an elderly person likely is….

A

Diverticular disease

57
Q

What is Rovsing’s sign?

A

When the LLQ is pressed there is pain felt on the right - positive for appendicitis

58
Q

Where does pancreatitis pain radiate to?

A

epigastric pain radiates to the back

59
Q

Which anitbiotcs are related to c.diff infection?

A

cephalosporins and clindamycin

60
Q

Name a drug which is a risk factor for c.diff (non antibiotic)

A

PPI

61
Q

How can c.diff be diagnosed?

A

CD toxin found on stool sample

62
Q

what is the 2nd line treatment for c.diff if oral metronidazole doesn’t work

A

Oral vancomycin

63
Q

Primary biliary cholangitis diagnosis?

A

Anti mitochondrial antibodies

64
Q

Itching in a middle aged woman is the classic presenation of…

A

Primary biliary cholangitis

65
Q

Treatment of haemochromatosis

A

venesection (blood letting)

66
Q

What must be done in patients with a suspected upper GI bleed?

A

Endoscopy within 24 hours

67
Q

Medical management of variceal bleeding?

A

Terlipressin and prophylactic antibiotics

68
Q

Raised urea and a background of normal kidney function indicates…

A

Upper GI bleed

69
Q

investigations of choice in primary sclerosing cholangitis

A

ERCP

70
Q

What condition is associated with primary scerosing cholangitis?

A

Ulcerative colitis

71
Q

jaundice, right upper quadrant pain and pruritus on a background of ulcerative colitis… diagnosis?

A

Primary sclerosing cholangitis

72
Q

How is liver cirrhosis diagnosed?

A

transient elastography or Fibroscan

73
Q

Who should be screened for cirrhosis?

A
  • Hep C positive people
  • Men who drink >50 units, women who drink >35 units
  • Those with alcohol related liver disease
74
Q

What is the most common form of inherited colorectal cancer?

A

Hreditary non polyposis colorectal cancer - HPNCC

75
Q

What X-ray sign would you see in ulcerative colitis?

A

Lead pipe appearance

76
Q

In spontaneous bacterial peritonitis, what is the causative organism seen on draining the ascitic fluid?

A

E.coli

77
Q

What is the treatment for spontaneous bacterial peritonitis?

A

IV Cefotaxime

78
Q

What is the first line treatment for crohn’s?

A

Glucocorticosteroid e.g. IC hydrocortisone

79
Q

What is the treatment for a flare of ulcerative colitis?

A

oral Mesalazine

80
Q

If oral mesalazine does not help a flare up of ulcerative colitis, what can be added?

A

Prednisolone

81
Q

What are the symptoms of carcinoid syndrome?

A
  1. Flushing
  2. Diarrhoea
  3. Bronchospasm
82
Q

What hormone is produced in carcinoid tumours?

A

5-HIAA

83
Q

What does the modified glasgow score assess?

A

The severity of acute pancreatitis

84
Q

What are the factors assessed in the modified glasgow score? - PANCREAS

A 
PaO2
Albumin
Nitrogen
Creatinine
Raised white cell count
Enzyme - lactate dehydrogenase
Age
Sugar (glucose)
85
Q

How to distinguish between IBD and IBS in primary care?

A

Faecal calprotectin

86
Q

Most common cause of upper GI bleed?

A

Peptic ulcer

87
Q

What is the gold standard investigation of oesophageal cancer?

A

Endoscopy

88
Q

Side effects of PPIs?

A

Hyponatraemia
Osteoporosis
Increased risk of c.diff

89
Q

Blood results typically seen in primary sclerosing cholangitis?

A

Raised ALP, gamma-GT and bilirubin

90
Q

Gold standard investigation for primary sclerosing cholangitis?

A

MRCP

91
Q

Raised ALP is most commonly associated by problems with….

A

The Bile Duct

92
Q

What is charcot’s triad?

A

Ascending cholangitis:

  1. Fever
  2. Jaundice
  3. RUQ pain
93
Q

What does a positive Rovsing’s sign indicate?

A

Appendicitis

94
Q

When would you see a positive murphy’s sign?

A

Acute cholecystitis

95
Q

What is the treatment of alcoholic hepatitis?

A

Prednisolone

96
Q

What would you see in the blood and ABG in mesenteric ischaemia?

A

Raised lactate, acidosis

97
Q

Most common site of ischaemic colitis?

A

Splenic flexure

98
Q

‘thumbprinting’ on abdominal x-ray indicates?

A

Ischaemic colitis

99
Q

Which hepatitis is most likely to precede hepatocellular carcinoma?

A

Hep C

100
Q

First line treatment of severe c.diff infection is…

A

Vancomycin

101
Q

Treatment for hepatic encephalopathy?

A

Lactulose and rifaximin

102
Q

First line treatment for a crohn’s clare up?

A

IV hydrocortisone

103
Q

If IV hydrocortisone does not aid a crohn’s flare up what is added?

A

Biologic therapy/monoclonal antibody e.g. infliximab

104
Q

How to monitor hepatocellular carcinoma recurrence?

A

AFP

105
Q

What would you see on abdominal x ray in gall stone ileus?

A

Small bowel obstruction

Air in the biliary tree

Phase 3b/finals (19 decks)

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