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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
Prophylaxis of variceal haemorrhage?
Propranolol
26
Anti-mitochondrial antibodies seen in...
primary biliary cirrhosis
27
Most common cuase of Hepatocellular carcinoma worldwide
Chronic Hepatitis B
28
Anti endomyseal antibody is associated with...
coeliac disease
29
What is the triad of Budd-Chiari syndrome?
sudden onset abdo pain ascites tender hepatomegaly
30
Investigation of of Budd-Chiari syndrome?
Doppler ultrasound
31
What is Barrett's oesophagus?
Squamous epithelium replaced by columnar epithelium
32
What cancer is associated with h..pylori?
B cell lymphoma of MALT tissue
33
First line antibiotic treatment for c.diff infection
Oral metronidazole
34
First line anti motility agent for IBS?
loperamide
35
Triad of Mesenteric ischaemia
CVD, high lactate and soft but tender abdomen
36
Management of a liver absess
drainage and antibiotics
37
Treatment of h,pylori infection
PPI + amoxicillin + clarithromycin
38
1st line test for coeliac disease
Tissue transglutaminase antiboties /anti TTG
39
Test for H.pylori post eradication therapy
Urea breath test
40
Complication of ERCP
pancreatitis
41
Describe the classic history of achalasia
Dysphagia to solids and liquids from the start
42
What is visible on barium swallow in achalasia?
Beak like deformity
43
What is the cause of coeliac disease?
HLA DQ2 or DQ8
44
If there is no FHx of coeliacs disease, what antibody blood tests can confirm diagnosis?
Anti TTG and anti endomysial
45
What would you see on duodenal biopsy in coeliac disease?
Villous atrophy Crypt hyperplasia Lymphocyte infiltration
46
What antibodies are positive in ulcerative colitis?
pANCA
47
Name 2 anti inflammatory drugs used in the treatment of ulcerative colitis?
Sulfasalazine and mesalamine
48
What can you hear on examination of bowel obstruction?
Tinkling bowel sounds
49
Most common site of intussusception?
Ileocaecal calve
50
What typically causes mesenteric ischaemia?
embolus
51
Name a key risk factor for mesenteric ischaemia?
Atrial fibrillation | smoking, vascular disease
52
What area of the bowel is most commonly affected in ischaemic colitis?
Splenic flexure
53
Severe abdo pain out of proportion to physical findings with a history of a fib points to...
Mesenteric ischaemia
54
Where is diverticular disease most likely to occur?
The sigmoid colon
55
What is the gold standard diagnositc test for diverticulitis?
Abdominal CT (not colonoscopy)
56
Left lower quadrant pain in an elderly person likely is....
Diverticular disease
57
What is Rovsing's sign?
When the LLQ is pressed there is pain felt on the right - positive for appendicitis
58
Where does pancreatitis pain radiate to?
epigastric pain radiates to the back
59
Which anitbiotcs are related to c.diff infection?
cephalosporins and clindamycin
60
Name a drug which is a risk factor for c.diff (non antibiotic)
PPI
61
How can c.diff be diagnosed?
CD toxin found on stool sample
62
what is the 2nd line treatment for c.diff if oral metronidazole doesn't work
Oral vancomycin
63
Primary biliary cholangitis diagnosis?
Anti mitochondrial antibodies
64
Itching in a middle aged woman is the classic presenation of...
Primary biliary cholangitis
65
Treatment of haemochromatosis
venesection (blood letting)
66
What must be done in patients with a suspected upper GI bleed?
Endoscopy within 24 hours
67
Medical management of variceal bleeding?
Terlipressin and prophylactic antibiotics
68
Raised urea and a background of normal kidney function indicates...
Upper GI bleed
69
investigations of choice in primary sclerosing cholangitis
ERCP
70
What condition is associated with primary scerosing cholangitis?
Ulcerative colitis
71
jaundice, right upper quadrant pain and pruritus on a background of ulcerative colitis... diagnosis?
Primary sclerosing cholangitis
72
How is liver cirrhosis diagnosed?
transient elastography or Fibroscan
73
Who should be screened for cirrhosis?
- Hep C positive people - Men who drink >50 units, women who drink >35 units - Those with alcohol related liver disease
74
What is the most common form of inherited colorectal cancer?
Hreditary non polyposis colorectal cancer - HPNCC
75
What X-ray sign would you see in ulcerative colitis?
Lead pipe appearance
76
In spontaneous bacterial peritonitis, what is the causative organism seen on draining the ascitic fluid?
E.coli
77
What is the treatment for spontaneous bacterial peritonitis?
IV Cefotaxime
78
What is the first line treatment for crohn's?
Glucocorticosteroid e.g. IC hydrocortisone
79
What is the treatment for a flare of ulcerative colitis?
oral Mesalazine
80
If oral mesalazine does not help a flare up of ulcerative colitis, what can be added?
Prednisolone
81
What are the symptoms of carcinoid syndrome?
1. Flushing 2. Diarrhoea 3. Bronchospasm
82
What hormone is produced in carcinoid tumours?
5-HIAA
83
What does the modified glasgow score assess?
The severity of acute pancreatitis
84
What are the factors assessed in the modified glasgow score? - PANCREAS
``` PaO2 Albumin Nitrogen Creatinine Raised white cell count Enzyme - lactate dehydrogenase Age Sugar (glucose) ```
85
How to distinguish between IBD and IBS in primary care?
Faecal calprotectin
86
Most common cause of upper GI bleed?
Peptic ulcer
87
What is the gold standard investigation of oesophageal cancer?
Endoscopy
88
Side effects of PPIs?
Hyponatraemia Osteoporosis Increased risk of c.diff
89
Blood results typically seen in primary sclerosing cholangitis?
Raised ALP, gamma-GT and bilirubin
90
Gold standard investigation for primary sclerosing cholangitis?
MRCP
91
Raised ALP is most commonly associated by problems with....
The Bile Duct
92
What is charcot's triad?
Ascending cholangitis: 1. Fever 2. Jaundice 3. RUQ pain
93
What does a positive Rovsing's sign indicate?
Appendicitis
94
When would you see a positive murphy's sign?
Acute cholecystitis
95
What is the treatment of alcoholic hepatitis?
Prednisolone
96
What would you see in the blood and ABG in mesenteric ischaemia?
Raised lactate, acidosis
97
Most common site of ischaemic colitis?
Splenic flexure
98
'thumbprinting' on abdominal x-ray indicates?
Ischaemic colitis
99
Which hepatitis is most likely to precede hepatocellular carcinoma?
Hep C
100
First line treatment of severe c.diff infection is...
Vancomycin
101
Treatment for hepatic encephalopathy?
Lactulose and rifaximin
102
First line treatment for a crohn's clare up?
IV hydrocortisone
103
If IV hydrocortisone does not aid a crohn's flare up what is added?
Biologic therapy/monoclonal antibody e.g. infliximab
104
How to monitor hepatocellular carcinoma recurrence?
AFP
105
What would you see on abdominal x ray in gall stone ileus?
Small bowel obstruction | Air in the biliary tree

Phase 3b/finals (19 decks)

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