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Year 3 Med 2 > GI additional notes > Flashcards

GI additional notes Flashcards

1
Q
  1. Wernicke’s encephalopathy is characterised by which triad?
  2. What is it caused by?
  3. What behaviour makes you at risk of this
A
  • Ataxia (staggering), confusion, opthalmoplegia
  • Vitamin B1 deficiency
  • Alcoholic patients
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2
Q
  1. Which diagnosis do these signs and symptoms elude to? Abdo pain, diarrhoea, raised faecal calprotectin
  2. What tests are diagnostic?
  3. What would biopsy suggest?
A

Ulcerative colitis

Colonscopy and biopsy are diagnostic

Continuous disease, diffuse mucosal atrophy and mucin depletion

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3
Q

27 year old male, 2 mo history of diarrhoea and lethargy. Lost 2kg during this time. Has a vesicular rash over his knees.

What is the diagnosis?

what KIND OF RASH IS THIS

A

Coeliacs

Dermatitis herpetiformis is associated with Coeliacs. Rash is found on buttocks and extensor surfaces of upper and lower limbs

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4
Q

What is Gilbert syndrome?

A

A benign familial, mild unconjugated hyperbilirubinaemia

20-30 years old

Results from a decreased hepatic clearance of unconjugated bilirubin

There is no abnormality to liver ezymes

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5
Q

What kind of rash is associated with Crohn’s?

A

Erythema nodosum- tender erythematous nodules and plaques on the shins

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6
Q

What is the classic triple therapy for H.pylori infection?

A

Omeprazole, amoxicillin and clarithromycin

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7
Q

What is the initial test to check for coeliacs?

  1. Abdo USS
  2. IgA Anti-tissue transglutaminase
  3. Abdo X-ray
  4. LFT
A

IgA Anti-tissue transglutaminase

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8
Q

55 year old man has new onset dyspepsia, weight loss and is positive for H. pylori, what is the most appropriate next step?

A

Endoscopy within 2 weeks- dyspepsia, weight loss and >55 means urgent endoscopy. Gastric ulcer so endoscope needed to check if its healing anyway. Once that is orderd THEN amoxicillin, clarithromycin and PPI

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9
Q

Describe epidemiology of crohns

A

15-25 and 80+ (roughly) bimodal

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10
Q

What is the correct long term medication to be used for UC that is located in the rectum?

A

Topical rectal aminosalicylates e.g., mesalazine

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11
Q

45 YEAR OLD FEMALE with Hx of liver cirrhosis attends emergency department vomiting blood. Palms are red, face is puffy and she smells of alcohol. She is resuscitated with fluid and blood. What other intervention is most appropriate while waiting for endoscopy?

  1. Broad spectrum abx
  2. Terlipressin and broad spectrum abx
  3. Propranolol
  4. Terlipressin
A

Terlipressin and broad spectrum abx

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12
Q

Indication of terlipressin

A

Oesophageal bleeds. Tyerlipressin is a synthetic analogue of vasopressin. It causes splanchnic vasoconstriction to help reduce portal venous pressure

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13
Q

IgA deficiency is a false negative for which disease?

A

Coeliacs

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14
Q

Histological features of ulcerative colitis

A
  1. Inflammatory changes that do not extend past the submucosa
  2. Goblet cell depletion
  3. Crypt abscesses (collections of neutrophils within an intestinal crypt)
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15
Q

What are the first line serological tests for coeliac disease?

A

Total immunoglobulin A (IgA) and (TTG) IgA tissue transglutaminase

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16
Q

Name extra-intestinal manifestations of IBD

A

Skin, eyes, biliary tree and peripheral locomotor system. Some occur in absence of active luminal disease: primary sclerosing cholangitis (PSC), ankylosing spondylitis and small joint arthritis.

17
Q

What is the first line diuretic used in ascites and peripheral oedema secondary to liver cirrhosis?

A

Spirinolactone- aldosterone antagonist. Furosemide can be added as an additional

18
Q

What is hereditary haemochromatosis?

Complications of haemochromatosis

A

Hereditary disorder of iron metabolism , where excessive iron accumulates in the body and is deposited in a number of sites, including the liver, heart, joints, pancreas and skin.

  • Liver fibrosis
  • Cirrhosis
  • Hepatocellular carcinoma
  • Cardiac dysfunction
  • Skin hyperpigmentation
  • Arthropathy
19
Q

Name a side effect of metformin

A

Metformin causes bile acid malabsorption and thus leads to chronic diarrhoea in patients taking this agent

20
Q

What is pabrinex? Who would you give it to?

A

Vitamin B1 – give to patients who drink excessively

Year 3 Med 2 (9 decks)

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