Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine Year 3 > GI and surgery > Flashcards

GI and surgery Flashcards

1
Q

Discuss the use of and mechanism of action for terlipressin

A

Use in variceal oesophageal bleeds

Vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Discuss key diagnostic features for haemorrhoids

A

Rectal bleeding
Itching and pain/discomfort
Swelling around the anus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Aside from band ligation and attempts to cease bleeding what other therapy should be initiated in an acute oesophageal variceal bleed?

A

Antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Mechanism of action and clinical use of metoclopramide

A

Dopamine antagonist

Antiemetic and prokinetic effects however patient can suffer dystonic reactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the first line treatment for dystonic reactions?

A

Procyclidine (anti-cholinergic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What property of methylnaltrexone makes it an effective therapy against opioid induced constipation

A

Cannot cross blood brain barrier

Diminished peripherally mediated opioid side effects without effecting central analgesic effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Mechanism of action and use of Bupivacaine

A

Locals anaesthetic - sodium channel blocker preventing depolarisation and therefore pain impulses to central pain centres

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

A patient needs to be started on clarithromycin, which drug should be stopped that has a major interaction with clarithromycin?

A

Simvastatin
Clarithromycin is a potent inhibitor of CYP3A4 and can therefore lead to large increase in amount of simvastatin levels increasing risk of myopathy and rhabdomyolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What values does the blatchford score use to assess severity of GI bleed

A

Blood urea
Haemoglobin
Systolic bp
Other markers: pulse, melaena, syncope, hepatic disease and heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

List histological/pathological features of ulcerative colitis

A

Crypt abscesses
Inflammation confined to mucosa
Pseudopolyps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does a positive Cullen’s sign suggest in the assessment of acute pancreatitis

A

Periumbilical discolouration due to haemorrhagic pancreatitis (blood vessel auto-digestion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

State the possible causes of raised amylase

A 
Acute pancreatitis 
Malignancy of pancreas, ovaries and lungs 
Cholecystitis 
Biliary disease 
Severe gastroenteritis 
Infection of salivary glands e.g. mumps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Typically how raised is serum amylase to be diagnostic for acute pancreatitis

A

3 times the upper limit of normal range

However does not have to be raised if other symptoms are suggestive of pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Recommend management of adult patient with C. difficile

A

Metronidazole and discontinuation of causative antibiotic

Fluid and electrolytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is kind of epithelia is the oesophageal mucosa

A

non-keratinising stratified squamous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Discuss the appropriate resuscitation of a haemodynamically unstable patient with an upper GI bleed

A 
Large bore IV catheters 
Crystalloids
retore to vital sign 
HDU monitor if indicated 
central venous monitoring 
Vital sin and urine output monitored
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

State pathological features of Ulcerative colitis

A

o Irregular surface
o Diffuse crypt architectural distortion
o Diffuse chronic inflammatory cell infiltrate, rich in plasma cells
o Crypt abscesses (The colonic mucosa of active ulcerative colitis shows “crypt abscesses” in which a neutrophilic exudate is found in glandular lumens of crypts of Lieberkuhn. The submucosa shows intense inflammation.
o The glands demonstrate loss of goblet cells and hyperchromatic nuclei with inflammatory atypia)
o Inflammation confined to mucosa/submucosa

Pseudopolyps (islands of oedematous mucosa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Treatment for dystonic reaction caused by therapy with dopamine antagonists

A

Procyclidine (anti cholinergic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the symptoms of venous incompetence

A

Leg pain, aching, itching, swelling, pigmentation, and eczema and ultimately ulceration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Outline the Dukes classification Of bowel cancer

A 
A - invasion confined to mucosa 
B - infiltration through muscle
B2 - through bowel wall 
C - node involvement
D - distant metastases
21
Q

What test is diagnostic (along with clinical history) for primary biliary cirrhosis

A

Antimitochondrial antibodies

22
Q

The most common causative pathogen of food poisoning in the UK

A

Campylobacter

23
Q

Histological features of Crohn’s

A 
Transmural chronic inflammation 
Lymphoid aggregates 
Presents in skip lesions 
Crypt architecture preserved 
Granulomatous 
Fissuring ulcers
24
Q

A 25 year old man presents with fatigue and joint pain, on examination you note is skin is quite tanned but otherwise non-remarkable

His blood tests reveal deranged LFTs, raised Ferritin and transferrin saturation

Subsequent genetic testing was positive, what is the most likely mode of inheritance

A

Autosomal recessive

Haemochromatosis - deranged LFT and iron overload

25
Q

Discuss possible complications of primary biliary cholangitis

A

Those of cirrhosis, osteoporosis, malabsorption of fat-soluble vitamins (A,D,E,K) due to cholestasis and decreased bilirubin in the gut lumen results in osteomalacia and coagulopathy,hepatocellular carcinoma

26
Q

Features and causes of acute liver failure

A

Jaundice, coagulopathy, and hepatic encephalopathy

Vital hepatitis, yellow fever, leptospirosis, paracetamol overdose

27
Q

Management of paracetamol overdose

A

IV acetylcysteine
Activated charcoal
Anti-emetic

28
Q

Features of Primary sclerosing cholangitis and associated complications

A

Chronic progressive cholestatic liver disease, characterised by inflammation and fibrosis of the intrahepatic and/or extrahepatic bile ducts, resulting in diffuse, multi-focal stricture formation. It is often associated with inflammatory bowel disease.

Liver failure
Cholangiocarcinoma
Hepatocellular carcinoma
ascending cholangitis

29
Q

From where does the bleeding occur in ischaemic colitis?

A

Splenic flexture (watershed)

30
Q

Which clinical sign?

In cholecystitis there is pain or catch of breath elicited on palpation of right hypochondirium during inspiration

A

Murphy’s sign

31
Q

Rovsing’s sign

A

palpation of the left lower quadrant of the abdomen increases the pain felt in the right lower quadrant. This may be an indicator of appendicitis, although it is not positive in all cases

32
Q

McBurney’s point

A

The site where the pain from appendicitis is usually most severe on palpation. The point is on the right side of the abdomen, approximately one-third of the distance from the anterior superior iliac spine to the umbilicus

33
Q

Likely diagnosis of a 50 year old male presenting with fever, RUQ pain and jaundice, he is obese and has a history gallstones

A

Ascending cholangitis

34
Q

Management of Ascending Cholangitis

A

Antibiotic therapy - piperacilin and tazobactam
Biliary drainage
intensive supportive care

35
Q

Most common cause of hereditary colorectal cancer

A

HNPCC

36
Q

Clinical features of Left sided colonic cancer

A

Constipation and large bowel obstruction
Alternating bowel habits
Retal bleeding
Decreased stool calibre

37
Q

Levels of which protein should be checked to ensure immunity 4 months after hepatitis B vaccination

A

Anti-HBs implies immunity (either exposure or immunisation). It is negative in chronic disease

38
Q

A 65-year-old woman presents with jaundice, weight loss and passing clay-coloured stools. She also describes recurrent bouts of colicky RUQ abdominal pain. On examination a mass is palpable in the RUQ

A

Cholangiocarcinoma

39
Q

A 40-year-old man with a history of back pain presents with epigastric pain and passing black, tarry stools. His pain is relieved by eating

A

duodenal ulcer

40
Q

Which form of inflammatory bowel disease is there increased risk of colorectal cancer?

A

Ulcerative colitis

41
Q

Radiological features of Crohn’s disease?

A
  • Kantor’s string sign
  • Proximal bowel dilation
  • Rose thorn ulcers
  • Bowel wall thickening
42
Q

Risk factors for acute mesenteric ischaemia

A

atrial fibrillation, heart failure, chronic kidney failure, being prone to forming blood clots, and previous myocardial infarction

43
Q

70 year old female presents with severe abdominal pain after eating and diarrhoea, on investigation she is hypotensive and an ABG reveals metabolic acidosis

A

Mesenteric ischaemia

44
Q

Papulovesicular lesions on the extensor aspects of a patients arm, along with a hx of steatorrhoea, bloating and abdominal pain, is characteristic of which disease?

A

Coeliac

45
Q

A 45-year-old woman presents with fatigue and pruritus. Blood tests show a raised bilirubin, ALP and IgM level

A

Primary biliary cirrhosis

46
Q

A 40-year-old woman presents with acute onset of upper abdominal pain and ascites. She has been on the combined oral contraceptive pill for 7 years. On examination she has tender hepatomegaly. There is no hepatojugular reflux and no lower limb oedema. Cardiovascular exam revealed no medical abnormalities. She is known to have polycythaemia vera of 10 years’ duration.

A

Budd-Chiari syndrome

47
Q

A patient presents semi-stuporous but responds to verbal stimuli, they are confused and grossly disorientated, which grade of hepatic encephalopathy is this?

A

Grade 3

48
Q

What is Courvoisier’s law?

A

states that in the presence of jaundice an enlarged gall bladder is unlikely to be due to gallstones - that is, pancreatic carcinoma or cholangiocarcinoma

Medicine Year 3 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions