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Phase 3b > GI Chapter 2 > Flashcards

GI Chapter 2 Flashcards

1
Q

What is hepatorenal syndrome?

A

cirrhosis + ascites +renal failure - if other causes of renal impairment have been excluded

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2
Q

What blood tests would you do when suspecting liver failure?

A

FBC (?infection ?GI bleed), U&E, LFT, clotting (inc. PT/INR), glc, paracetamol level, hep, CMV, EBV serology, ferritin, a-antitrypsin, caeruloplasmin, autoantibodies

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3
Q

Treat liver failure related cerebral oedema

A

on ITU with 20% mannitol IV, hyperventilate

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4
Q

most common causes of cirrhosis

A

chronic alc. abuse, HBV or HCV infection

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5
Q

What is the drug used for pruritis

A

Cholestyramine

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6
Q

overall prognosis of cirrhosis

A

5 yr survival rate is 50%

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7
Q

An inherited disorder of iron metabolism in which inc. iron absorption leads to iron deposition in joints, liver heart, pancreas, pituitary, skin

A

hereditary hemochromatosis

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8
Q

Management of her. hemochromatosis

A

Venesect, vitamin preps containing no iron, screening

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9
Q

Other reasons for hemochromatosis

A

many transfusions - about 40L

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10
Q

Which disease is caused by the gene found on chromosome 14?

A

a-1-antitrypsin-d

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11
Q

Presentation of A1AD

A

dyspnoea from emphysema, cirrhosis, cholestatic jaundice

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12
Q

Disease: interlobular bile ducts are damaged by chronic autoimmune granulomatous inflammation

A

1ary biliary cirrhosis

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13
Q

blood tests in 1aryBC

A

inc ALP, gGT, mildly inc. ALT&AST

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14
Q

Which disease is associated with male gender, HLA-A1;B8, DR3, AIH

A

1ary sclerosing cholangitis

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15
Q

Pathogenesis of autoimmune hepatitis

A

suppressor t-cell defects with autoantibodies directed against hepatocyte surface antigens.

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16
Q

How is AIH managed?

A

Immunosuppression - Pred 30mg/d for a month to maintenance of 5-10mg

17
Q

NAFLD - typical patient

A

middle aged obese female

18
Q

Which disease causes too much copper in the liver?

A

Wilson’s disease - disorder of biliary copper secretion.

19
Q

Which is the most common benign liver tumour and what should you not do?

A

Haemangioma. Biopsy! -> bleed

20
Q

What is the prevalence of hepatocellular carcinoma?

A

90% of 1ary liver cancer - common in China and Africa

21
Q

Which disease is a relapsing remitting inflam. disorder of the colon

A

Ulcerative colitis

22
Q

What is a complication of UC?

A

Perforation and bleeding, toxic dilatation, venous thrombosis

23
Q

What’s a protective factor of UC

A

smoking - UC 3x as common in non-smoker and may relapse with stopping smoking

24
Q

Treatment of UC

A

5-ASA - sulfasalazine & steroids for induction of remission

25
Q

Crohn’s associations

A

altered cell-mediated immunity; smoking inc risk by 3-4x.

26
Q

Treatment of Crohn’s

A

Steroids -> looking to wean

27
Q

Extra-GI symptoms of Crohn’s

A

clubbing, skin, joint&eye probs

28
Q

Define IBS

A

IBS denotes a mixed group of abdominal problems for which no organic cause can be found

29
Q

Prevalence of IBS

A

10-20% of the population

30
Q

Risk factors for pancreatic cancer

A

Smoking, alcohol, carcinogens, dm, chronic pancreatitis, inc. waist circumference, possibly high fat/red meat diet

31
Q

Genetics of pancreatic cancer

A

95% have mutations in the KRAS gene

32
Q

Head of pancreas tumours present how?

A

painless obstructive jaundice

33
Q 
What deficiencies cause:
scurvy
beriberi
pellagra
xerophthalmia
A

lack of vit c
vit b1 (thiamine)
nicotinic acid
vit a

34
Q

Which cells do carcinoid tumours stem from?

A

enterochromaffin cells (neural crest) -> can produce 5HT

35
Q

What’s a carcinoid crisis?

A

when tumour outgrows blood supply or is handled too much -> mediator release -> life-threatening vasodilation, hypotension, tachy, bronchoconstriction and hyperglycemia. Tx with octreotide

36
Q

Name 3 common causes of malabsorption in the UK

A

coeliac dx, chronic pancreatitis, Crohn’s

37
Q

associations of coeliac disease

A

HLA DQ2 in 95%; the rest ar DQ8; autoimmune disease, dermatitis herpetiformis

38
Q

Signs of alcohol withdrawal

A

10-72hrs after last drink: pulse inc., bp dec., tremor, confusion, fits, hallucinations

Phase 3b (28 decks)

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