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gi ducas Flashcards

1
Q

intrinsic muscles of the tongue - which cranial nerve

A

hypoglossal CNXII

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2
Q

Extrinsic muscles of the tongue

A

CNXII except palatoglossus - CNX

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3
Q

taste anterior 2/3

A
  • CNV3 - mandibular branch
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4
Q

taste posterior 1/3

A

CNVII - chorda tympani branch

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5
Q

two layers of the oesophagus

A

outer longitudinal layer, inner circular layer

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6
Q

what is peristalsis

A

a series of wave like muscle contractions that move food through the digestive tract

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7
Q

two oesophageal sphincters

A

UOS - cricopharyngeus

LOS- functional found at the GO junction

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8
Q

what does the diaphragm do

A

separates the thorax from the abdominal cavity

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9
Q

what is aponeurosis

A

big flattened tendon

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10
Q

what is the caval hiatus

A

the level at whic IVC passes the diaphragm

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11
Q

level of caval hiatus

A

T8

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12
Q

level of oesophageal hiatus

A

T10

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13
Q

level of aortic hiatus

A

T12

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14
Q

where will ascites drain in men

A

rectovisceral pouch

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15
Q

role of parietal cells

A

secrete HCL and intrinsic factor for B12 absorption

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16
Q

role of G cells

A

secretes gastrin and stimulates parietal cells to secrete HCl

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17
Q

role of chief cells

A

secrete pepsin - proteolytic

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18
Q

branches of abdominal aorta

A

coeliac axis, superior mesenteric, inferior mesenteric

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19
Q

level of coeliac axis

A

T12

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20
Q

level of superior mesenteric

A

L1

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21
Q

level of inferior mesenteric

A

L3

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22
Q

drainage of the inferior mesenteric vein

A

splenic vein then the HPV

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23
Q

peptic ulcer risk factors

A

middle aged man, NSAIDs, H pylori, smoker, silinger-ellison syndrome

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24
Q

what is dyspepsia

A

epigastric discomfort, nausea and vomiting, bloating and burping,

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25
Q

what is dyspepsia seen

A

peptic ulcer disease, GORD and gastric cancer

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26
Q

epigastric pain worsened by eating, eased by antacids and lying flat, rupture will present as haematemesis and associated with gastric malignancy

A

gastric ulcer

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27
Q

epigastric pain relieved by eating, may wake the patient at night, rupture will present as rectal bleeding or melaena

A

duodenal ulcer

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28
Q

when to test for H pylori

A

after one month of uncomplicated dyspepsia with no relief from weight loss and antacids

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29
Q

management of ruptured peptic ulcer

A

ABCDE

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30
Q

RLQ pain, diarrhoea, weight loss, mouth ulcers, perianal disease

A

crohns

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31
Q

examples of perianal disease

A

sinuses, fissures, skin tags, abscesses

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32
Q

diarrhoea with blood and mucus, lower abdominal pain, faecal urgency, tenesmus, night rising, PR blood on examination

A

UC

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33
Q

pathology of crohns

A

granulomas, crypitis and crypt abscesses, thicken of bowel wall and fat wrapping stricture, deep fissuring ulceration and cobblestoning of mucosa

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34
Q

pathology of UC

A

no granolomas, cryptitis and crypt absecess, brances and irregular crypts, plasma cells at the bottom of cryots, superficial ulceration - pseudopolyps

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35
Q

what are crypts

A

the glands found in the lining of intestines and increase surface area of intestines for the absorption of water and electrolytes

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36
Q

complications of crohns

A

malabsoption, gallstones, fistulas, anal disease, bowel obstruction, perforation

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37
Q

complications of UC

A

toxic megacolon, colorectal carcinoma, primary sclerosing cholangitis, blood loss

38
Q

IBD investigations

A

endoscopy and mucosal biopsy, pANCA antibodies, pain AXR, CRP and albumin, MUST

39
Q

drug treatment of IBD

A

prednisolone, sulfalazine, azathioprine, infliximab

40
Q

use of prednisolone/budesonide in IBD

A

induce remission during flare and Vit D

41
Q

what is sulfasazine

42
Q

use of 5-AS in IBD

A

oral, suppositories, enemas, reduces risk of colon cancer, MONITOR RENAL FUNCTION

43
Q

what os azathioprine

A

immunosuppressant

44
Q

remember in immunosuppressants in

A

monitor bone marrow suppression and hepatitis and pancreatitis

45
Q

what is infliximab

46
Q

result of Anti-TNF

A

often into full remission for 8-12 weeks with single infusion

47
Q

signs of chronic liver disease

A

hepatomegaly, jaundive, ascites, clubbing, palmar erythema, dupuytrens contracture, xanthelasma, gynaecomastia spider naevi, encephalopathy

48
Q

symptoms of chronic liver disease

A

malaise, nasdea, RUQ discomfort

49
Q

pathophysiology of alcohol related liver disease

A

free radicals generates in the breakdown of alcohol through the cytochrome P-450 pathway

50
Q

raised AST, ALT, biliribin and decreased albumin, prolonged PT

A

alcoholic related liver disease

51
Q

what is common in end stage liver disease

A

hepatocellular carcinoma

52
Q

treatment of alcohol related liver disease

A

stop drinking

53
Q

pathophysiology of non alcoholic liver disease

A

simple steatosis, hepatosteatosis, cirrosis and ESLD

54
Q

treatment of non alcoholic liver disease

A

weight loss

55
Q

varices around the para umbilical region

A

caput medusae

56
Q

prophylaxis of oesophageal varices

A

beta blockers or variceal ligation/ banding, TIPSS as secondary prophylaxis

57
Q

treatment of acute bleeding oesophageal varices

A

variceal ligation, balloon tamponade, correct clotting imbalance, terlipressin to contrict blood vessels

58
Q

faecal oral route, acute disease

59
Q

hep B transmission

A

bodily fluids

60
Q

most common hep

61
Q

hepC transmission

A

blood to blood

62
Q

only found with hep b

63
Q

hep E

A

similar to hep A, common in tropics

64
Q

HBsAg

A

currently infected - surface antigen

65
Q

anti-HBs

A

recovery and immunity

66
Q

anti-HBc

A

previous or ongoing infection - core antibody

67
Q

IgM antiHBc

A

acute infection

68
Q

HB DNA

A

infectivity and active replication

69
Q

young/middle aged women with liver disease symptoms

A

autoimmune hep

70
Q

how to diagnose autoimmune hepatitis

A

liver biopsy - peice meal necrosis

71
Q

ASMA

A

autoimmune hep

72
Q

management of autoimmune hep

A

corticosteriods and azathioprine

73
Q

middle aged women with an itch and positive AMA

74
Q

young/middle aged man with IBD and ANCA + with narrowed bile ducts on ERCP

75
Q

what increases the risk of cholangiocarcinoma

76
Q

management of PSC

A

liver transplant for ESLD

77
Q

what does paracetamol effect

78
Q

what is haemochromatosis

A

genetic iron overload

79
Q

excess copper, kaider fleischer rings in eyes

A

wilsons disease

80
Q

liver failure and lung emphysema

81
Q

inflammation of gall bladder

A

cholecystitis

82
Q

inflammtion of the bile duct

A

cholangitis

83
Q

abdominal pain radiating to the back

A

pancreatitis

84
Q

most common colorectal cancer

A

adenocarcinoma from glandular crypts

85
Q

what do colorectal cancers usually start out as

A

polyps whic have an APC mutation

86
Q

symptoms of colorectal cancer

A

change in bowel habit, weight loss, PR bleeding, tenesmus, iron deficiency anaemia, bowel obstruction

87
Q

most common site of colorectal cancer

A

left side and rectum

88
Q

what does right hemicolectomy remove

A

tumours in the caecum, ascending an proximal transverse colon

89
Q

what does left hemicolectomy remove

A

tumours of the distal transverse and descending colon

90
Q

what does sigmoid colectomy remove

A

tumours from the sigmoid colon

91
Q

what does an anterior resection remove

A

tumours of the lower sigmoid colon or higher rectum

92
Q

APR removes what

A

tumours of the lower rectum leavinga collostomy

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