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phase 4 > gi/liver passmed > Flashcards

gi/liver passmed Flashcards

1
Q

what is intramural gallbladder wall calcification a risk factor fall

A

gallbladder cancer

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2
Q

what is mirizzi syndrome

A

hepatic obstruction caused by gallstone

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3
Q

what is the modified glasgow score for acute pancreatitis

A

pao2, age, neutrophilic, calcium, renal function, enzymes, albumin, sugar

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4
Q

symptoms of acute cholecystitis

A

ruq pain and fever

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5
Q

symptoms of acute cholangitis

A

RUQ pain, fever, jaundice

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6
Q

best blood test for acute pancreatitis

A

lipase

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7
Q

gall stone location if no jaundice

A

cystic duct

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8
Q

gallstone location if jaundice

A

common bile duct

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9
Q

what is a pseudocyst

A

present after 4 weeks of acute pancreatitis and can middle raise amylase

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10
Q

what blood test does a prognostic test for pancreatitis

A

glucose

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11
Q

breathing complications in pancreatitisi

A

ARDS

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12
Q

causes of acute pancreatitis

A 
GETSMASHED
gallstones
ethanol
trauma
steroids
mumps
autoimmune
scorpian venom
hypercalcaemia, hypertriglyceridaemia
ERCP
drugs - azathioprine, mesalazine, sodium valporate furosemide
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13
Q

symptoms of chronic pancreatitis

A

steatorrhoea, diabetes, abdominal pain after meals

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14
Q

investigations in chronic pancreatitis

A

abdo xray

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15
Q

treatment of gastric MALT lymphoma

A

eradicate H.pylori

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16
Q

what is reynold pentad

A

charcots triad + hypotension and confusion

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17
Q

treatment of pseudocyst

A

conservative

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18
Q

complications of gastrectomy

A 
vit b12 deficiency
osteoporosis
weight loss
early satiety
iron deficiency anaemia
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19
Q

what are pigmented stones associated with

A

sickle cell anaemia due to increased red cell haemolytic

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20
Q

imaging for chronic pancreatitis

A

can use abdominal xray

but CT is more sensitive and specific

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21
Q

where does biliary colic radiate to

A

inter scapular region

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22
Q

most common organism in cholangitis

A

e.coli (then klebsiella after)

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23
Q

treatment of unresectable pancreatic cancer

A

biliary stenting

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24
Q

treatment of acute cholecytitis

A

IV Abx and early laparoscopic cholecystectomy

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25
Q

X-ray sign in sigmoid volvulus

A

coffee bean

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26
Q

risk factors of sigmoid volvulus

A

elderly, neurological conditions, chronic constipation

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27
Q

what surgery can be done to defunction the bowel

A

loop stoma

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28
Q

colorectal screening programme

A

FOB every 2 years 60-74 years and if +e have a colonoscopy

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29
Q

treatment of lower rectal tumour

A

anterior resection

radiothrapy

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30
Q

what analgesia is preferred in bowel surgery and why

A

epidural due to quicker return to normal bowel function

31
Q

sigmoid volvulus treatment

A

decompression via rigid sigmoidoscopy with flatus tube insertion

32
Q

when is a flexible sigmoidoscopy offered for screenign

A

at 55years

33
Q

risk factor of anal cancer

A

HPV, HIV, CIN, smoking

34
Q

treatment of anal fissure

A

diet
bulk forming laxatives
libricants
topical GTN

35
Q

what does post defecatory bleeding suggest

A

haemorrhoids

36
Q

what does painful rectal bleeding with passage of stool suggest and on wiping

A

fissure in ano

37
Q

symptoms of gastric volvulus

A

vomiting
pain
failure to pass NG tube

38
Q

use of gastrografin enema

A

to look for colorectal anatomises

39
Q

where does diverticular usually occur

A

in descending colon or sigmoid

40
Q

cell type in anal cancer

A

squamous

41
Q

antibodies in autoimmune hepatitis

A

anti smooth muscle and anti nuclear

42
Q

antibodies in PBC

A

antimitochondrial

43
Q

what can effect the 13c urea breath test results

A

course of antibiotics in the past 4 weeks or PPIs in past 2 weeks

44
Q

treatment of severe UC flare

A

admit, IV corticosteroids, if mild, rectal mesalazine or short course of oral steroids

45
Q

investigation for liver cirrhosis

A

transient elastography (fibroscan) - used to be liver biopsy

46
Q

symtoms of refeeding syndrome

A

arrhythmias, low potassium, low magnesium, low phosphate, fluid shifts

47
Q

investigation in PSC

A

ERCP/MRCP
liver biopsy - onion skin due to dilated stricture
pANCA

48
Q

treatment of c.diff

A

metronidazole

49
Q

what would you think of if liver failure post cardiac arrest

A

ischaemic hepatitis, raised ALT

50
Q

abg in mesenteric ichaemia

A

metabolic acidosis

51
Q

prevention of varicella bleed

A

propranolol

52
Q

treatment of vatical bleed

A

terlipressin

53
Q

malignancy linked to HNPCC

A

endometrial cancer and pancreatic cancer

54
Q

diagnosis of malnutrition

A

unintentional weight loss >10% in 6 months, BMI <18.5 or BMI <20 and weight loss >5% in last 6 months

55
Q

symptoms of acute fatty liver of pregnancu

A

jaundice, abdo pain an pruritus during pregnancy

56
Q

why do those with coeliac require regular immunisations

A

functional hyposlepnism - give pneumococcal vaccine every 5 years

57
Q

investigations pre fundoplcication for resistant GORD

A

oesophageal pH and manometry studies

58
Q

what does the inferior mesenteric artery suppled

A

the hind gut, which is th distal third of the colon and rectum superior to the pectinate line

59
Q

where does the inferior mesenteric artery arise from

A

L3 vertebra

60
Q

liver enzyme to look at liver function

A

PT and albumin

61
Q

budd chiari symptoms

A

sudden onset abdominal pain, ascites, tender hepatomegaly

62
Q

what test to confirm h.pylori eradicatons

A

urea breath test

63
Q

symptoms of oesophageal cancer

A

hoarse voice
weight loss
dysphagia

64
Q

treatment of c diff if metronidazole doesn’tt work

A

vancomycin

65
Q

inducing remission in chrons

A

Iv hydrocortisone

66
Q

what would difficulty in swallowing salvia being the worst suggest

A

globus pharyngis (globus hystericus)

67
Q

investigation of carcinoid syndrome

A

5-HIAA urinary

68
Q

what is gilbert’s syndrome

A

benign condition causing mild rise in bilirubin

69
Q

what is SAAG

A

serum ascitic albumin gradient and >11 means portal HTN

70
Q

treatment of chrons flare if steroids don’t work

A

biologics

71
Q

investigations in acute mesenteric ischaemia

A

raised lactate

72
Q

side effect of omeprazole

A

hyponatraemia

73
Q

which IBD is more linked to tenesmus

A

UC

phase 4 (19 decks)

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