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Capsule notes > GI Med > Flashcards

GI Med Flashcards

1
Q

how does hyperthyroidism affect the liver

A

presents with high transaminases and jaundice

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2
Q

definitive diagnosis for AI Hep

A

liver biopsy

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3
Q

management for AI hep

A

start high dose steroids

add azathioprine later

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4
Q

what does liver biopsy show in AI hep

A

interface hepatitis (inflammation spilling over the portal tract limiting membrane to hepatocytes)

plasma cells

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5
Q

duration of therapy in AI hep

A

at least 2 years after blood tests normalise

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6
Q

treatment for peptic stricture

A

ppi if underlying GORD

balloon dilatation

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7
Q

severe complication of balloon dilatation

A

oesophageal perforation

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8
Q

investigation for oesophageal dilatation

A

CT with oral contrast

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9
Q

initial treatment of severe acute ulcerative colitis

A

IV hydrocortisone

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10
Q

initial treatment for mild acute ulcerative colitis

A

oral or rectal mesalazine

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11
Q

clinical evidence of severe colitis

A

6 or more stools per day, bloody stools and pulse >90

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12
Q

if no response to initial treatment for acute UC, what should you add

A

infliximab or IV ciclosporin

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13
Q

contraindications to ciclosporin

A

hypertension

renal impairment

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14
Q

maintenance therapy for UC

A

oral +/- topical mesalazine

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15
Q

why send off blood glucose in chronic liver disease pt

A

blood glucose is an indicator of liver synthetic function

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16
Q

management for acute oesophageal varix

A

fluid resus
IV vasopressin (terlipressin)
IV antibiotics
refer to endoscopy service

band ligation/sclerotherapy
TIPSS

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17
Q

last resort for bleeding varices when endoscopy not available

A

Sengstaken-Blakemore tubes

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18
Q

long term management for varices

A

non-cardioselective beta blockers

if not tolerated regular endoscopy and band ligation

19
Q

most common cause of portal hypertension

A

cirrhosis

20
Q

5 causes of macrocytic anaemia

A 
pregnancy
alcohol
folate deficiency
b12 deficiency
hypothyroidism
21
Q

why does thiamine need to be given slowly

A

reduce incidence of anaphylaxis

22
Q

why do you not give glucose before thiamine

A

glucose can precipitate Wernicke’s

NB give if critically hypoglycaemic

23
Q

initial screening for AI hep

A

Autoantibodies

serum immunoglobulins

24
Q

maximum tumor size for Whipple’s procedure

A

3cm

25
Q

if whipple procedure contraindicated, what can you do?

A

percutaneous biliary stent insertion to relieve biliary obstruction
gastrojejunostomy for gastric outlet/duodenal obstruction

26
Q

PBC symptoms

A 
pruritis
lethargy
loss of appetite
jaundice
xanthelasma
spider naevi
splenomegaly
27
Q

investigations for PBC

A 
LFT - minor increase AST/GGT. high ALP
USS abdo
serum lipids
Antibodies
viral hep screen
blood clotting
28
Q

contraindications for USS liver biopsy

A 
extensive ascites
platelet <100
INR >1.3
HB<100
acute confusional state
29
Q

complications of PBC

A 
malabsorption
osteoporosis
HCC
liver failure
haematemesis
hypothyroidism
30
Q

initial treatment for PBC

A

cholestyramine for pruritis
UDCA
fat solube vitamns
Steroids if inflammatory/AI overlap

31
Q

drug for Wilson’s disease

A

penicillamine

32
Q

signs of chronic pancreaetitis

A 
intermittent epigastric pain boring to back
diarrhoea/malabsorption
weight loss
anaemia
diabetes
33
Q

investigations for chronic pancreatitis

A 
abdo x ray (calcifications)
fbc
lft
serum albumin
amylase
CT
MRCP
34
Q

complications of late stage chronic pancreatitis

A 
carcinoma
opiate addiction
pseudocyst formation
malabsorption
diabetes
35
Q

AI hep antibodies

A

Smooth muscle

Liver kidney

36
Q

PBC antibodies

A

AMA

37
Q

what antibiotic can cause cholestasis?

A

macrolide antibiotics

38
Q

what would differentiated WCC show for macrolide induced cholestasis

A

increased eosinophils

39
Q

what drugs can cause drug induced liver disease

A

statins
thiazolodinediones
beta lactams

40
Q

symptoms of haemochromatosis

A

tiredness, arthralgia, hepatomegaly, slightly deranged LFTs, new diabetes, male

41
Q

investigations for haemochromotosis

A

iron studies
high iron
high serum ferritin
low TIBC

42
Q

investigation for haemochromotosis complications

A 
echo - cardiomyopathy
ECG - cardiomyopathy
genotyping
liver biopsy - cirrhosis
radiograph of joints - chondrocalcinosis
hypogonadism/pituitary dysfunction
43
Q

Screening for chronic hepatitis related HCC

A

USS every 6 months +/- AFP

Capsule notes (7 decks)

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