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ICM/FCM > GI (passmed) > Flashcards

GI (passmed) Flashcards

1
Q

What would cause abnormal LFTs in a non-alcoholic patient with T2DM?

A

Non-alcoholic liver disease

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2
Q

What imaging tool would you use to diagnose NAFLD?

A

Ultrasound

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3
Q

How does diabetes cause NAFLD?

A

Insulin resistance

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4
Q

What diagnostic test would you do to confirm H pylori?

A

Carbon-13 urea breath test

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5
Q

What is the triple management therapy for H pylori?

A

Amoxicillin, Clarithromycin & Omeprazole

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6
Q

If a patient has an allergy to penicillin, what other medication is used in the treatment of H pylori?

A

Metronidazole

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7
Q

In crohn patients who develop a perianal fistula, what medication would you prescribe?

A

Oral Metronidazole

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8
Q

What does NESTS stand for in Crohn’s disease? (Don’t set the nest on fire)

A 
N - No blood or mucus  
E - entire GI tract (from mouth to anus) 
S - Skip lesions 
T - Terminal ileum
S - Smoking
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9
Q

What is the specific test to diagnose IBD?

A

Faecal calprotectin

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10
Q

What is faecal calprotectin and what does it indicate?

A

Released by the intestines when inflamed as made by WBC

Indicates IBD and IBS

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11
Q

What is faecal elastase and what does it indicate?

A

Measures digestive enzymes produced by the pancreas that do not degrade through the digestive tract

Helps to detect pancreatitis, cystic fibrosis, diabetes

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12
Q

What first line steroid is used in the treatment of crohns?

A

Oral Prednisolone / IV Hydrocortisone

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13
Q

What immunosuppresent medication is used in Crohns disease?

A

Azathioprine

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14
Q

What does CLOSEUP mean in ulcerative colitis? (U - C CLOSEUP)

A 
C - Continuous inflammation
L - limited to colon and rectum 
O - Only superficial mucosa affected 
S - smoking is protective 
E - excrete blood and mucus 
U - use aminosalicylates 
P - primary sclerosing cholangitis
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15
Q

If a patient with ulcerative colitis presents with liver symptoms and signs, what condition would you think of as the cause?

A

primary sclerosing cholangitis

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16
Q

What results would you see on the LFTs when investigating primary sclerosing cholangitis to show a cholestatic picture?

A

Raised ALP
Raised Bilirubin
Raised ALT and AST

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17
Q

What is the gold standard test for diagnosing primary sclerosing cholangitis and what would it show?

A

MRCP

  • Bile duct lesions
  • Bile duct strictures
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18
Q

What is the gold standard investigation for the diagnosis of IBD?

A

Endoscopy with biopsy

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19
Q

What are the two treatments for oesophageal varices?

A

Terlipressin

Sengstaken-Blakemore tube

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20
Q

What are oesophageal varices?

A

Enlarged veins in the oesophagus

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21
Q

In a patient with an ongoing acute upper GI bleed, what is the treatment if endoscopic therapy has not worked?

A

Laparotomy and surgical exploration

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22
Q

What is the treatment of ascites secondary to liver cirrhosis?

A

Aldosterone antagonist - Spironolactone

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23
Q

How does using an aldosterone antagnonist like spironolactone reduce ascities?

A

By inhibiting aldosterone, it leads to reduced sodium retention and increased sodium excretion through the urine

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24
Q

What is a side effect of using a loop diuretic such as furosemide?

A

Hypokalaemia and alkalosis which promotes the formation of ammonia that can cause hepatic encephalopathy

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25
Q

What serious condition do you need to exclude in a patient presenting with painless jaundice?

A

Pancreatic cancer

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26
Q

Why would pancreatic cancer cause painless jaundice?

A

The blockage of the biliary tree without pain means it is not because of gallstones and instead a pancreatic mass

27
Q

What findings on the LFTs would show and obstructive cause for jaundice?

A

Bigger raise in ALP and GGT than ALT

28
Q

What is the first line management for UC flare in hospital?

A

IV hydrocortisone

29
Q

What medication can be used for remission in a mild/moderate flare up of UC?

A
30
Q

Pt over 55 presents with raised platelets and nausea/vomiting, reflux, weight loss and upper GI Pain
- What type of referral would you do and why?

A

Non Urgent for endoscopy - rule out upper GI cancers

31
Q

Pt over 55 presents with dysphagia/upper abdo mass/weight loss/reflux - what is your management?

A

Urgent referral to gastro

32
Q

What finding associated with the mouth would you see that is caused by vitB12/folate deficiency?

A

Glossitis (red swollen tongue)

33
Q

What type of anaemia causes B12 deficiency anaemia?

A

Pernicious anaemia

34
Q

What is the first line treatment for management of severe ulcerative colitis in hospital?

A

IV steroids

35
Q

What antibody is detected in ulcerative colitis?

Bianca has ulcerative colitis

A

P-ANCA

36
Q

Where do patients normally feel pain with UC?

A

Left lower quadrant

37
Q

What is the first line treatment for inducing remission and maintaining mild-moderate UC and please give an example?

A

Topical and/or oral aminosalicylates

Mesalazine

38
Q

How is anaemia a complication of GORD?

A

GORD can lead to inflamed ulcerated oesophagus/cancers that can lead to chronic bleeds

39
Q

List some complications of GORD

A
  • Benign strictures (narrowing of oesophagus)
  • Anaemia
  • Barretts oesophagus (oesophagus lining becomes red)
  • oesophageal carcinoma
40
Q

Besides lifestyle advice and antacids, what is the management for endoscopically proven GORD?

A

Full dose PPI for 1/2 months

then put to low dose

41
Q

What is the first line treatment for hemochromatosis?

A

Venesection

42
Q

What risk factors increase the risk of c diff?

A
  • Prolonged hospital exposure
  • PPI
  • Antibiotics (cephalosporins)
43
Q

What is the complication of c difficle?

A

Toxic megacolon

44
Q

Which of the following confirms the diagnosis of c difficle?

  • Stool C.difficile antigen
  • Stool C.difficile toxin
A

C difficile Toxin confirms current infection

C difficile confirms exposure to bacteria

45
Q

What is Achalasia and what symptoms present with this condition?

A

Smooth muscle fibres in the lower portion of the oesophagus do not relax

  • Difficulty swallowing
  • retrosternal pain
  • regurgitation of food
46
Q

What is Hirschsprung’s disease?

A

Birth defect where nerves are missing from parts of the intestine
- presents with constipation

47
Q

What is the difference between a colostomy and ileostomy?

A

Colostomy - connects the colon to the abdominal wall

    • LIF
    • Non-spouted
    • Formed stool in stoma bag

Ileostomy - connects the last part of the small intestine (ileum) to the abdominal wall

    • RIF
    • Spouted (prevents touching the skin)
48
Q

What scoring system is used to determine the severity of cirrhosis?

A

Child-pugh score

49
Q

What type of ulcer is associated with UC and crohns?

A

Pyoderma gangrenosum

50
Q

What two medications can relax the lower oesophageal sphincter and thus help to resolve achlasia?
Hint - One drug is used in treating BP and the other is an antiplatelet

A

CCB

Aspirin

51
Q

How does the cause of difficulty swallowing food differ between achalasia and oesophageal carcinoma?

A

Achalsia - difficult to swallow foods and liquids at the same time

Carcinoma - difficult swallowing foods first and then liquids later as the tumour grows

52
Q

What is the investigation of choice for diagnosing coeliac disease?

A

Serum IgA tissue transglutaminase antibody testing

53
Q

What skin condition can be associated with coeliac disease and where would you most likely find it on the body?

A

Dermatitis herpetiformis

  • very itchy
  • affects elbows, knees, back and buttocks
54
Q

What other hepatitis does the Hep B vaccination provide immunity to?
Hint - The…needs company ;)

A

Hep D

- Needs Hep B in order to replicate

55
Q

List three symptoms that can occur if a patient drinks alcohol whilst on metronidazole

A
  • Flushing
  • Tacycardia
  • Nausea
56
Q

Name the 3 symptoms associated with ascending cholangitis? Charcots triad

A
  • RUQ pain
  • Fever
  • Jaundice
57
Q

Vit B12 is associated with crohns disease

What social factor is iron deficiency associated with?

A

Alcoholism

58
Q

List three symptoms of acute pancreatitis

A
  • Sudden severe epigastric pain
  • Nausea/vomiting
  • loss of appetite
59
Q

What blood test is associated with acute pancreatitis?

A

Serum lipase - released by pancreas to digest fats

60
Q

What 4 symptoms are associated with bowel obstruction?

A
  • Abdominal pain
  • Abdominal distention
  • Vomiting
  • Constipation
61
Q

What is acute cholecystitis in comparison to ascending cholangitis?

A

Acute cholecystitis - inflammation of the gallbladder
– Gallstone stuck in cystic duct that comes out from the gallbladder and so causes the inflammation

Ascending cholangitis - inflammation of the bile duct
– Gallstone has started to travel down the common bile duct but has got stuck and therefore causes inflammation

62
Q

How does acute cholangitis present?

A
  • Sudden sharp pain in RUQ that radiates to right shoulder
  • Worse by deep breathing
  • Persistent
  • Can have fever/vomiting
  • Palpable gallbladder

Jaundice less likely

63
Q

What are the 5 common risk factors of gallstone disease?

Hint - F

A 
Fat
Female
Forty
Fertile
Family history

ICM/FCM (16 decks)

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