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Year 4 part 2 > GI (Passmed) > Flashcards

GI (Passmed) Flashcards

1
Q

When is fluid restriction preferred over giving spironolactone for ascites

A

IF sodium levels <125

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2
Q

What is the role of abdominal paracentesis

A

SYmptomatic relief to patients with tense ascites

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3
Q

What is Pellagra

A

Dermatitis (rash)
Dementia
Diarrhoea

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4
Q

What causes Pellagra

A

B3 deficiency

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5
Q

What WBC count indicates a moderal C.difficile infection

A

WBC <15 * 10^9

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6
Q

What WBC indicates severe c.difficile infection

A

More than 15*10^9

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7
Q

What antigen implies Hep B acute disease

A

HBsAg

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8
Q

What is the significant of Anti-HBs

A

Immunity

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9
Q

What does Anti-HBc imply

A

Previous infection

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10
Q

What is the investigation of choice for diagnosing primary sclerosing cholangitis

A

ERCP/MRCP

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11
Q

What needs to be checked in someone taking mesalazine

A

FBC

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12
Q

What is given for refractory Crohn’s disease

A

Infliximab alongside azathioprine

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13
Q

When is Mesalazine given to induce remission of Chron’s

A

If steroids fail to do so

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14
Q

In what disease (chron’s or UC) are granuloma’s found in

A

Chrohn’s

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15
Q

What blood vessel is repsonsibly for haematemasis from a peptic ulcer

A

Gastroduodenal artery

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16
Q

Management of nausea + raised WCC only

A

Non-urgent referral for upper Gi endoscopuy

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17
Q

What metabolic findings is associated with gastritis

A

Metabolic alkalosis (loss of H+ ions)

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18
Q

What prophylaxis is given for variceal bleeds

A

Propranolol

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19
Q

Type 1 vs Type 2 hepatorenal syndrome

A

Type 1 is rapid onset

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20
Q

What isthe first line investigation for acute mesenteric ischaemia

A

VBG: lactates are raised

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21
Q

What vitamin deficiency can reuslt in easy bruising

A

C

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22
Q

What finding is indicative of Boerhaave syndrome

A

Mild crepitus in the epigastric region

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23
Q

Alcoholic ketoacidosis vs Diabetic Ketoacidosis

A

Alcohol: normal glucose

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24
Q

Management of a head of pancreas cancer

A

Pancreaticoduodenectomy

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25
Q

Management of Barrett’s oesophagus if dysplasia is seen on biopsy

A

Endoscopic mucosal therapy

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26
Q

What is Courvoisier’s law

A

That painless jaundice is unlikely to be gallstones but pancreatic malignancy

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27
Q

How do urea levels help differentiate between an upper GI bleed and lower GI bleed

A

High urea levels = Upper GI Bleed

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28
Q

What is the iron study profile seen in haemochromatosis

A

Raised transferrin and ferritin with low TIBC

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29
Q

What stool sample specifically is needed to diagnose C.difficile infection

A

C.difficile toxins

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30
Q

What medication should be stopped in c.difficile infections

A

Oromorph

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31
Q

What shohuld paracentesis show for spontaneous bacterial peritonitis

A

> 250 cells/ui

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32
Q

What grade of hepatic encephalopathy is a coma found in

A

Grade IV

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33
Q

What hsoulud be given first, B12 or folate

A

B12

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34
Q

What is the Child-Pugh classification

A

Bilirubin levels
Albumin
PTT
Encephalopathy
Ascites

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35
Q

What is the key investigation for a suspected perforated peptic ulcer

A

An erect Chest X-Ray

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36
Q

What Bowel disease is tenesmus commonly seen in

A

Ulcerative COlitis

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37
Q

Step up management of Ulcerative Colitis

A

Topical Aminosalicylate for distal rectal

If not achieved in 4 weeks, add oral aminosalicylate

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38
Q

Management of extensive UC disease

A

TOpical Aminosalicylate + high dose oral aminosalicylate

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39
Q

If extensive disease management is not managed properly by topical and oral aminosalicylate, what should be given

A

Oral 5-ASA and oral corticosteroid

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40
Q

Management of severe colitis

A

IV Steroids

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41
Q

What drug historically causes c.difficile infections

A

Clindamycin

42
Q

WHat is Peutz-Jeghers Syndrome

A

Small bowel obstruction (dur to intussuception) + blue/yellow mucosa

43
Q

WHen does desferrioaxamine become first line for haemachromatosis

A

When Venesection is not possible

44
Q

What two factors are used to decide if glucorticoid therapy is needed for alcohol hepatitis

A

Prothrombin time and serum bilirubin

45
Q

First line investigation of appendicitis

A

USS abdomen

46
Q

What condition (UC or Chron’s) is triggered by Stopping smoking

A

UC

47
Q

What is the triad for refeeding syndrome

A

Hypokalaemia
Hypophosphataemia
Hypomagnesaemia

48
Q

In what gastric disease are skin tags found

A

Crohn’s

49
Q

Where is a mass felt in overflow constipation

A

Left side

50
Q

How do we retain remissino in proctitis and proctosigmoiditis

A

Topical azathioprine (with or without oral azathioprine)

The rest is normally oral azathiioprine

51
Q

What are indications for enteral nutrition (tube feeding)

A

Head or neck trauma
Surgery
Coma
Dementia
Tumours of the head, neck or oesophagus

52
Q

Investigations for perianal fistulas

A

MRI Pelvis

53
Q

Management of a perianal fistula

A

Oral Metronidazole

54
Q

What is the treatment of choice for small bowel bacterial overgrowth syndrome

A

Rifaximin

55
Q

Risk Factors for SBBOS

A

Diabetes Mellitus and Scleroderma

56
Q

What should be given to reduce mortality risk during paracentesis

A

IV human albumin solution

57
Q

Management of asymptomatic gallstones

A

Re-assurance

58
Q

What hepatitis is usually transmitted through anal-oral sex

A

Hepatitis A

59
Q

How is Hepatitis B commonly spread

A

Sexual Transmission

60
Q

How is Hep C typically spread

A

Through exposure to contaminated blood or needles

61
Q

When should adults be refrred for GI cancer pathway

A

Occult test shows blood

40+ AND unexplained weight loss + abdo pain

50+ AND unexplained rectal bleeding

60+ AND iron deficiency anaemia or changes in bowel habit

62
Q

Management of someone with rectal bleeding + abdominal pain and under 50

A

Refer to hospital

63
Q

Where are ileostomies usually placed

A

Right iliac fossa

64
Q

Where are colostomies typically placed

A

Left iliac fossa

65
Q

Management of a diverticular bleed

A

Active surveillance - usually heal spontaneously

66
Q

How to detect fistulas in the gut

A

CT abdomen

67
Q

Where do anal fissures typically arise

A

Posterior margin of the anus

68
Q

Management of an anal fissure

A

Laxatives (bulking)

69
Q

What is Hartmann’s proceedure

A

Sigmoiectomy + stoma bag

70
Q

When are loop ileostomies used

A

rectal cancers (diverts bowel contents away from the distal anastomoses)

71
Q

What type of cancers are rectal cancers

A

Adenocarcinomas

72
Q

What symptom is present in small bowel obstruction but not large bowel obstruction

A

Vomiting - no vomiting in large bowel obstruction

73
Q

When are hartmann’s proceedure indicated

A

Emergency: Perforation or obstruction

74
Q

Indication for anterior resection

A

upper rectal tumours (near sigmoid colon)

75
Q

What is a common complication of a laproscopy

A

Pulmonary Emphysema

76
Q

What is the daignostic test for pancreatitis

A

CT contrast

77
Q

COmplication of acute pancreatitis

A

ARDS

78
Q

Blockage of what duct does not cause jaundice

A

Cystic duct

79
Q

Scending cholangitis vs cholecystitis

A

Ascending has dranged LFTs vs no deranged lfts in cholecystitis

80
Q

First line management of an SAH

A

Coiling

81
Q

Ferritin levels in alcohol excess

A

Raised

82
Q

What defines mild UC

A

<4 stoools a day

83
Q

What defines moderate UC

A

4-6 stools a day

84
Q

What defines severe UC

A

> 6 stools a day

85
Q

Primary screening done for suspected bowel cancer

A

Faecal immunochemical test

86
Q

When should someone be offered bowel screening

A

60-74

87
Q

When is a sigmoidoscopy chosen over a colonoscopy for checking for colorectal cancer

A

If there is rectal bleeding

88
Q

If someone is unfit for sigmoidosocpy or colonoscopy, what is the investigation of choice

A

CT colonography

89
Q

Diagnosis of acute cholecystitis if USS is uncertain

A

HIDA scan

90
Q

What is the most common cause of small bowel obstruction

A

Adhesions

91
Q

Describe Duke A

A

Cancer in boeel lining NOt muscle

92
Q

Define Sukes’ B

A

Cancer grown into muscle layer of bowel

93
Q

Define Dukes’ C

A

Cancer spread to lymph node

94
Q

Define Duke’s D

A

Cancer spread to another organ

95
Q

Indirect vs direcvt inguinal hernia

A

Indirect: Lateral to the inferior epigastric artery

Direct: Medial to the inferor epigastric artery

96
Q

Management of an epigastric hernia

A

Lose weight/ supportive

97
Q

Management for umbilical hernias

A

Use of a truss

98
Q

Management of a unilateral inguinal hernia

A

Open repair with mesh (routinely)

99
Q

When is a hernia truss indicated for hernias

A

Only when surgery is not an option (second line)

100
Q

What happens in an indirect inguinal hernia when you cover the deep inguinal ring

A

It stops the reappearance of the lump when asked to cough

If it re-appears = direct inguinal hernia

101
Q

Investigation for a hiatus hernia

A

Endoscopy

Barium Swallow - diagnostic

102
Q

Management of Achalasia

A

Endosocpic injection with botulinum toxin

Year 4 part 2 (10 decks)

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