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Misc. Notes Year 1 > GI RECAP > Flashcards

GI RECAP Flashcards

1
Q

What is angular cheilitis associated with

A

Iron deficiency

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2
Q

What can enamel erosion be associated with

A

GORD

Bulimia/Anorexia Nervosa

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3
Q

Where is McBurnley’s point

A

1/3 between the right ASIS and the umbilicus

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4
Q

What is Rovsing’s sign

A

palpation of the left lower quadrant of a person’s abdomen increases the pain felt in the right lower quadrant - Appendicitis

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5
Q

What is Russell’s sign

A

Calluses on knuckles of patients who regularly self-induce vomiting

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6
Q

What is Murphy’s sign

A

the patient is asked to inhale while the examiner’s fingers are hooked under the liver border at the bottom of the rib cage. The inspiration causes the gallbladder to descend onto the fingers, producing pain if the gallbladder is inflamed

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7
Q

What is Charcot’s triad and what does it indicate

A

right upper quadrant pain
jaundice
fever

Suggestive of ascending of ascending cholangitis

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8
Q

What 2 deficiencies could cause someone to easily bruise

A 
Vitamin C (Scurvy)
Vitamin K
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9
Q

What asides from deficiencies could cause someone to easily bruise

A

Liver disease

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10
Q

What can the TIPS procedure be used for

A

Ascites

Portal hypertension

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11
Q

What are the ways to check for H.Pylori infection

A 
Gastric biopsy
Urease breath test
Histology
Culture
Faecal Ag test
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12
Q

Which 3 types of cells do the liver sinusoids contain

A

Endothelial cells - form fenestrated structure
Kuppfer cells - macrophages resident to sinusoids
Stellate (Ito) cells - storage of Vit A

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13
Q

What 3 reaction types can occur in phase 1 of drug metabolism

A

Oxidation
Reduction
Hydrolysis

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14
Q

What does phase 1 of metabolism do to a drug

A

Makes it more polar

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15
Q

What occurs in phase 2 of drug metabolism

A

Conjugation

Addition of an endogenous compound to increase polarity

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16
Q

What does albumin transport

A

Transports fatty acids, bilirubin, thyroid

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17
Q

Give 2 examples of α-globulins

A

Caeruloplasmin, retinol binding protein

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18
Q

Give 2 examples of β-globulins

A

Transferrin

Fibrinogen

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19
Q

What length of time constitutes the difference between acute and chronic liver failure

A

6 Months

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20
Q

What things can cause Acute liver failure

there are loads

A

Viral, Drug, Shock liver, Cholangitis, Alcohol, Malignancy, paracetamol, Budd-Chiari, AFLP, Cholestasis of pregnancy

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21
Q

How can u treat an itch caused by liver failure or autoimmune hepatitis

A

sodium bicarb bath, cholestyramine or Ursodeoxycholic acid

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22
Q

What is Fulminant Hepatic Failure

A

Jaundice + Encephalopathy in a patient with prev. normal liver

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23
Q

What are the causes of Fulminant Hepatic Failure

again, there are loads

A

Paracetamol, Fulminant viral, Drugs, HBV, Non-A-E hepatitis, acute fatty liver of pregnancy (AFLP), mushrooms, malignancy, Wilsons, Budd-Chiari, Hep A

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24
Q

What is the disease progression of NAFLD

A

Steatosis -> NASH -> Cirrhosis

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25
Q

What is marked piecemeal necrosis seen in

A

Autoimmune hepatitis

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26
Q

Periductal ‘onion-skinning’ fibrosis seen in

A

PSC

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27
Q

Bronzed diabetic? and explain the condition

A

Haemochromatosis
Systemic iron deposition
Predisposes to hepatocell. carcinoma, diabetes, cardiac failure and impotence

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28
Q

Treatment for Haemochromatosis

A

Venesection

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29
Q

Kaiser-Fleisher rings seen in which disease?

A

Wilson’s disease

Copper accumulates in liver and brain

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30
Q

Treatment for Wilson’s disease

A

Copper chelating drugs

Symptomatic relief where possible

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31
Q

What is Budd-Chiari syndrome

A

Thrombosis of hepatic veins

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32
Q

Name some pre-hepatic causes of portal hypertension

A

Portal vein thrombosis or occlusion (congenital)

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33
Q

Name some intrahepatic causes of portal hypertension

A

Presinudoidal - Schistosomiasis

Postsinusoidal - Cirrhosis, alcoholic hep, congenital fibrosis

34
Q

Name some post hepatic causes of portal hypertension

A

Budd-Chiari and venous occlusive disease

35
Q

What is the preventative treatment for variceal bleeding

A

Beta blockers

Ligation

36
Q

What is the treatment for Variceal bleeding

A

Sclerotherapy
Balloon tamponade
TIPS

37
Q

What are ALT and AST

A

Intracellular enzymes which catabolize steps in gluconeogenesis
ALT present exclusively in the liver
AST less specific and also found in cardiac tissue and muscle
Enzymes released into bloodstream from damaged hepatocytes

38
Q

How can you tell the difference between NAFLD and Alcohol related liver disease from just liver function tests

A

Ratio of AST: ALT can point to likely cause of elevation
In NAFLD, AST: ALT is typically less than 1:1
2:1 indicates alcohol-related liver disease
lets get wASTed

39
Q

What is GGT and what can cause it to be elevated

A

GGT found in hepatocytes and biliary epithelial cells

Raised GGT can be caused by Alcohol, pancreatic disease, renal failure, COPD, diabetes, post-MI

40
Q

What can cause elevated ALP and GGT

A

Bile duct obstruction, PSC, PBC, drugs causing cholestasis, malignancy

41
Q

What are the 3 types of gallstones

A

Cholesterol
Pigmented (bilirubin)
Mixed

42
Q

What can cause excess cholesterol in bile

A

Female, Obesity, Diabetes, Genetic

43
Q

What can cause excess bilirubin in bile

A

excess haemolysis (e.g. haemolytic anaemias)

44
Q

What is biliary colic caused by

A

Gallstone impacting in cystic duct

45
Q

What is pain, which radiates to the back, associated with

A

Pancreatitis

46
Q

What is Grey Turner’s sign

A

Bruising of the flanks

47
Q

What is Cullen’s sign

A

Periumbilical bruising

48
Q

Which enzymes are involved in autodigestion of pancreatic tissue

A

Proteases break down blood vessels causing haemorrhage

Lipases break down the fat tissue surrounding the pancreas

49
Q

What are some causes of Chronic Pancreatitis

A

CAMP: CF, Alcohol, Malnourishment, Pancreatic duct obstruction

50
Q

How does chronic pancreatitis result in diabetes

A

Replacement of pancreas by chronic inflammation and scar tissue,
Destruction of endocrine acini and islets so no insulin or glucagon produced

51
Q

What length of bowel indicated Short Bowel Syndrome

A

<200cm

52
Q

How would you describe a diverticulum

A

Mucosal herniation through muscle coat

53
Q

What is Meckel’s Diverticulum

A

Incomplete regression of vitellointestinal duct
Asymptomatic finding
Symptomatic in children: Rectal bleeding, obstruction, perforation which can mimic appendicitis

54
Q

What are most cancers of the mouth

A

Squamous Cell Carcinoma

>90% of oral cancers

55
Q

Where can oral cancer present

A

Soft palate, floor of mouth, ventral tongue and borders

Rarely on hard palate, dorsum of tongue

56
Q

What are the symptoms of a left-sided colorectal malignancy

A

blood PR
altered bowel habit
obstruction

57
Q

What are the symptoms of a right-sided colorectal malignancy

A

anaemia

weight loss

58
Q

What is HNPCC

A

Hereditary nonpolyposis colorectal cancer

59
Q

What is FAP

A

Familial Adenomatous Polyposis

60
Q

Which out of FAP and HNPCC has more polyps

A

FAP (>100 polyps)

HNPCC usually has <100

61
Q

What gene is mutated in FAP

A

APC gene

62
Q

What gene is mutated in HNPCC

A

Mutation in DNA mismatch repair gene

63
Q

Name 3 tumours of the endocrine pancreas

A

Gastrinoma
Insulinoma
Glucagonoma

64
Q

What can a gastrinoma cause

A

Zollinger-Ellison syndrome

Acid hypersecretion can lead to peptic ulcers

65
Q

What can an insulinoma cause

A

Produces insulin, causing the body to store sugar rather than burn it, hypoglycaemia

66
Q

What can a glucagonoma cause

A

Produces glucagon, increases blood sugar, hyperglycaemia

67
Q

What type of hypersensitivity is Coeliac disease

A

Type IV

68
Q

What happens in coeliac disease

A 
Immune reaction (T cells) to Gliadin in wheat fluid, gluten in small intestine
Causes damage to enterocytes and decreases absorption
69
Q

What is the mnemonic for causes of Malabsorption

A 
These Defo Cause Absorption Problems 
Tropical sprue
Disaccharide deficiency
Coeliac/Crohn’s
A-beta-lipoproteinemia
Pancreatic insufficiency
70
Q

What is the weekly limit for alcohol

A

14 units spread over 3 days for men and women cmon it’s the 21st century

71
Q

What is the treatment for tropical sprue

A

Tetracycline and Folic Acid

72
Q

What is Schilling’s test for

A

Pernicious anemia

73
Q

What is Pernicious anaemia

A

Vitamin B12 deficiency

74
Q

Define diarrhoea

A

3 or more loose stools in 24 hours

75
Q

What organisms classically have a short incubation period

A

Staph Aureus

Bacillus Cereus

76
Q

What organisms classically have a medium incubation period

A

Clostridium Perfringens

Salmonella

77
Q

What organisms classically have a long incubation period

A

E. Coli

Campylobacter

78
Q

What is the sepsis 6 bundle

A

3 Gives and 3 Takes
Give O2, Fluid & Antibiotics
Take FBC, Lactate, Urine output

79
Q

The triad of which signs/symptoms suggest Budd Chiara syndrome

A

Abdominal pain
Tender hepatomegaly
Ascites

80
Q

What is the most common type of hernia

A

Inguinal

81
Q

Define a hernia

A

Abnormal protrusion of a viscus outwith its normal body cavity

Misc. Notes Year 1 (13 decks)

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