GI (Week 13) Flashcards
What are the two major classifications of liver disease based on area?
Diffuse (e.g. acute hepatitis)
Focal (space occupying lesion)
Define ‘fulminant’
Severe acute inflammation, rapidly progressing to liver failure
What does ‘acute on chronic’ mean?
Chronic disease presenting as acute exacerbations with evidence of underlying chronicity
What are the three hallmarks of liver cirrhosis?
Diffuse
Fibrosis
Nodule formation
Name two microscopic features of acute hepatitis
Diffuse hepatocyte swelling
Spotty necrosis (dead hepatocytes)
Inflammatory cell infiltrate
Give an example of a non-neoplastic focal liver lesion
Liver cysts
Give an example of one benign and one malignant focal neoplasm in the liver
Benign: Haemangioma
Malignant: Hepatic adenoma
Which two types of hepatitis can only occur acutely?
A and E
Name three features of decompensated cirrhosis
Jaundice
Ascites
Encephalopathy
What is the route of transmission and incubation period of hepatitis A?
Faeco-oral route
30 day incubation
In hepatitis E genotype 1 infection, what is the significance in pregnant women?
Higher mortality
In hepatitis E genotype 3 infection, what other symptoms can be seen?
Neurological e.g. Guillain-Barre syndrome
What can chronic infection of hepatitis B lead to?
Chronic liver disease
What does surface antigen in the blood indicate in Hepatitis B serology?
Current Hep. B infection
What does surface antibody indicate in Hep. B serology?
The patient has encountered the virus or vaccine and has made an immune response.
NO CURRENT INFECTION
What does core antibody indicate in Hep. B serology?
Only made if the patient has suffered the virus by direct infection
What does IgM in Hep. B virus indicate?
New infection
What does IgG in Hep. B virus indicate?
Someone who has been infected previously (e.g. 2 months ago)
What is unique about hepatitis D infection?
Single stranded RNA virus which requires hepatitis B infection to survive
Which type of hepatitis is most common in Scotland and injecting drug users?
Hepatitis C
What is MRCP imaging?
MRI scan of the bile duct
How do gallstones cause acute pancreatitis?
They become trapped in the Ampulla of Vater and cause bile reflux
Name the layers of the GI tract
Mucosa
Submucosa
Muscularis propria
Adventitia
Define Barrett’s oesophagus
Metaplasia in response to mucosal injury, changing from squamous into glandular
What are the main risk factors for squamous carcinoma?
Smoking and drinking
What are the main risk factors for adenocarcinoma of the oesophagus?
GORD and obesity
Name three causes of chronic gastritis
Autoimmune
Bacterial
Chemical
Name three causes of upper GI bleeding
Peptic ulcer
Oesophagitis
Varices
What does Terlipressin do in terms of varice treatment?
Splanchnic vasoconstriction (avoid in dehydration)
Name three complications of ulcerative colitis
Toxic dilatation
Iritis
Increased malignancy risk
Define Crohn’s disease
Chronic inflammatory condition affecting anywhere from mouth to anus
Name three drug treatments of Crohn’s disease
Thiopurines
Methotrexate
Biologics (Infliximab)
Give three features of Crohn’s disease
Granulomas
Skip lesions
Transmural ulceration
Give three features of UC
Diffuse inflammation
Inflammed centre on mucosa
From rectum to left side
Why does low albumin occur in inflammation?
Cytokines degrade albumin
Name three drugs which must be considered when a patient presents with GI bleeding?
NSAIDs (ulcer)
Iron (dark stool)
Aspirin (anti-platelet so increases bleeding risk)
Why can a patient with cancer have elevated platelets?
Initially platelets are low but bone marrow kicks in to combat this and in cancer states overcompensates
In cancer treatment, what name is given to the process of giving chemo/radiotherapy in conjunction with surgery?
Neo-adjuvant therapy
What is an AP resection?
Abdomino-pertioneal resection, removing rectum, sigmoid colon and anus
