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FOUNDATION MEDICINE > GI Y1 > Flashcards

GI Y1 Flashcards

1
Q

Supine

A

Laying on the back

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2
Q

Prone

A

Laying on the the front

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3
Q

Sagittal plane

A

symmetric , Cut the body into left and right

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4
Q

Coronal plane

A

cut the body into anterior and anterior

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5
Q

Axial (transfers) plane

A

cut the body into superior and inferior (top and bottom)

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6
Q

Oppsite words
Superior (cranial or rostral)

A
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6
Q

Oppsite words
Superior (cranial or rostral)

A
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7
Q

Oppsite words
Superior (cranial or rostral)
Anterior
Medial
Proximal
Superficial

A

Inferior (caudal)
Posterior
Lateral
Distal
Deep

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8
Q

embryo anatomy

A
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9
Q

Flexion
Extension

A

decrease the angel between parts
Increase angle between parts

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9
Q

Flexion
Extension

A

decrease the angel between parts
Increase angle between parts

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10
Q

When Metoclopramide should be avoided?

A

Metoclopramide is a medication commonly used to treat gastroesophageal reflux disease (GERD) symptoms, nausea, and vomiting. However, it should be avoided in cases of bowel obstruction because it can exacerbate the obstruction and cause further complications.

Bowel obstruction is a condition where the passage of intestinal contents is blocked, either partially or completely.

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11
Q

Sigmoid Volvulus

A
  • Old patients
  • high fibre diet
  • chronic constipation
  • AXR - show coffee bean sign
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12
Q

Intrahepatic causes of Juandiace

A

Gilberts syndrome
Alcoholic liver disease
Primary biliary cirrhosis
Autoimmune hepatitis

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13
Q

Post hepatic causes Juandiace

A

Choledocholithiasis

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14
Q

Achalasia (name of defected neurons )

A

The progressive degeneration of myenteric neurons
Preventing food from being effectively moved through Esophages
Daysphagia progressively (improves when moving the head back)
Trypanosoma cruzi -> chagas disease

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15
Q

PARALYTIC Leus

A

similar to sigmoid volvulus but no coffee beans sign

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16
Q

Globus hysterics

A

Young women
Previous history of anxiety
Feeling lump in the throat

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17
Q

Acute Cholecystitis (which duct, sign )

A

complication of gallstone
Gallstones obstruct the cystic duct and stop the emptying of the gallbladder
RUQ pain
Positive Murphy’s sign (feeling the inflamed gallbladder )

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18
Q

Acut Pancreatic

A

acute epigastric pain
Radiate to the back due to the involvement of retroperitoneum
High level of Amylase

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19
Q

Appendicitis

A

Rebound tenderness and guarding
Central pain radiates to the right iliac fossa
Tachycardia
Positive McBurney’s point
Rosving’s sign - pressing on LIF causes pain in RIF.
Rosving’s sign - pressing on LIF causes pain in RIF.

Treatment :
Appendectomy
analyiscs
antibiotic

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20
Q

Ulcerative colitis
Get worst after quitting smoking

A
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21
Q

AMA

A

anti mitochondrial antibody is the most specific test for primary biliary cholangitis (PBS)

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22
Q

primary biliary cholangitis (PBS)

A

AMA
MRCP
it caused by autoimmune destruction of both intra and extra-hepatic bile duct

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23
Q

Wilsons Disease

A
  • Chronic hepatitis
    Neurogenic degeneration (aggressive behaviour)
    autosomal recessive
    treatment :
    Penicillamine or trientene (copper chelating agents )
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24
Q

Clostridium difficicle gastroenteritis

A

History of PO antibodies (e.g for chest infection)
as antibodies can disrupt the normal gut flora leading to the overgrowth of C.difficicle

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25
Q

Alpha 1- antitrypsin can be caused by — genetic

A

autosomal recessive

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26
Q

Coeliac disease

A

Autoimmune reaction to gluten
+ anti-tissue transglutaminase (anti TTG)
+ anti endomysial (antiEMA)
Malabsorption
Small bowel specifically jejunum
Atrophy of intestinal villi (coeliac small intestinal mucosa + crypt hypertrophy)
LINK TO TYPE 1 DIABETES
Dermatitis herpetiformis

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27
Q

When patients have IgA deficiency and is suspected to have coeliac disease what can of test can be done

A

anti TTG and anti EMA for IgG version

28
Q

what is Charcot’s triad

A

Charcot’s triad is a set of three symptoms that are typically associated with acute cholangitis
1. right upper quadrant pain
2. fever - rigor (shaking )
3. painful jaundice (raised bilirubin)

29
Q

Haemorrhoide

A

fresh blood on toliet paparer

30
Q

Direct ingual hernia

A

cough will causes it to reappear after reduction
point toward the groin

31
Q

Indirect inguinal

A

will not reappear after the reduction
point towards the groin

32
Q

Femoral hernia

A

more common in females
Point down the leg

33
Q

How to treat the following:
1. low BP + Haemtemesis
2. actively bleeding peptic ulcer
3. Uncontrol oesophageal visceral

A
  1. Iv fluid
  2. Heater probe coagulation + adrenaline injection
  3. TIPs
34
Q

GORD

A

Heartburn
water brush
regurgitation of excessive saliva with acid
Odynphagia
MANAGEMENT
Endoscopy
stop smoking
loss weight
prop the head up of bed
H2 antagonist
PPI for 8 weeks
Barrets oesophagus
PPI optimisation

35
Q

tumour maker of colorectal cancer

A

CEA

36
Q

Crohons disease

A

palpable lesion on the shin ->IBS
Slim there maybe have been wight lost

37
Q

tumour marker Hepatocellular carcinoma

A

alpha fetoprotein

38
Q

why is azathioprine given with caution

A

is bone marrow suppression thus a weak immune system.
given for patients with ulcercolitis

39
Q

what is Terlipression

A

is given in variceal bleeding for patients with cirrhosis
its vasoconstriction of splanchnic circulation decreases portal pressure and reduces the risk of bleeding from varices

40
Q

Peptic ulcer includes 7 days of tripe therapy what are these drugs

A

PPI+ Amoxicillin + clarithromycin
OR if the patient allergic to penicillin
PPI+ Amoxicillin + Metronidase

41
Q

COlumnar

A

Squamous cells epithelium

42
Q

Irritable bowel syndrome

A

females
discomfort is only better when having a bowel movement

43
Q

Paneth cells

A

The Paneth cells are found at the base of the
crypts of Lieberkühn and have a role in defence and regulating bacterial flora

44
Q

Hepatitis A

A
  • Faecal-oral spread
  • Acute hepatitis, no chronic infection
  • Serology :Hepatitis A antibody (anti-HAV): This test detects antibodies to the HAV virus, which is spread through contaminated food or water.
  • Management: Vaccine
45
Q

Hepatitis E

A
  • Faecal-oral transmission in the tropics
    Tropical genotype associated with severe disease in pregnant women
  • Some immunocompromised humans can get chronic infection
  • No vaccine yet available
46
Q

Hepatitis D

A
  • Only found with Hepatitis B - exacerbates Hep B infection
  • Serology: Hepatitis D antibody (anti-HDV)
47
Q

Hepatitis B

A
  • Transmission (bodily fluids)
    Sex
    Mother to child
    Blood to blood (unscreened transfusions, tattoos)
  • Serology:
    Hepatitis B surface antigen (HBsAg)
    Antibodies to hepatitis B surface antigen (anti-HBs)
    Antibodies to hepatitis B core antigen (anti-HBc)
    Clinical features
    Chronic disease is more likely to result if first exposure is in childhood
    Spontaneous cure is not uncommon, even after years of infection
  • Management: Vaccinations
48
Q

Antibodies to hepatitis B core antigen (anti-HBc) - ‘C’ for Caught -

A

this means the person has developed antibodies due to a previous infection

49
Q

Hepatitis C

A
  • Same as Hep B
  • Strongly associated with hepatocellular carcinoma
  • Once chronic infection is established, spontaneous cure is not seen
  • Management
    chronic hep B - suppressive antiviral drug (more widely used) OR peginterferon alone (sustained cure possible in minority of cases)
    Chronic hep C - choice of antiviral regime based on many factors; aim is >90% SVR
    Cirrhotic patients at those at risk of complications treated as priority
50
Q

what bacteria causes Severe Vomiting

A

S.aureus - <24hrs onset

51
Q

what causes Watery Diarrhoea

A

Clostridium difficile (C. diff)- use of antibiotics 💊
(think the 4 C’S!)

52
Q

other casues of watery diarrhoea

A
  • Bacillus cereus => fast onset - reheated rice 🍚
  • Listeria - unpasteurised milk products 🐄
  • Vibrio cholerae - Travel Abroad (SE asia) ✈️🌏
  • E. coli - Traveller’s Diarrhoea
  • Giardiasis (parasite)🐛💦
53
Q

Bloody Diarrhoea

A

E. coli 0157 🩸
Campylobacter jejuni - BBQ, Travellers diarrhoea 🍖/✈️🌏
Salmonella - eggs and poultry 🍳🐔
Amoebiasis (parasite)🐛🩸
* E. coli 0157 - from farmyard animals/ petting zoos. has shiga toxins (ENDOTOXIN!)causing bloody diarrhoea
Can lead to haemolytic uraemic syndrome.
Use of antibiotics causes toxins to be released from dying cells so DO NOT use antibiotics if you suspect HUS.

E coli - short history bloody diarrhoea // travelling + diarrhoea // haemolytic uraemic syndrome + thrombocytopaenia = E COLI (subtype 0157)

54
Q

Viral gastroenteritis

A

Onset: 24hrs

Norovirus - winter vomiting bug
(raw chicken/turkey)🎅

55
Q

Parasites

A

Amoebiasis - bloody diarrhoea - tropical areas

Giardiasis - Faecal-oral transmission - pets , farm animals or human

56
Q

treatment for

Ecoli 0157-

C.diff -

A
  • Supportive measures
  • Oral vancomycin and hygiene measures
    (remember to wash hands w/ soap! C.diff has spores which alcohol cant break!)
57
Q

Gastric ulcer

A
  • Dyspepsia
  • Epigastric pain worse after eating
  • Pain eased by antacids and lying flat
  • Rupture will present as haematemesis (vomiting blood)
58
Q

Duodenal ulcer

A
  • Dyspepsia
  • Epigastric pain relieved by eating
  • Pain worse when lying flat - may wake patient during the night
  • Rupture will present as rectal bleeding/melaena (blood in stool)
59
Q

Croup is caused by…

A

B- parainfluenza

60
Q

the first line antibiotic treatment for a C. difficile infection?

A

A- Oral Vancomycin

61
Q

A patient presents with bloody diarrhoea and is confirmed via stool culture to be infected with E.coli 0157. What is the best management below?

A

fluid only

62
Q

Bacillus cereus

A

Reheated rice

63
Q

Barretts oesophagus is the metaplasia of epithelial cells of the lower oesophagus from

A

stratified squamous to simple columnar epithelium

64
Q

Coeliac disease is strongly associated with genetic

A

is strongly associated with HLA-DQ2 (95% of patients) and HLA-DQ8 (80%).

65
Q

Diverticulosis

A

condition in which diverticula are present in the intestine without signs of inflammation.

66
Q

Upper midline abdominal incisions will involve the division of the

A

linea alba

67
Q

How is Aspergillus fumigatus treated? lung infection

A

Amphotericin B

68
Q

Hepatocellular carcinoma is associated

A

Hepatitis C

69
Q

Oesophageal cancer

A

is associated with alcohol excess and smoking.

70
Q

Inguinal hernia is above the inguinal ligament, Femoral hernia is below the inguinal ligament

A

FOUNDATION MEDICINE (23 decks)

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