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GIT Question Bank(From 801 Page) Flashcards

1
Q

What are the drugs causing Chronic or relapsing diarrhea?

A

NSAIDS,Aminosalycilates,SSRI

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2
Q

Biochemical changes in suspected Malabsortion?

A

Decrease Albumin,zinc,ca,mg,po4

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3
Q

Haematological changes in malabsorption?

A

Microcytic anemia,macrocytic anemia & increase PT (k deficiency)

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4
Q

investigations for malabsorption?

A

Biochemical,small gut,pancreas & Bile salt functions

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5
Q

Lung conditions causing wt loss?

A

TB,COPD,Empyema,Ca(small call especially)

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6
Q

Chronic infection Causing wt loss?

A

HIV,TB,Brucellosis,Gut infestation

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7
Q

Neurodegenarative Diseases causing wt loss?

A

Dimentia,PD,MND

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8
Q

Cardiac causes of wt loss?

A

Ccf,IE

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9
Q

Drugs causing constipation?

A

Opiates,Anti cholinergic,CCB(verapamil),Iron,Aluminium containing Antacids

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10
Q

Neurological Causes of wt loss & constipation?

A

Constipation:PD,Cerebrovascular accident,MS,Spinal cord lesion

Wt loss:PD,Dimentia,MND

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11
Q

Metabolic causes of constipation?

A

DM,Hypercalcemia,Hypothyroidism,pg

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12
Q

What are the clinical features of Small,large and malabsorption diarrhea?

A

Small: large volume watery,bloating,mid abdominal cramp

Large:Blood and mucus,lower abdominal cramp

Malabsorption:steatorrhea, undigested food,wt loss and nutritional disturbances

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13
Q

Metabolic causes of abdominal pain?

A

DM,AIP,Hypercalcemia

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14
Q

Drug causes of abdominal pain?

A

Steroid,azathiprine,Alcohol,lead

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15
Q

Haematological causes of abdominal pain?

A

Sickle cell anemia,hemolysis

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16
Q

Neurological causes of abdominal pain?

A

SC lesion,radiculopathy,Tabes dorsalis

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17
Q

Most common cause of chronic Abdominal wall pain(CAWP)?How to confirm clinically?

A

Anterior cutaneous nerve entrapment syndrome.

Carnett’s sign(Pain is unchanged or worse after abdominal muscle is tensed)

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18
Q

GI causes of oral ulcer?

A

Chron’s & coeliac disease

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19
Q

Dermatological causes of oral ulcer?

A

Dermatitis Herpetiformis
Lichen planus
Immunobullous disease
Erythema Multiforme

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20
Q

Drugs causing oral ulcer

A

Nicorandil
NSAID
MTx
Penicillamine
Ace-I,ARB(losartan)
Cytotoxic drugs
SJS

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21
Q

Infection causing oral ulcer?

A

Candida
HSV
HIV
TB
Syphilis

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22
Q

Who are at risk for Apthous ulcer?

A

Woman prior to menstruation

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23
Q

In candidiasis odynophagia and dysphagia indicates?Rx?

A

Pharyngeal and oesophageal
1.Topical miconazole/nystatin
2.oral fluconazole

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24
Q

In old age dry mouth occur in 40% people..Base line salivary flow? And saliva on stimulation?

A

Baseline falls but on stimulation unchanged

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25
Q

GERD

Neverthless all patient Develos Oesophagitis,Barrets or strictures are found to have??

A

Hiatus Hernia

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26
Q

which anemia occurs in GERD?

A

IDA

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27
Q

Indication of Rx in Barret’s Oesophagus?

A

Symptoms of gerd or strciture

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28
Q

Severe chest pain+severe vomiting+Dysphagia Dx?Preferred Inv?

A

Gastric volvulous due to twisting of large Hiatus hernia..
Inv:CXr(air bubble on chest) & Barrium swallow

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29
Q

Inv of GERD?

A

1.Young with no warning feature-No inv
2.Investigation of choice: UGIE
3.Gold: 24Hours pH (<4 for more than 6% of study time)
4.Impedance test - to detect weakly acidic or alkaline reflux

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30
Q

Drugs causing Oesophagitis?

A

Bisphosphonates
Tetracyclines
NSAIDS
Potassium supplement

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31
Q

1.commonest benign tumor of Oesophagus?
2.Commonest Malignant tumor?
3.Commonest in lower 3rd

A

1.Leomyoma
2.Squamous cell ca
3.Adenocarcinoma

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32
Q

Complication of plummer vinson syn

A

Squamous cell ca of oesophagus

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33
Q

Risk factors of squamous cell ca of Oesophagus

A

1.Smoking
2.Alcohol
3.betel nut
4.achalasia Cardia
(২ টা post)
4.Post cricoid web(plummer vinson)
5.post caustic stricture
6.Coeliac disease
7.Tylosis(familial hyperkeratosis of palm and sole

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34
Q

Drug causing Oesophageal stricture?

A

Bisphosphonates

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35
Q

Which mal absorption causes proximal muscle weakness?

A

Vit-D

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36
Q

Which mal absorption causes muscle wasting?

A

Protein

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37
Q

Which malabsorption causes purpura and bruising?

A

Vit c & K

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38
Q

Which mal absorption cause poor wound healing?

A

Zinc,vit C, protein

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39
Q

C/f of Pharyngeal pouch?
IOC?

A

Dysphagia+halitosis+regurgitation + gurgling after swalloimg

IOC: Barrium swallow

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40
Q

Achalasis

1.Associated Autoimmune Disease?
2.Defective release of which neurotransmitter causes achalasia? Degeneration of which cell?
3. Which infection ks clinicall indistinguishable from Achalasia?

A

1.৩ টা Rheumatic (SLE,RA,sjogre) আর Type 1 DM

2.NO, degeneration of Ganglionic cell
3.Chagas diseas(T.cruzi)

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41
Q

Investigation of Achalasia cardia

A

1.IOC: UGIE (to exclude pseudo achalasia - ca of gastric fundus)
2.confirm by Manometry
3 Barrium meal - Rat tail (tappered narrowing)

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42
Q

Latest endoscopic Rx of achalasia

A

POEM (peroral endoscopic myotomy)

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43
Q

Which therapy is needed after Hellers operation of achalasia?

A

PPI

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44
Q

What is nutcracker oesophagus?
Rx?

A

-Extremely Forceful peristaltic activity leading to episodic chest pain & dysphagia

Rx:Nitrates & nifedipine

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45
Q

Secondary causes of oesophageal dysmotility

A

1.Crest syndrome
2.Dermatomyositis
3.RA
4.Myasthenia Gravis

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46
Q

Commonest site of Gastric ulcer?

A

90% are located in lesser curve within antrum/at the junction between body and antral mucosa

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47
Q

Commonest site of duodenal ulcer?

A

Anter wall 50%

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48
Q

Causes of chronic non specific Gastritis?

A

H.pylori
Autoimmune(pernicious)
Post gastrectomy

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49
Q

Properties of H.pylori

A

1.Gm negative
2.spiral
3.flagella
4.produce urease

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50
Q

Virulence factors of H.pylori

A

1.vaca
2.Caga
3.baba
4 oipa(outer inflammatory protein A)

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51
Q

Adhesion factor of H.pylori?

A

bAba-with Lewis b antigen on epithelial cell

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52
Q

Which variety produce duodenal ulcer?

A

Antral predominent (Hypergastrinemia)

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53
Q

Which variety causes Gastric cancer?

A

Corpus/gastric variant causes gastric atropy and hypochlorhydrua & by converting Dietary nitrates to mutagenic nitrites

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54
Q

Which hematological disease is associated with pud?

A

ITP

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55
Q

For H.pylori which test is Gold?

A

Culture. It can define antibiotic sensitivity too

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56
Q

Best test for population screening?

A

Serology

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57
Q

Commonest A/E of eradication therapy?

A

Diarrhoea (50%)

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58
Q

Extra gastric disorder where H.pylori eradication is indicated?

A

1.ITP
2.IDA

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59
Q

Gastric disorder where H.pylori eradication is indicated?

A

1.PUD (old or new)
2.Dyspepsia
3.previous endoscopic resection of early gastric ca
4.Extranodal marginal lymphoma of MALT type
5.Long term NSAID and kow dose aspirin
6.unexplain B12 deficiency

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60
Q

H.pylori eradication is indicated in GERD..T/F?

A

F

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61
Q

What are the indepandant risk factor for PUD?

A

H.pylori
NSAID

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62
Q

Which anemia is most common after subtotal gastrectomy?

A

IDA

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63
Q

Most stricking symptom of pud perforation?

A

Sudden severe pain

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64
Q

The most common site for GOO?

A

Pylorus

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65
Q

In GOO, Succation splash is seen after 4hr of last meal.What is diagnostic of GOO?

A

Visible peristalsis

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66
Q

Commonest site of Gastrinoma(zollimger Ellison syndrome)?

A

Pancreatic head/proximal duodenal wall

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67
Q

Gastrinoma/Z.E.S is associated with?

A

MEN 1

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68
Q

Presentation of Gastrinoma/ZES?

A

Severe,often multiple PUD at unusual site like post bulbar duodenum, jejunam,oesophagus.Duration is short and poor response to standard therapy.Diarrhoea in 1/3rd case

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69
Q

Test for gastrinoma/ZES?

A

Secretin stimulation test
(Dramatic and paradoxical rise in gastrin level)

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70
Q

Which diet are responsible for gastric ca?

A

Smoked, salted or prickled foods,nitrates and nitrites

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71
Q

Which vit responsible for Gastric ca?

A

CA(remember Gastric cancer is caused by ca)

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72
Q

Urea producing oragnism?

A

PUNCH
proteus(alkalaine urine)
Ureaplasma (renal calculi)
Nocardia
Crycptococcus
H.pylori

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73
Q

H.pylori associated gene causing Gastric ca?

A

CagA

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74
Q

Risk factors for Gastric Ca?

A

1.H.pylori
2.smoking
3.Alcohol
4.Diet & Vitamin
5.gastric adenomatious polyp
6.Diffuse gastric ca (CDH1 mutation)
7.FAP
8.previous partial gastrectomy (>20 yrs)
9.pernicious anemia
10.menitriers disease

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75
Q

Which histological type of gastric ca is more common?

A

Intestinal

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76
Q

What are the paraneoplastic syndrome of Gastric ca?

A

Thrombophlebitis(Trousseaus sign)
Achanthosis Nigricans
Dermatomyositis

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77
Q

T/F Lymphoid tissue normally present in normal stomach.

A

F

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78
Q

Which chromosomal translocation is associated with gastric lymphoma?

79
Q

Gastric carcinoid(neuroendocrine)

1.commonest cell?
2.Commonest site?
3.best inv?

A

1.ECL and other endocrine cell
2.fundus and body in long standing pernicious anemia
3.EUS is best investigation

80
Q

GIST arises from which cell?
Associated Gene?

A

Interstitial cells of cajal(stillete)
C-kit proto onco gene

81
Q

Common gastric polyp?

A

Fundic gland polyp
Hyperplastic polyp
Adenomatous polyp

82
Q

Causes of Gastroparesis?

A

Inherited
Diabetic neuropathy (*)
Systemic sclerosis
Myotonic dystrophy
Amyloidosis
Drugs: CCB,OPIATES,ANTI CHOLINERGIC (TCA & PHENOTHIAZINES)

83
Q

Coeliac disease associated HLA?

84
Q

Coeliac disease associated Ag and ab?

A

Anti endomyseal ab(ttg ag)
IgA mainly (IgG in IgA deficiency)

85
Q

Causes of subtotal villous atrophy?

A

WiZ এর HIV আর Treatment Radiation দিয়ে CLD হয়ে G(2) elo

whipples dis
Hiv enteropathy
Tropical sprue
Radiation
Coeliac disease
Lymphoma
Dermatitis Herpetiformis
Gammaglobulinemia(hypo)
Giardiasis

86
Q

For mucosal healing in coeliac disease?

A

Glutein free diet

87
Q

Neurological complications of Coeliac disease/

A

Encephalopathy
Cerebellar atrophy
PN
Epilepsy

88
Q

What is key to Mx of Coeliac disease?

A

Dietetic follow up

89
Q

DermatitisHerpetiformis

1.Lesion & site?
2.Immunoglobulin?
3.Biopsy finding?
4.1st line Rx and drug

A

1.Lesion & site? Crops of intense itchy blister on Knee, elbow,back and buttock

2.Immunoglobulin?IgA (linear/granular) at Dermo Epidermal junction

3.Biopsy finding?- partial villous atrophy

4.1st line Rx and drug
Usually response to Gluten free diet
Some pt need DAPSONE

90
Q

Tropical Sprue

1.Tropical Countries?presentation?
2.Rx?

A

1.West indies,southern india,Malaysia,indonesia.. Condition often begins after an episode of diarrhoeal illness
2.Tetracycline 250mg 4 times-28 days(মনে রাখব t এর জন্য T)

91
Q

SIBO

1.What are the motility disorders causing SIBO?

A

Diabetic autonomic neuropathy and Systemic sclerosis

এগুলা ইউজুয়ালী gastroparesis/intestinal obstruction করে।কিন্তু এখানে ডায়রিয়া করবে।মাথায় রাখা লাগবে।

92
Q

SIBO

Which immune related disorder causes #SIBO?

A

Hypogamma globulimemia!
এটা subtotal villous atrophy ও করে।মাথায় রাখবি

93
Q

SIBO

Most common cause of recurrent Gastrointestinal infection in SIBO?

A

Giardiasis

94
Q

SIBO

1.Gold standard investigation for SIBO?
2.Non invasive test?

A

1.Culture of small bowel aspirate obtained at endoscopy is the GOLD
2.Non invasive- Hydrogen breath test

95
Q

SIBO

1.First line Treatment?

A

A course of Broad spectrum Antibiotic for 2 weeks (Rifaximin) /cipro/metro/amoxicillin

96
Q

Which antibiotic is not absorbed from the GUT after oral administration?

97
Q

Whipples diseases

1.causative organism is Gm positive or negative?

A

Gm Positive bacilli

98
Q

whipples disease

1.which group of ppl affected?
2.Foamy macrophage deposited in?
3.which mal absorption occurs?
4.which system affected?

A

1.Middle aged men of europe
2.Lamina propria causing lymphatic obstruction
3.Fat malabsorption
4.Almost All system

99
Q

whipples disease

1.First symptom?
2.Commonest GI symptom?
3.Fever?
4.Endocarditis?

A

1.Joint symptom(Large joint seronegative)
2.Wt loss (90%),Diarrhoea(75%)
3.Mild fever is common
4. Endocarditis can occur in late phase

100
Q

whipples disease

Dx and Treatment?

A

Dx: Small bowel biopsy(jejunal) + PCR
Rx:2wks ceftriaxone 2g followed by co trimoxazole 1 year…if relaps, repeat(usually CNS) same treatment + doxycycline,hydroxychloroquine

101
Q

Coeliac disease

Hyposplenism is found in Coeliac disease..T/F

102
Q

Bile Acid Diarrhoea

1.Causes of Bile Acid Diarrhoea?

A

Type 1: Terminal ileal disease(Ileal resection & chrons disease)
Type 2: idiopathic
Type 3: other causes of malabsorption

103
Q

Bile Acid Diarrhoea

1.Investigation of Bile Acid Diarrhoea?
2.Treatment?

A

1.
-75 (SEHCAT)
-Non invasive 7alpha hydroxyxholestenone

2.Rx: Colestyramine,colesevelam

104
Q

Consequences of Ileal Resection?

A

1.watery diarrhoea (decrease Bile absorption)
2.Gall stone(lithogenic bile formation due to decresed bile salt pool)
3.Impaired fat & B12 absorption
4.oxalate stone of kidney(funabsorbed bile binds to calcium and oxalate become free)

মনে রাখব দুইটা stone (Bile and renal),B12, diarrhoea & fat mal absorption

105
Q

Radiation Enteropathy

1.common sites?

A

1.Terminal Ileum
2.Sigmoid colon
3.Rectum(commonest)

106
Q

Radiation Enteropathy

1.common complications?

A

1.proctocolitis
2.Bleeding from talengiectasia
3.Small bowel stricture
4.Adhesions
5.Fistula:Recto vaginal,colovesical and Enterocolic
6.Malabsorption(SIBO,BILE ACID DIARRHOEA)

107
Q

Abetalipoprotinemia

1.which lipoprotein deficiency?
2.Associated conditions?

A

1.Apo-B - failure to Chylomicron formation leading to failure of fat soluble vitamins absorption

2.
a.Acanthocytosis
b.Retinitis pigmentosa
c.Cerebellar & Dorsal column sign

108
Q

Protein losing Enteropathy!

Peripheral oedema and hypoprotienemia in context of normal LFT and absent protienurea..

How to confirm?

A

1.Fecal clearance of alpha 1 antitrypsin measurement
2.51 cr lebelled albumin after IV injection

109
Q

Protein losing Enteropathy

1.Common causes?
2.Cardiac Cause?
3.Connective tissue disorder cause?
4.Lymphatic obstruction?

A

Protein losing Enteropathy

1.Common causes?-Ulcerative গুলা

2.Cardiac Cause?- Constrictive pericarditis

3.Connective tissue disorder cause?-SLE

4.Lymphatic obstruction?
-Intestinal Lymphactesia
-constrictive pericarditis
-lymphoma

110
Q

What is diaphram disease?

A

Intense submucosal fibrosis and circumferencial stricturing due to NSAID

111
Q

Common site of intestinal ulcer?Infection causing intestinal ulcer?

A

ILeum.
Infection:TB,Typhoid,Yersenia enterocolitica

112
Q

Meckels diverticulum.

Commonest GIT anomaly

Important measurements?

A

★0.3-3% ppl(2%)
★100cm away from Ileocecal valve
★5cm in diameter
★Complication arise within 2years of life

113
Q

Meckels diverticulum

Common ectopic tissue?

A

1.Gastric mucosa-50%
2.colonic
3.pancreatic
4.Endometrial

114
Q

Meckels

Complications?

A

1.PUD
2.Perforation
3.Intusseption
4.Diverticulitis
5.Obstruction

115
Q

Food intolerance are immune mediated.T/F?

A

F..They are not immune mediated…Resulting from either pharmacological(tyramine,histamine,monoaodium glutamate) or metabolic(lactase deficiency) or other Mechanism

116
Q

Lactose intolerance

90% adult lack Lactase enzyme which convert Lactose to glucose and galactose prior to absorption.In primary -jejunal morphology is normal

In lactase deficiency what occurs?

A

Unhydrolyzed lactose enters in colon where bacterial fermantation produce
-volatile short chain fatty acids
-Hydrogen
-Co2

117
Q

Lactose intolerance

1.Correct diagnosis is suggested by?
2.Non invasive test?

A

1.clinical improvement after withdrawal of lactose
2.Lactose H2 breath test

118
Q

Most common small intestinal benign tumor?

A

Periampullary Adenoma

119
Q

Drugs causing chronic intestinal pseudo obstruction?

A

Opiates
Drugs with anti cholinergic effect (TCA,phenothiazines)

120
Q

Which paraneoplastic syndrome is associated with chronic intestinal pseduo obstruction?

A

Small cell lung ca (myenteric plexus disorder)

121
Q

Example of neoplastic polyp with common site?

A

1.Conventional Adenoma- throughout colon but larger one in distal colon and rectum

2.Sessile serrated Adenoma:Right colon

3.Traditional serrated Adenoma: Distal colon

122
Q

Risk factor for malignant chancge of polyp?

A

1.Size >2cm
2.Multiple polyp
3.Serrated polyp (except small rectal hyperplastic polyp)
4.villous architecture
5.High grade dysplasia

123
Q

Different gene in classical Adenoma-carcinoma

A

1.Early Adenoma-APC Gene
2.Intermediate- KRAS gene
3.Late-DCC/SMAD4
4.CA-Tp53

124
Q

Different Gene in Serrated neoplasia pathway?

A

Sessile Serrated adenoma- BRAF+IGFBP7 এটা থেকে Ca হবে MLH1 (HNPCC/LYNCH) দিয়ে

Traditional Serrated Adenoma: BRAF+KRAS এতা থেকে ca হবে MGMT

125
Q

Risk factors of colorectal ca

1.Factors decrese risk?

A

1.Dietary fibre & fruits, vegetables
2.Ca,Folic Acid,omega 3 FA
3.Aspirin,NSAIDS,STATINS

126
Q

Risk factors of colorectal ca

1.which operation increase risk?

A

Cholecystectomy
Ureterosigmoidostomy

127
Q

Risk factors of colorectal ca

Which diet increase risk?

A

Red meat& saturated animal fat

128
Q

Risk factors of colorectal ca

Type 2 DM increase risk T/F?

129
Q

Risk factors of colorectal ca

Which vitamin decrease risk?

A

Folic Acid

130
Q

Risk factors of colorectal ca

Which mineral decrease risk?

131
Q

colorectal ca

1.Right vs left colon?

A

1.Right colon- Anemia & occult bleeding or altered bowel habit.But obostruction is a late feature
2.Left colon- Fresh per rectal bleeding & Early obstruction

132
Q

colorectal ca

1.Investigation of choice?
2.Helpful investigation for F/U?
3.Most important determinent of Prognosis?

A

1.Colonoscopy
2.CEA
3.TNM staging at Diagnosis

133
Q

Non Polyposis Syndrome

Commonest Hereditery Cancer syndrome.(SBA)

1.Synonym? gene?
2.Mean age of onset?
3. Proximal or distal?
4.Diagnosis?
5.Prevention?

A

1.Lynch syndrome.HNPCC gene
2.45 years.
3.2/3rd proximal tumor unlike sporadic
4.Criteria+ microsatellite PCR
5.Aspirin reduce risk

134
Q

FAP & MAP

এগুলা হচ্ছে Polyposis syndrome

A

FAP(APC) is AD whereas MAP(MUTYH) is AR.

Apc তে Truncated Mutation হয়।(loss of function)

বাকী গুলা gain of function

135
Q

FAP

Commonest tumor & Site?

A

Periampullary Adenoma(Duodenal)

136
Q

FAP

T/F Tamoxifen and NSAID have protective role in Desmoid FAP

137
Q

FAP

100% predictive of FAP

138
Q

FAP

What is Turcot syndrome?

A

FAP+ CNS TUMOR (ASTROCYTOMA/MEDULOBLASTOMA)

139
Q

HNPCC

Modified amsterdam criteria?

A
  • 3 or more relative at least 1 first degree

-2 or more generation

-one member affected before 50y

  • FAP excluded
140
Q

FAP

Extra intestinal features?

141
Q

FAP

Extra intestinal features?

A

1.CHRPE
2. Gardner syndrome-Osteoma,epidermoid,dental abnormality
3.Desmoid tumor
4.other malignancy (Brain,thyroid,adrenal,liver)

142
Q

Gardner syndrome is associated with?

A

FAP(OSTEOMA,EPIDERMOID& DENTAL ABNORMALITY)
এখানে কিন্ত Desmoid নাই

143
Q

What are GIT polyposis syndrome?

A

Neoplastic: FAP&peutz jeghers
Non neoplastic:Juvenile polyposis,Cowden disease,cronkhite canada

144
Q

GIT polyposis associated with oesophageal polyp?

A

1.cowden
2.cronkhite canada

সব C গুলা Oesophagus মনে রাখব

145
Q

GIT polyposis most commonly causing small bowel polyp?

A

Peutz jegher

146
Q

GIT polyposis most commonly causing colonic l polyp?

147
Q

Cowden syndrome(PTEN) associated with?

A

Congenital anomalies
Oral and cutaneous Hamartoma
Thyroid and breast ca

148
Q

GIT polyposis most commonly causing intussusception and pigmentations?

A

Peutz jegher

149
Q

peutz jegher syndrome

1.Gene and mutation?
2.triad?
3 essential other examination

A

1.STK11, truncating mutation
2.small bowel polyp+mucocutaneous pigmentation+AD pattern.

3.Men: Testicular exam
Women: pelvic exam, cervical smear and regular mammography

150
Q

Diverticulosis

Common site?
What is left sided appendicitis?

A

Sigmoid colon & Descending colon

Diverticulitis is lt sided appendicitis

151
Q

Laxative

Bulk forming?

A

Ispagula,methyl cellulose

152
Q

Laxative

Stimulant?

A

Docusatw,bisacodyl,senna,dantron

153
Q

Laxative

Osmotic?

A

Lactulose,lactitol,mg salt

154
Q

Laxative

Serotonergic?

A

Prucalopride

155
Q

Laxative

Prosecretory?

A

Lubiprostone

156
Q

Laxative

Fecal softener?

A

Docusate,arachis oil enema

157
Q

In several idiopathic constipation which laxative should be avoided?

A

ইসুপগুল (Bulking)

158
Q

Laxative abuse

1.Tiger skin occur due to?

A

Accumulation of lipofuscin pigment in macrophage in laminapropria

159
Q

Laxative abuse

1.what is cathartic colon? ★★★

A

Megacolon due to laxative abuse..Barium anema shows
featurelesa mucosa loss of haustra,shortening of bowel

160
Q

★RET oncogene

A

Gain of function: MEN 2
Loss of function : Hirschprung
মনে রাখবো Hirschprung - Harabe(loss)

161
Q

Causes of Acute colonic pseudo obstruction?

A

surgery,trauma,burn
RF(uremia),respiratory failure
Drugs:Opiates,phenothiazines
Diabetic autonomic neuropathy
Electrolytes: decrease K&mg

162
Q

Causes of both acute and chronic obstruction?

A

Diabetic AN
Opiates, phenothiazines(TCA শুধু chronic করে)

163
Q

T/F
Fecal impaction causes fecal incontinence?

164
Q

T/F
Anxiety causes pruritus Ani

165
Q

IBD

Which inflammatory markers are associated with IBD?

A

Tnf alpha,IL12&23

166
Q

IBD

Which infection is prevented by IBD?

167
Q

IBD

Which operation protect from UC?

A

Appendicectomy

168
Q

IBD

Genetic factors of IBD..which genetic factor is associated with severe UC?

A

HLA-DR 103(Severe UC)
Hnf4alpha
LAMB1
CDH1

169
Q

IBD

Pseudopolyp,crypt,Thumb pitting mucosa,lead pipe, limited to mucosa are associated with?

170
Q

IBD

Cobblestone,rose thorn,string sign?
Non caseating granulona?

171
Q

IBD

What is curative for UC?

172
Q

IBD

What is typical for UC?

A

Crypt abscess

173
Q

IBD

5-ASA& MtX

A

5 ASA has no role in CD
mTX has no role in maintenance in UC

174
Q

IBD

What remains the mainstray treatment of CD?

A

Glucocorticoids

175
Q

IBD

In UC bloody diarrhoea +mucus+ abdominal cramp indicates?

A

Left sided colitis/extensive colitis

176
Q

In UC per rectal bleeding+mucus+tenesmus indicates?

177
Q

What are the cardinal features of UC?

A

Rectal bleeding(proctitis)+mucus+Bloody diarrhoea (left sided/extensive colitis)

178
Q

IBD

Commonest site of CD?

A

Ileal/ileocolonic(40%)
Involve perianal but Spare rectum★★★

179
Q

IBD

In CD feature of UC but rectal sparing..Site?

A

Chrons colitis

180
Q

IBD

In CD Acute/chronic pseudoobstruction.Site?

181
Q

IBD

Severity Assessed by?

A

True love witts criteria..
1.>or equal 6 bloody stool/24hr
Plus one or more
-Fever
-Anemia
-Tachycardia
-raised inflammatory markers

182
Q

IBD

toxic megacolon,PSC and cholangiocarcinoma,adenocarcinoma are the complications of?

183
Q

IBD

Which bacteria you will search during bacteriological inv?

A

Clostridium difficile

184
Q

IBD

Features Unrelated to the activity of IBD?

A

Autoimmune Hepatitis
PSC & cholangiocarcinoma
Gall stone & oxalate renal stone
Amyloidosi
Sacroilitis
Metabolic bone disease

185
Q

IBD

Extra intestinal features of IBD

A

A PIE SAC

Apthous ulcer
Pyoderma gangrinosum
Iritis,episcleritis,conjunctivitis
Erythema Nodosum
Sclerosing cholangitis
Arthritis
Clubbing

186
Q

IBD

Painful ulcer in shin + UC
Painful Nodule in shin+ UC

A

Pyoderma gangrinosum
EN

187
Q

IBD

Pyoderma & EN are associated with Active disease..T/F?

188
Q

IBD

Drugs for remission induction?

A

Aminosalisylates & steroid

189
Q

IBD

Drug for maintenance?

A

Antimetabolites(Azathioprine,mercapturine,MTx)

190
Q

IBD

Severe ulcerative colitis refractory to steroid?

A

Ciclosporin

191
Q

IBD

Mtx has important role in UC maintenance?T/F

A

F… No role

192
Q

IBD

Maintenance therapy for CD?

A

Thiopurines
(Azathiprines & mercapturine)

193
Q

IBD

In pregnancy which drug must be avoided?

A

Mtx (6 months prior)
Tofacitinib

194
Q

IBD

CD is associated with which type of diet?

A

Low residue,high refined sugar

My Notes (3 decks)

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