last min tings <3 Flashcards
what is smooth muscle coupled by
gap junctions
what is the indirect pathway of gastic secretion
ach and gastrin stimulating ECL - resulting in histamine which acts on the partietal cell
give exmalpes of PGE antagonists
NSAIDS
what do you give alongside NSAIDS
misoprostol - a PGE1 analougue
examples of mucosal strenghtneres
sucralfate and bismuth chealate
what suppresses peristalsis
CCK and gastrin
what is the oder of carbs
polysarrharides
ogliosaccharides
monosaccharides
what must all dietry carbs be converted to
monosahharides for absoption
what does B12 bind to before binding to intrinsic faactor
hapatocorin
what controls the defeacation reflec
pudenal nerves
what is an exampled of a simulant purgitave
bisacodyl
what is an example of a faecal softener
docusate sodium
how are fatty acids oxidised
through b oxidation
what do a4-b7 and madcam-1 do
allow lymphoctes to move into the assocaited tissue and into the gut
treatment of allergic oesophagitis
steroids, chromoglycate and montelukast
what are squamous papilloma associated with
HPV
what is the first type of gastric adenocarcinoma
interstitial
form polypoid mass/ exophytic
tumuors have rolled up edges
h pylori assocaited
what is the second type of gastric adenocarcinoma
expands / infiltrates the stomach wall
signet ring on histology
gastic lymphom
b cell
how to treat diverticular disease
uncomplicated - antibiotcs
complicacated - drainage, hartmanns procedure
which patients is hairy leukoplkia seen in
HIV patients and EBV patients
what do you do when there are ALARM symtpoms in dyspepsia
test for h pylori
what is tropical sprue
colonisation of intestine by infectous agent in the carribrenas - cause is unknown
whipples disease
caused by tropheryma whipplei
required antibiotics
middle agend man
how to treat a carcinoid of the appendix
<1cm - addpendectomy
>2cm - complete right hemi colon
treatment of small bowel obstructuvion
nasogastric tube to decompress the stomach
what are kuppfer cells
macrophages which remove bacterial matter and dead RBC which produced bilirubin
what are stellate celles
store via A and are within the space of disse, may deposit collagen, beginning liver cirrhosis
treatment of gallstones
laparoscopic cholecystectomy
ursodeoxyxholic acid
morphine buprenophrine
atropine or GN
what does CPY450 do
makes the drug have an OH group
what does UDP-GT do
adds a larger group onto the OH
how to treat hepatic encephalophy
laculose (converts ammonia into ammonium) and antibiotics eg rifaximin
who gets NASH
non - drinkers
what si compensated cirrhosis
clinically normal, incidental finding
symptoms - spider naevi
what is decompensated cirrhosis
liver failure - end staege
jaundice, ascites, encelophaty
where is the fundus of gall bladder loacted
L1
what is a paediatric inguinal hernia assocaited with
processes vaginalis
inx for appendicitis
US
treatment of achalasi
CCBs and nitrates
botox
cardiomyotomy, baloon oesophageal dilation
what cancer is assoc with pulmmer vinson syndrome
oesophageal adenocarcinoma
inx for gastroperesis
oesophageal mamometry
inx for malabsoprtion
FBC, coagultion, LFTs and then endoscopy / imaging
when to offer a lower GI test ofr IBS
if >50
treatement for IBS
stop opiates and analgesia
loperamide
antispasmodics - mebeverine
amitryptiling
what are some symptoms of acute mesenteric ischaemia
pain out of proption, no abdo signs, rapid hypovolaemia, constant/central/RIF pain
treatment of acute mesenteric ischaemic
metro and gent - due to the mucosal damage
inx of mesenteric ischaemia
CT angiogrpahy at laparotomy
inx of meckels
radionucleotide scan and laparptomy
what is trulove and witts criteria
> 6 blood stools/day + 1 of fever, tahcy, anaemia, elevated ERS = severe UC
invx of bowel obstruction
abdo xray
things with short incubtation times
bacillus ceurss and staph aureus
things with medium incubation times
salmonella nad c perfingens
things with long incubation time
campylobacter and e coli and giardiasis and enteric fever
how to treat enteric fever
cefiriaxone
leptin
reduced levels minic starvation
insulin
inhibit food intake
orlistat
inhibits pancreas uuptake so decreases TAG absoption
direct inguinal hernia is caused by
weak posterior wall
prehepatic jaunice
excess haem production eg malena - increased unconjugated bilirubin
intrahepatic jaundice
hepatocellular damage leading to intrahepatic choelsista eg viral drugs - increased conjugated or unconjugate bilirubin
post hepatic jaundice
obsruction to bile flow from liver eg gallbladder - increased conjugated bilirubin
symptomas of carcinoid tumours
flushing, wheexing, diarrhoea
t1
no deeper than mucosa
t2
not through muscularis
t3
though muscularis propria
t4
tumour has directly invaded other organs
whats in the hepatoduodenal ligament
CBD, portal vein, proper hepatic artery
