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GI -pass med > liver > Flashcards

liver Flashcards

1
Q

hepatic encephalopathy

A
  1. caused by increased ammonia in the ciculation
  2. acute liver failure or decomp of chronic
  3. mx - lactulose increases secretion of ammonia
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2
Q

C. diff diarrhea

A
  1. caused by Clindamycin/ciprofloxacin / PPI
  2. diagnosis is made by C.diff antigen in stool
  3. mx - metronidazole and 2nd line is vanc
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3
Q

non symptomatic gall stones

A

no mx necessary

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4
Q

UC

A
  1. bloody diarrhea and pain in the llq
  2. Primary schlerosing cholangtis and ‘back pain’ - Sacroillitis
  3. high risk of colorectal cancer
  4. continous/inflammation in submucosa/crypt abscess and depletion of goblet cells
  5. endoscopy - pseudopolyps
  6. enema - loss of haustrations and lead pipe colon
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5
Q

Mx barrets

A
  1. symptomatic but no metaplasia - endoscopic surveillance with biospy and high dose ppi
  2. metaplasia - endoscopic surveillance very 3-5 years
  3. dysplasia - mucosal resection/radiofreq ablation
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6
Q

urea breath test

A
  • also used to check for h.pylori eradication

- no antibiotics for 4 weeks and no PPI for 2 weeks

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7
Q

wilson’s disease

A
  1. excess copper - AR thus problem with ceruloplasmin which is the transport protein that free copper binds to
  2. low ceruloplasmin/low serum copper/ increased 24 hour copper secretion
  3. Kayser fleisher rings
  4. neurological and liver signs
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8
Q

2 week referral for dyspepsia - endoscopy

A
  1. all patients with dysphagia
  2. upper abdo mass
  3. > 55 years with reflux/pain/dyspepsia
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9
Q

dyspepsia without referral mx

A
  1. 1 month of PPI

or

  1. test and treat for H.pylori via urea breath test and triple therapy for 7 days
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10
Q

UC flares

A
  1. mild - < 4 stool
  2. modertale 4 -6 stool within minimal systemic upset
  3. > 6 stool with fever/tachy/systemic upset
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11
Q

goldstandard for GORD

A

24 hour ph monitoring

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12
Q

Budd chiari syndrome

A
  1. background of procoagulation condition
  2. hepatic vein thrombosis
  3. abdo pain /ascites / tender hepatomegaly
  4. Ix - Ultrasound with doppler
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13
Q

Vit C def

A
  1. asorbic acid def
  2. collagen synthesis -> bleedy tendency an poor wound healing
  3. facilitates iron absorbtion - iron deficiency
  4. gingivitis and lose teeth
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14
Q

Crohn’s mx

A

Remission -

  1. oral/topical/IV glucocorticoids
  2. Aminosalycylate - Mesalazine

Maintain remission

  1. Azathiprine
  2. methotrexate
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15
Q

HNPCC

A
  1. increased risk of colorectal cancer
  2. increased risk of bowel cancer
  3. increased risk of endometrial cancer
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16
Q

UC mx - inducing remission

A
  1. topical aminosalicyclate (mesalazine) if beyond rectum or not improved start oral mesalazine
  2. oral corticosteroid
17
Q

UC mx - maintaining remission

A
  1. rectal aminosalicylateand/or oral aminosalicyclate

2. > 2 exacerbations a year = oal azathioprine

18
Q

PPI SE

A
  1. hyponatremia
  2. hypomagnesemia - muscle pain
  3. osteoporosis
  4. increased risk of C diff
19
Q

Ascites

A
  1. SAAG (serum/ascites albumin ratio) > 11 = due to portal hypertesion
  2. aldosterone antagonist - sprinolactone
  3. drainage
  4. prophylactic abx to reduce the risk of spontaneous bacterial perionitis
20
Q

Hep D

A
  1. co infection - hep B and hep D infection at the same time

2. superinfection - Hep B surface antigen positive patient subsequently develops hep D

21
Q

Coeliac’s

A
  1. check for TTG IGA antibodies and duodenal biopsy for diagnosis
  2. biopsy shows - villous atrophy/crypt hyperplasoa and increase in intraepithelial lymphocytes
  3. iron/folate and B12 def
22
Q

Peutz jeher’s syndrome

A
  1. autosomal dominal condition
  2. numerous harmartomous polyps in GI tract - no malignant potential
  3. pigmented freckles on lips, face, palms and soles
  4. intussception
23
Q

NALFD disease

A
  1. ultrasound - fatty changes on liver
  2. enhanced liver fibrosis blood test - check for advances levels of fibrosis
  3. mx - weight loss

GI -pass med (2 decks)

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