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Gastroenterology > Luminal > Flashcards

Luminal Flashcards

1
Q

What is the 1st and 2nd line treatment for GORD?

A

1st line treatment - omeprazole PPI

2nd line treatment - ranitidine H2 antagonist ON

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2
Q

What type of bacteria is H. pylori?

A

A gram negative aerobic bacteria which lives in the stomach.

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3
Q

What are the tests for H. pylori?

A
  1. urea breath test
  2. stool antigen testing
  3. rapid urease test (CLO test)
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4
Q

What is the treatment for H. pylori?

A

Triple therapy of a PPI and two antibiotics for 7 days.

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5
Q

How does barretts oesophagus develop?

A

Constant reflux of acid results in the lower oesophagus epithelium changing in a process known as metaplasia from squamous to columnar epithelial cells.

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6
Q

What is the risk of barretts oesophagus?

A

It’s a premalignant state, but increases the likelihood of developing adenocarcinoma of the oesophagus.

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7
Q

What is the treatment for barretts oesophagus?

A

PPI and aspirin but not yet in guidelines

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8
Q

What are the causes of a UGIB?

A

Varices, cancer, ulcers, mallory-weiss tear

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9
Q

What is seen on a blood test of a patient with a UGIB?

A

Raised urea and a drop in Hb.

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10
Q

What is the treatment of UGIB?

A

Blood transfusion, OGD, terlipressin, prophylactic antibiotics.

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11
Q

What are the specific aspects of Crohn’s disease?

A

No blood or mucus, entire GIT, skip lesions, terminal ileum most affected and transmurial (full thickness), smoking is a risk factor.

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12
Q

What are the specific aspects of UC?

A

Continuous inflammation, limited to colon and rectum, only superficial mucosa affected, smoking is protective, excrete blood and mucus, use aminosalicylates, primary sclerosing cholangitis.

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13
Q

What is faecal calprotectin screening test used for?

A

Indication of how inflamed the intestines are

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14
Q

What is the 1st line treatment of Crohn’s disease to put the patient into remission?

A

Steroids - prednisolone

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15
Q

What is a curative treatment of UC?

A

Ulcerative colitis typically only affects the colon and rectum. Therefore, removing the colon and rectum (panproctocolectomy) will remove the disease. The patient is then left with either a permanent ileostomy or something called an ileo-anal anastomosis (J-pouch). This is where the ileum is folded back in itself and fashioned into a larger pouch that functions a bit like a rectum. This “J-pouch” which is then attached to the anus and collects stools prior to the person passing the motion.

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16
Q

What are the 2 auto antibodies that are present in patients with coeliac disease?

A

Anti-tissue transglutaminase (anti-TTG) and anti-endomysial (anti-EMA).

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17
Q

What is the pathophysiology of coeliac disease?

A

Inflammation affects the small bowel, particularly the jejunum. It causes atrophy of the intestinal villi. The intestinal cells have villi on them that help with absorbing nutrients from the food passing through the intestine. The inflammation causes malabsorption of nutrients and the symptoms of the disease.

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18
Q

What are symptoms of coeliac disease?

A

Weight loss, diarrhoea, fatigue, mouth ulcers, anaemia secondary to iron deficiency, dermatitis herpetiformis (an itchy blistering rash on the abdomen).

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19
Q

Which patients are always tested for coeliac disease?

A

T1DM as the two conditions can be linked.

20
Q

Coeliac tests must take place when the patient…

A

is on a gluten containing diet.

21
Q

What may be seen on an endoscopy of a patient with coeliac disease?

A

Villous atrophy and crypt hypertrophy

22
Q

A diagnosis on Barrett’s Oesophagus canot be made without this test…

A

Upper GI endoscopy with biopsy

23
Q

What is the treatment for a low grade dysplasia Barrett’s oesophagus?

A

Radiofrequency ablation should be the standard of care for flat (non-nodular) low-grade dysplasia in Barrett’s oesophagus.

24
Q

What is the first line treatment of a patient with an active bleeding MWT?

A

First-line treatment in an actively bleeding patient is therapeutic endoscopy. Endoscopy is probably the most sensitive and specific diagnostic test for MWT and can also help to rule out other causes of upper GI bleeding.

25
Q

MWT ceases spontaneously in what percentage of patients?

A

80-90%

26
Q

What are the risk factors for oesophageal cancer?

A

Low socioeconomic status, smoking, excessive alcohol use, GORD, Barrett’s oesophagus, and obesity are some of the main risk factors.

27
Q

What is an oesophageal stricture?

A

A benign esophageal stricture, or peptic stricture,[1] is a narrowing or tightening of the esophagus that causes swallowing difficulties.

28
Q

What are oseophageal varices?

A

Oesophageal varices are dilated collateral blood vessels that develop as a complication of portal hypertension, usually in the setting of cirrhosis.

29
Q

What are the main causes of gastritis?

A

Helicobacter pylori infection may cause both an acute and chronic gastritis.[4] Erosive gastritis may occur in response to NSAID/alcohol use or misuse[1][2][3] and to bile reflux into the stomach that may follow previous gastric surgery or cholecystectomy.

30
Q

What can break down the protective layer on the stomach mucosa?

A

H. pylori and medications such as steroids/NSAIDs.

31
Q

Risk factors of gastric ulcers include…

A

Smoking, alcohol, spicy food, stress, caffeine

32
Q

How does eating affect gastric and duodenal ulcers?

A

Makes gastric ulcers more painful and duodenal ulcers less painful

33
Q

What is a Kocher’s scar from?

A

Open cholecystectomy

34
Q

What is a gridiron scar from?

A

Appedicectomy

35
Q

What are the causes of ascites in CLD?

A
  1. portal hypertension
  2. hypoalbuminaemia
  3. salt and water retension secondary to RAAS activation
36
Q

What are the causes for hepatomegaly?

A 
Infection (hepatitis, malaria)
Infiltration (sarcoid, fatty liver, haemocromatosis)
Blood-related (lymphoma, leukaemia)
Biliary (PBC, PSC)
Cancer (HCC)
Congestion (RHF, tricspid regurgitation)
37
Q

What are some extra-intestinal maifestations of IBD?

A

Clubbing, conjunctivitis, erythema nodosum

38
Q

Name some causes of gynaecomastia…

A

testicular failure, thyrotoxicosis, drug induced (spirolactone), chronic liver disease

39
Q

What could be causing a pulsatile liver?

A

tricuspid regurgitation

40
Q

What are the causes of a massive splenomegaly (past umbilicus)?

A

malaria, myelofibrosis, CML, RA, infective endocarditis

41
Q

Portal hypertension does not cause hepatomegaly, true or false?

A

true

42
Q

What manifestations can portal hypertension cause?

A

caput medusa, varices, gastropathy, ascites

43
Q

What are some causes of constipation?

A

medications such as opiates
hypothyroidism
diabetes
anal fissure

44
Q

What is the primary symptom of short bowel syndrome?

A

diarrhorea - which can result in dehydration, malnutrition and weight loss

45
Q

What is IBS?

A

Irritable bowel syndrome (IBS) is a chronic condition characterised by abdominal pain associated with bowel dysfunction. The pain is often relieved by defecation and is sometimes accompanied by abdominal bloating.

46
Q

What should a patient with IBS show on FBC?

A

Nothing, it should be normal. If there is an anemia present then not IBS.

Gastroenterology (3 decks)

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