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Phase 2A (HV) > Miscellaneous- Gi + Liver > Flashcards

Miscellaneous- Gi + Liver Flashcards

1
Q

What antibodies are associated with autoimmune hepatitis

A 
ANA 
Anti Smooth Muscle (anti-actin)
Anti soluble liver antigen (anti SLA/LP)
Anti Liver Kidney Microsome 1 
Anti Liver Cytosol
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2
Q

Tumour marker for hepatocellular carcinoma

A

Alpha fetoprotein

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3
Q

Tumour marker for chalangiocarcinima

A

CA19-9

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4
Q

What diseases is cholangiocarcinoma associated with

A

PSC
UC
Chronic cholecystitis

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5
Q

Where does cancer of liver metastasise to

A

Lung bones

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6
Q

What enzyme conjugates bilirubin

A

UDP Glucosonyl transferase

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7
Q

What is the classical LFT findings in alcoholic liver disease

A

AST;ALT ratio is 2;1

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8
Q

1st line treatment for hepatic encephalopathy

A

1st line- Lactulose

Additionally add
Abx- rifaximin
Nutritional support- e.g. nasogastric feeding

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9
Q

What antibodies is PBC associated with

A

Anti mitochondrial antibody (AMA M2)

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10
Q

Key signs and Sx of PBC

A 
Hyperpigmentation of pressure points 
Xanthasmos 
Clubbing 
RUQ pain 
Jaundice (cholestatic)
Joint pain
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11
Q

What is PBC

A

Autoimmune disease characterised by the destruction of intra-hepatic ducts

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12
Q

Tx for PBC

A

Ursodeoxycholic acid

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13
Q

What is PSC

A

Chronic inflammation of the intra and extra-hepatic ducts of the liver

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14
Q

Sx of PSC

A 
Nights sweats 
Fever
RUQ pain 
Jaundice 
Fatigue
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15
Q

Gold standard Ix for PSC

A

ERCP/MRCP- beaded string

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16
Q

Tx for PSC

A

Lifestyle changes- avoid alcohol
Antihistamines for pruritus
Strictures dilated via ERCP

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17
Q

Sx of pellagra

A

B3 niacin deficiency
Dementia
Dermatitis
Diarrhoea

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18
Q

Mode of inheritance of haemochromotosis

A

Autosomal recessive (mutation in HFE gene)

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19
Q

What is the role of hepcidin

A

Protein responsible for controlling iron absorption (low in haemochromotosis)

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20
Q

Sx of haemochromotosis

A

Hyperpigmentation- bronze look
Organomegaly
Joint pain

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21
Q

Initial treatment and pharmacological treatment of haemochromotosis

A

CX- avoid alcohol
1st line- venesection
Rx- deferoxamine

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22
Q

List 4 pathophysiological causes for ascites

A

Local inflammation- peritonitis
Leaky blood vessels
Low flow- cardiac failure, cirrhosis, thrombosis
Low protein- hupoalbuminaemia

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23
Q

What causes wernickes encephalopathy

A

Deficiency in vit b1- thiamine

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24
Q

Triad associated with wernickes encephalopathy

A

Ophthamaloplegia
Ataxia
Confusion

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25
Name a pharmacological tx for diarrhoea
Loperamide- opioid receptor agonist
26
What condition is strongly associated with autoimmune hepatitis
Graves’ disease
27
Treatment for cdiff
Oral vancomycin and metronidazole/fidoxamin
28
4 causes of peritonitis
Bacterial infection Perforation of organ- SBP bile leak Blood from ruptured ectopic pregnancy
29
Causes of portal hypertension
Pre- portal vein thrombosis Intra- cirrhosis, schistosomiasis, sarcoidosis Post- budd chiari, CHF, constrictive pericarditis
30
Risk factors for gallstone
Fat Female Forty Fertile
31
What is Charcot triad and what disease is it associated with
Ascending chilangitis Fever RUQ pain Jaundice
32
1st line and gold standard investigation for ascending cholanangitis
1st line- Abdominal uss Gs- MRCP
33
Tx for ascending cholangitis
``` IV antibiotics (cefotaxime and metronidiazole) ERCP- relieve obstruction ```
34
B what bacteria can cause ascending cholangitis
Ecoli Klebsiella Enterococcus
35
Sign of acute cholecystitis
Murphys sign- inspiartory arrest on RUQ palpitation
36
What type of hernias have a female predominance
Femoral
37
3 broad catergories of bowel obstruction and 3 causes
Obstruction- tumour, diaphragmatic disease, gallstones in ileum Contraction- hircshpprung disease, intramural tumour, inflammation Pressure- intersucception, volvuous, adhesions
38
What is the most common cause of bowel obstruction in children under 2
Intersucception
39
1st line investigation for bowel obstruction
Abdominal X-ray- coffee bean sign (specific for volvulus)
40
Tx for bowel obstruction
If fluids Decompression Analgesics and anti emetics Abx
41
Most common cause of SBO in adults
Adhesions
42
Causes of oesophageal cancer
``` Achlasia Barrets oesophagus Corrosive oeshagitis Diverticulitis Eoshageal web Gord Alcohol smoking Hiatal hernia ```
43
Achlasia appearance on X-ray
Birds beak
44
What can h-pylori cause
Gastritis Peptic ulcers (90% causes in duodenal ulcer) Gastric cancer
45
1st line tx for Wilson’s
Pencillamide (copper chelater)
46
Cause of Wilson’s disease
Autosomal recessive- mutation of ATPB7 gene
47
Where are femoral hernias located
Inferior and lateral to pubic tubercle
48
List 5 antibiotics that cause c-diff
``` Carbapenams Cephalosporins Clindamycin Co-amoxiclav Ciprofloxacin ```
49
What change is seen in barrets
Stratified squamous to simple columnar
50
What is the treatment for ascites
Treat underlying cause Slat and fluid restriction Spiranolactone
51
What is the 1st line tx for crohns
Corticosteroids- oral prednisalone
52
1st line tx for UC
Topical or oral sulfalasalzine (5 ASA)
53
What is the 1st line Ix for coeliacs
Total IgA and IgA tTG
54
What histology changes are seen in coeliacs
Villous atrophy | Crypt hyperplasia
55
List 3 complications of coeliacs
Anaemia Osteoporosis Hyposplenism
56
What changes can be seen in colonoscopy in a patients diagnosed with crohns
Cobblestone appearance Skip lesions Deep ulcers
57
What changes can be seen on colonoscopy in pts with UC
Psuedopooyps, | Continuation of inflammation form rectum
58
What changes can be seen on histology in crohns
Transmurral inflammation Granulomas non casesting Increase in goblet cells Skip lesions
59
What changes can be seen on histology in UC
Continuous inflammation Mucosa only No/decreased goblet cellls Crypt abscesses
60
Name r extra manifestations of IBD
Pyoderma gangrenosum Erythema nodusum Uveitis Arthralgia
61
What are the types of oesophageal cancers and where are they mostly found
Adenicarcinoma- lower 1/3 of oesophagus | Squamous cell carcinoma- upper 2/3 of oesophagus
62
List 5 risk factors for oesophageal adenocarcinoma
``` Gord Achlasia Barrets Smoking Obesity ```
63
List 5 rf for oesophageal squamous cell carcinoma
``` Achlasia Smoking Alcohol HPV diets risk in nitrosamines Hot fluids ```
64
List 5 causes of gastric cancer
``` H-pylori Obesity Smoked foods Pernicious anaemia Mutations/fhx ```
65
Where are most colorectal cancers found
Rectum
66
List 5 causes of dyspepsia
``` Large volume meals Obesity Smoking Pregnancy Excess acid H-pylori infection GORD ```
67
What is the treatment for eradication of h-pylori
Triple therapy Omaeprazole + amoxicillin + clarithromycin for 7 days
68
What is the most common cause of pseudommebranous colitis and it’s associated Sx
C-diff infections ``` Mucoid, green smell watery stools Abdominal cramps Fever Nausea Abdominal pain ```
69
What is Achlasia
The failure of oesophageal peristalsis and LOS relaxation due to loss of ganglia from Auerbach plexus (muscularis propria)
70
Gs investigation for Achlasia
Oeshaphagel mammometry
71
1st line ix for Achlasia
Barium swallow- birds beak appearance
72
Tx for Achlasia in A- a good surgical candidate B- poor surgical candidate
A- balloon dilation (1st line) B- nitrates (isosorbide nitrate) and calcium channel blockers (verapamil/nifedipine) 2nd line- botulinum toxin
73
Gs ix for diverticulitis
Ct abdomen
74
List 5 rf of Gord
``` Smoking Obesity Alcohol Hiatal hernias Scleroderma ```
75
Tx for divertucular disease
Diet modification- high fibre diet and increase fluid intake (whole grain and fruit) Bulkforming laxatives for constipation- Antispasmodics for pain
76
List 5 causes of dyspepsia
``` Large volume meals Smoking Alcohol Pregnancy Obesity Excess acid production Prolonged use of NSAIDs ```
77
Red flags for dyspepsia
Vomiting Anaemia/bleeding Abdominal pain/weight loss Dysphagia
78
Tx for dyspepsia w/o red flag Sx
Review medication Lifestyle and diet modifications Full dose PPI for 4 weeks Test and treat h-pylori
79
Tx for dyspepsia w/ red flag Sx
Review medication and stop NSAIDs use Endoscopy Referral to malignancy specialist
80
What clinical tool is used to classify faeces
Bristol stool chart
81
Name three types of diarrhoea
``` Inflammatory Exudative Osmotic Dysentery Secretory ```
82
What are the abdominal radiograph findings in bowel obstruction
Dilated bowel proximal to obstruction | Absence of gas in bowel distal to obstruction
83
What are haemorrhoids
Are swollen inflamed veins of the rectum and anus
84
List symptoms of haemorrhoids
``` Anal pruritus Discomfort when sitting Painful Sore anus Fresh blood on wiping ```
85
Name 2 non surgical and one surgical tx for haemorrhoids
Ns- topical analgesia, high fibre diet, bulk forming laxatives Surgical- band ligation
86
List 5 causes of acute infectious diarrhoea
``` Viral infection- rotavirus, Norovirus Parasitic infection - giardia lambila Bacterial infection- salmonella IBD IBS Anxiety Antibiotic associated diarrhoea ```
87
List 5 rf of colorectal cancer
``` UC/Crohns Low fibre diet Obesity Smoking Alcohol High intake of red meat Increasing age FHx ```
88
List 4 complications of diverticulitis
Perforation Sepsis Abscess formation Obstruction
89
What drug is used to treat ruptured oesophageal varicies
IV Terlipressin
90
What drug would you use if iv terlipressin was contraindicated
IV somatostatin
91
Gs ix for appendicitis
Ct scan abdo
92
Name the 3 different type of gallstones
Cholesterol Calcium billurubinate- chronic haemolytic anaemia Brown pigment- stasis and infection
93
1st line treatment for autoimmune hepatitis and tx for remission
1st line- prednisalone | Remission- azathioprine
94
What is cirrhosis
Diffuse fibrosis and structural abnormality of the liver due to chronic inflammation
95
Features of internal haemorrhoids
Painless rectal bleeding Bright red blood in toilet after defacation No abnormalities to external rectal anal canal

Phase 2A (HV) (13 decks)

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