Pass Med Q's Flashcards
most common site of ischaemic colitis
splenic flexure
most common inherited colorectal cancer risk factor
HNPCC
what cancers does HNPCC increase risk of
colorectal
endometrial
which vitamin can be teratogenic in high doses
vitamin A
what vitamin deficiency can Isoniazid cause?
what are the clinical effects?
vitamin B6
- causes peripheral neuropathy
what blood gas abnormality can mesenteric ischaemia cause
lactic acidosis
1st line treatment of C.Diff
metronidazole 10-14 days
2nd line treatment of C.Diff if severe/not responding to metronidazole
vancomycin
findings on duodenal biopsy in Coeliacs disease
villous atrophy
crypt hyperplasia
increased lymphocytes
most common causative organism in spontaneous bacterial peritonitis
E.Coli
tx of spontaneous bacterial peritonitis
IV Cefotaxime
what it toxic megacolon?
how does it present?
inflammation causes gas to become trapped
- can be a complication of UC
- presents with pain, increased temp, tachycardia
- Abdo XRAY: transfère colon >6cm diameter
antibodies in autoimmune hepatitis
anti-smooth muscle
typical patient for autoimmune hepatitis
young females
- amenorrhoea common
what is carcinoid syndrome
liver mets release serotonin into circulation
symptoms of carcinoid syndrome
flushing, diarrhoea, bronchospasm, hypotension, weight loss
Ix of carcinoid syndrome
urinary 5-HIAA
tx of carcinoid syndrome
octeotride
what is melanosis coli
dark pigments in colon due to chronic laxative use
what Haematological cancer is there increased risk of in coeliacs
T cell lymphoma
why is pneumococcal vaccine given in coeliac disease
functional hyposplenism
what is Peutz Jeghers
autosomonal dominant
- hamartous polyps in GI tract
- freckles around lips
what needs to be checked before giving a patient with IBD azathioprine / mercaptopruine
TPMT activity
- some patients may have genetic mutations that can increase side effects with these drugs
how does Budd Chiari Present
sudden onset abdo pain, ascites, tender hepatomegaly
how does intestinal angina present
triad of severe colicky pain post prandial, abdominal bruit, weight loss
side effects of PPIs
hyponatraemia, hypomagnesmia
osteoporosis – increased fracture risk
increased C.Diff risk
what patients should receive prophylaxis against spontaneous bacterial peritonitis
patients with ascites if:
- previous episode
- fluid protein < 15 g/L
hepatomegaly with hard irregular edge
metastasis
biochemistry in Wilsons
decreased caeruloplasmin
decreased serum copper
increased urinary copper excretion
what is pellagra
vitamin D3 deficiency
- dermatitis, diarrhoea, cognitive defecit
common causes of pancreatitis
alcohol
gallstones
post ERCP
what is a TIPS procedure
connects hepatic vein to portal vein
what is globs pharyngitis
persistent feeling of lump in throat even though there isn’t one
iron study results in patient with Haemochromatosis
transferrin saturation > 55%
raised ferritin + iron
low TIBC
causes of Budd Chiari syndrome
polycythemia rubra vera
pregnancy
COC
thrombophilia
signs of right heart failure
hepatomegaly - liver is firm, smooth, tender, pulsatile ascites raised JVP oedema
what is pernicious anaemia
autoimmune antibodies to gastric parietal cells/intrinsic factor
- B12 deficiency
mechanism of action loperamide
decreased gastric motility through stimulation of opiod receptors
1st line Ix for liver cirrhosis
‘Fibroscan’ - transient elastography
what is sister Mary Josephs node
palpable node in umbilicus due to mets
why should metoclopramide be avoided in bowel obstruction
increased risk of perforation
what should patients be given prior to appendectomy
prophylactic antibiotics
- Co -amoxiclav
how is TIBC affected in
- iron deficiency anaemia
- anaemia of chronic disease
high in iron deficiency
low in anaemia of chronic disease
how long should a patient stop PPIs before endoscopy
2 weeks prior
most common site for diverticulitis
sigmoid colon
