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Year 4: General Surgery + GI > Pass Med Q's > Flashcards

Pass Med Q's Flashcards

1
Q

most common site of ischaemic colitis

A

splenic flexure

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2
Q

most common inherited colorectal cancer risk factor

A

HNPCC

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3
Q

what cancers does HNPCC increase risk of

A

colorectal

endometrial

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4
Q

which vitamin can be teratogenic in high doses

A

vitamin A

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5
Q

what vitamin deficiency can Isoniazid cause?

what are the clinical effects?

A

vitamin B6

- causes peripheral neuropathy

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6
Q

what blood gas abnormality can mesenteric ischaemia cause

A

lactic acidosis

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7
Q

1st line treatment of C.Diff

A

metronidazole 10-14 days

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8
Q

2nd line treatment of C.Diff if severe/not responding to metronidazole

A

vancomycin

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9
Q

findings on duodenal biopsy in Coeliacs disease

A

villous atrophy
crypt hyperplasia
increased lymphocytes

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10
Q

most common causative organism in spontaneous bacterial peritonitis

A

E.Coli

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11
Q

tx of spontaneous bacterial peritonitis

A

IV Cefotaxime

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12
Q

what it toxic megacolon?

how does it present?

A

inflammation causes gas to become trapped

  • can be a complication of UC
  • presents with pain, increased temp, tachycardia
  • Abdo XRAY: transfère colon >6cm diameter
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13
Q

antibodies in autoimmune hepatitis

A

anti-smooth muscle

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14
Q

typical patient for autoimmune hepatitis

A

young females

- amenorrhoea common

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15
Q

what is carcinoid syndrome

A

liver mets release serotonin into circulation

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16
Q

symptoms of carcinoid syndrome

A

flushing, diarrhoea, bronchospasm, hypotension, weight loss

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17
Q

Ix of carcinoid syndrome

A

urinary 5-HIAA

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18
Q

tx of carcinoid syndrome

A

octeotride

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19
Q

what is melanosis coli

A

dark pigments in colon due to chronic laxative use

20
Q

what Haematological cancer is there increased risk of in coeliacs

A

T cell lymphoma

21
Q

why is pneumococcal vaccine given in coeliac disease

A

functional hyposplenism

22
Q

what is Peutz Jeghers

A

autosomonal dominant

  • hamartous polyps in GI tract
  • freckles around lips
23
Q

what needs to be checked before giving a patient with IBD azathioprine / mercaptopruine

A

TPMT activity

- some patients may have genetic mutations that can increase side effects with these drugs

24
Q

how does Budd Chiari Present

A

sudden onset abdo pain, ascites, tender hepatomegaly

25
Q

how does intestinal angina present

A

triad of severe colicky pain post prandial, abdominal bruit, weight loss

26
Q

side effects of PPIs

A

hyponatraemia, hypomagnesmia
osteoporosis – increased fracture risk
increased C.Diff risk

27
Q

what patients should receive prophylaxis against spontaneous bacterial peritonitis

A

patients with ascites if:

  • previous episode
  • fluid protein < 15 g/L
28
Q

hepatomegaly with hard irregular edge

A

metastasis

29
Q

biochemistry in Wilsons

A

decreased caeruloplasmin
decreased serum copper
increased urinary copper excretion

30
Q

what is pellagra

A

vitamin D3 deficiency

- dermatitis, diarrhoea, cognitive defecit

31
Q

common causes of pancreatitis

A

alcohol
gallstones
post ERCP

32
Q

what is a TIPS procedure

A

connects hepatic vein to portal vein

33
Q

what is globs pharyngitis

A

persistent feeling of lump in throat even though there isn’t one

34
Q

iron study results in patient with Haemochromatosis

A

transferrin saturation > 55%
raised ferritin + iron
low TIBC

35
Q

causes of Budd Chiari syndrome

A

polycythemia rubra vera
pregnancy
COC
thrombophilia

36
Q

signs of right heart failure

A 
hepatomegaly
- liver is firm, smooth, tender, pulsatile
ascites
raised JVP
oedema
37
Q

what is pernicious anaemia

A

autoimmune antibodies to gastric parietal cells/intrinsic factor
- B12 deficiency

38
Q

mechanism of action loperamide

A

decreased gastric motility through stimulation of opiod receptors

39
Q

1st line Ix for liver cirrhosis

A

‘Fibroscan’ - transient elastography

40
Q

what is sister Mary Josephs node

A

palpable node in umbilicus due to mets

41
Q

why should metoclopramide be avoided in bowel obstruction

A

increased risk of perforation

42
Q

what should patients be given prior to appendectomy

A

prophylactic antibiotics

- Co -amoxiclav

43
Q

how is TIBC affected in

  • iron deficiency anaemia
  • anaemia of chronic disease
A

high in iron deficiency

low in anaemia of chronic disease

44
Q

how long should a patient stop PPIs before endoscopy

A

2 weeks prior

45
Q

most common site for diverticulitis

A

sigmoid colon

Year 4: General Surgery + GI (13 decks)

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