Passmed Questions Flashcards

(26 cards)

1
Q

Biliary Colic

A

RUQ
Caused by gallstones lodged in the bile duct.
Provoked by eating a fatty meal.
Has no fever + inflammation

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2
Q

Acute Cholecystitis

A

RUQ
Inflammation / infection of the gall bladder secondary t gall stones.
Murphy’s sigh positive

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3
Q

Ascending Cholangitis

A

RUQ
Ascending cholangitis is a bacterial infection of the biliary tree. MOST common predisposing gallstone.
Charcot’s triad of RUQ pain, fever and jaundice

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4
Q

Acute pancreatitis

A

Epigastric - can radiate to the back.
Due to alcohol / gallstones.
Pain is often very severe.
examination may reveal tenderness, ileus + low grade fever.

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5
Q

Peptic Ulcer Disease

A
Epigastric 
History of NSAID / alcohol excess. 
Most common duodenal ulcer (relieved by food). 
Gastric ulcer worsens by eating. 
Features: Haemorrhage, melena.
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6
Q

Appendicitis

A

Right iliac fossa.
Pain central abdomen before localising to right iliac fossa.
Features: anorexia, Tachycardia, low grade pyrexia, tenderness in RIF.

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7
Q

Acute Diverticulitis

A

LLQ
Colicky pain in LLQ
Features: Diarrhoea, sometimes bloody.
Fever, raised inflammation, WCC.

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8
Q

Intestinal Obstruction

A

Central.
History of malignancy (intraluminal obstruction)
Features: Vomiting

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9
Q

Ruptured abdominal aortic aneurysm

A

Central abdominal pain radiating to the back.
Features: sudden collapse, severe central abdominal pain with developing SHOCK.
Shock: hypotension, tachycardic and history of CVD.

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10
Q

Mesenteric Ischeamia

A

Central Abdominal pain.
History of AF / CVD
Features: Diahoea, rectal bleeding and metabolic acidosis (seen in dying tissues).

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11
Q

Cause of acute pancreatitis

A
Gall stones 
Ethanol 
Trauma 
Steroids
Mumps 
Autoimmune 
Scorpion venom 
Hypertriglyceridaemia, Hyperchylomicronaemia, Hypercalcaemia, Hypothermia
ERCP 
Drugs ( macolides, diuretics, steriods, sodium)
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12
Q

On palpation: palpate over the LIF pain bounces to the RIF

A

Rovsing’s sign

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13
Q

Affects between 6 -18 months of age. Boys are effected more than girls.

A

Intussusception, one portion of bowel into the lumen, commonly around ileo-caecal region.

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14
Q

Common in females and pregnant women

A

Femoral Hernias

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15
Q

Familial Adenomatous polyposis

A

Mutation of APC gene

Feature: colonic adenomas

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16
Q

Peutz-Jeghers

A

STK11 mutation on chromosome 19.

Features: Multiple benign intestinal hamartomas

17
Q

Plummer-Vinson Syndrome

A

Triad of: dysphagia, glossitis, Fe deficiency anaemia.

18
Q

Mallory Weiss syndrome

A

Severe vomiting, → painful mucosal lacerations at the gastroesophageal junction resulting in haematemesis. Common in alcoholics

19
Q

Gilbert’s Syndrome

A

Autosomal recessive
Due to deficiency of UDP glucuronosyltransferase.

This enzyme conjugates bilirubin in the liver.
Results in build-up of unconjugated bilirubin which cannot be excreted.

20
Q

What must be present for the diagnosis of Barrett’s oesophagus

21
Q

Pancreatic cancer

A

Tumour are adenocarcinoma which typically occur at the head.

Associates with BRCA2 gene.

22
Q

Chronic pancreatitis:

A

Inflammatory condition effecting exocrine + endocrine function.
80% of cases is due to alcohol.

Other issues: Hereditary Haemochromatosis / ducts obstruction due to tumour.

23
Q

Crohns Disease

A

inflammatory bowel disease, commonly affects the terminal ileum and colon, also mouth to anus.

Inflammation involves all layers down to Serosa = more prone to stricture, fistulas and adhesions.

24
Q

Ulcerative colitis, what to look for ?

A

Mucosal inflammation, crypt abscess, shallow ulceration, and marked pseudopolyps.

25
Toxic Megacolon
It is greater than 6cm on the AXR. Occurs in IBD. This is because the colon is unable to remove gas / faeces from the body = build-up in the colon.
26
What is Wilson's Disease?
A genetic disorder, due to excessive copper deposition in tissues. Metabolic abnormalities including increased copper absorption from small intestine and decreased hepatic copper excretion.. Combination of neurological disease and liver. Buzzword: Kayser - Fleischer ring (dark rings ciruclating the iris of the eye).