Passmedicine/Pastest Flashcards
melanosis coli
pigment deposit in bowel wall associated with laxative abuse
soft but tender abdomen
sign of mesenteric ischaemia
palpable umbilical nodule due to metastaic cancer
sister mary josephs node
what is NOT a notifiable disease
HIV
how is coeliac disease investigated
tissue transglutaminase antibody (IgA) - 1st line screening test
jejunal biopsy - diagnostic, shows villous atrophy
what should you always ask with dyspesia
ALARM symptoms
anaemia, loss of weight, anorexia, recent onset progressive, melaena
name an antidiarrheal
loperamide - stimulates opiod receptors
what score is used to assess pancreatitis severity
modified glasgow score
triad of dysphagia, iron deficiency anaemia and glossitis
Plummer vinsen syndrome
what is budd chiari syndrome
hepatic vein thrombosis
what typically causes budd chiari and how does it present
haematological disease e.g. polycythaemia, thrombophilia,
pregnancy
contraceptive pill
presents with abdo distention and ascites and tender hepatomegal
how is budd chiari investigation
SAAG - serum- ascites albumin gradient will be raised
this shows the ascites is due to portal hypertension
what is zollinger ellison syndrome
condition characterised by excessive levels of gastrin, usually from a gastrin secreting tumour usually of the duodenum or pancreas. Around 30% occur as part of MEN type I syndrome
causes epigastric pain and diarrheao
results in multiple gastroduodenal ulcers
what is spontaneous bacterial peritonitis
Spontaneous bacterial peritonitis (SBP) is a form of peritonitis usually seen in patients with ascites secondary to liver cirrhosis
how is SBP treated in tayside
severe : taxobactam and pipercillin - step down to co trimox
incidental finding - co trimox
when is prophylaxis ABx of SBP indicated in ascites and what are usually given
if ascitic protein less than 15g/L
hepatorenal syndrome
passmedicine says cipro not sure of local guidance
how is toxic megacolon diagnosed on Abdo x ray
transverse colon greater than 6cm
what is kernicteris
prolonged jaundice in newborn results in brain damage - can cause cerebral palsy
what happens if you rapidly diurese for ascites
hypochloraemic alkalosis
what test should be done after finding NAFLD incidentally
.
NICE recommend that if NAFLD is found incidentally then an enhanced liver fibrosis (ELF) blood test should be performed to assess for more severe liver disease.
investigation of choice for liver cirrhosis
transient elastography
melanosis coli
laxative abuse
how do you calculate alcohol units
vol (ml) x EBV/1000
Which diabetes drug is most likely to cause cholestasis?
gliclazide
define toxic megacolon
transverse colon more than 6cm
migratory areas of depapillation on dorsum of tongue associated with pain/burnign when eating spicy foods
geographic tongue
