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Pastest Flashcards

1
Q

Cardiomyotomy (Heller’s procedure)

A

Surgical treatment of achalasia

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2
Q

Grey Turner’s sign?

A

Flank bruising (suggests retroperitoneal inflammation of bleeding, e.g. ruptured abdominal aneurysm, ruptured ectopic pregnancy, PANCREATITIS, or abdominal trauma)

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3
Q

Most common presentation of Meckel’s diverticulum?

A

Painless rectal bleeding

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4
Q

May present with “redcurrant jelly” stool on the nappy

A

Intussussception

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5
Q

Swirled mesentery on CT scan

A

Internal herniation of bowel

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6
Q

Diffuse distension throughout the small and large bowel
May occur following abdominal surgery
Can be caused by fracture of the thoracolumbar spine

A

Paralytic ileus (adynamic obstruction)

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7
Q

Recognised complications of diverticular disease?

A

Haemorrhage
Colocutaneous fistula
Pneumaturia

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8
Q

Linked with HLA-B8?

A

Coeliac

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9
Q

Where does pancreatic cancer usually arise from?

A

The head of the pancreas

-It is an adenocarcinoma

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10
Q

Most common cause of acute pancreatitis?

A

Gallstones and alcohol

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11
Q

Amylase levels to diagnose pancreatitis?

A

Pancreatitis diagnosed when amylase is five times the upper limit of normal

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12
Q

Recognised complications of ileostomies?

A 
Dermatitis
Renal calculi
Gallstones
Salt and water depletion
Parastomal hernia (most common complication!)
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13
Q

What is GORD associated with?

A

Smoking, high alcohol intake, hiatus hernia, pregnancy, obesity, systemic sclerosis and tight clothes (lol)

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14
Q

Patients may complain of heartburn, an acid taste in mouth (acid brash), excess salivation (waterbrash), difficulty swallowing and nocturnal asthma?

A

GORD

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15
Q

A 35 year old housewife ahs notcied progressivley worsening difficulty swallowing over several years. She has been trouble by regurgitation of undigested food, halitosis and suffers from fits of coughing when lying flat

A

Achalasia

DIAGNOSIS MAY BE OBVIOUS ON CHEST RADIOGRAPH (wide mediastinum and shadow behind the heart)

  • usually presents 30-40 years
  • more common in women
  • dysphagia gradually progresses over the years
  • regurgitation of partially digested food
  • halitosis
  • foul eruption
  • patients may aspirate = coughin
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16
Q

Plummer-Vinson syndrome

A

Iron-deficiency anaemia, angular chelitis and dysphagia due to a postcricoid oesophageal web

This condition is premalignant and should be biopsied

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17
Q

Cephalic phase of gastric acid secretion

A

Triggered by sight. smell, thought and taste of food

Stimulated by VAGUS nerve

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18
Q

Gastric phase of acid secretion

A

Most significant phase

Initiated by presence of food in the stomach, particularly protein rich food

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19
Q

Intestinal phase of gastric acid secretion

A

Least significant phase

The presence of amino acids and food in the duodenum stimulate acid production

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20
Q

Three factors which stimulate gastric acid secretion

A

Acetylcholine (from parasympathetic neurons of the vagus nerve that innervate parietal cells directly)

Gastrin (produced by pyloric G cells)

Histamine (produced by mast cells)

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21
Q

Which cells produce histamine?

A

Mast cells

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22
Q

Three factors which inhibit gastric acid secretion?

A

Somatostatin
Secretin
Cholecystokinin

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23
Q

What do ALP and GGT reflect?

A

Obstructive disease

24
Q

Which organ synthesises vitamin K?

25
Kawasaki's disease?
Acute systemic vasculitis, involving medium sized vessels, affecting mainly children under 5 years - very frequent in Japan - infective trigger suspected -early diagnosis is crucial to prevent cardiac complications
26
Clinical features of Kawasaki's disease
- Fever (lasts more than 5 days) - Bilateral conjunctival congestion - Dryness and redness of lips and oral cavity - acute cervical lymphadenopathy - Polymorphic rash - Redness and oedema of palms and soles
27
A 3 year old boy is brought into the Emergency department with a 5 day history of fever and irritability, with red eyes and reduced eating for the last 24 hours. On examination he was noted to have dry cracked lips, mild conjunctivitis and cervical lymphadenopathy
Kawasaki's disease | Treatment = IV immunoglobulin and aspirin
28
Barking cough, harsh stridor and hoarseness, usually preceded by fever and coryza
Croup -symptoms often begin (and are worse) at night (acute epiglottitis tends to have onset over hours, with no preceding coryza or cough. It will have drooling saliva and a soft stridor)
29
Treatment for infected chicken pox?
Flucloxacillin in conjunction with aciclovir
30
Mild dehydration
Few clinical signs of dehydration | -can be managed with oral rehydration solution for around 24 hours until vomiting and profuse diarrhoes subside
31
Moderate dehydration
5-10% body weight loss -clinical signs of dehydration - thorsty, restless/lethargic, with reduced skin turgor, dry mucous membrane, rapid pulse, prolonged CRT, sunken eyes and anterior fontanelle Managed with a trial of ORS but if no improvement, IV fluid should be given
32
Severe dehydration
>10% body weight loss Patients appear shocked, cold/drowsy and sweating with marked oliguria, rapid and weak pulse etc IV fluid is indicated as an immediate resuscitation, and then subsequent rehydration allowing for deficit and ongoing fluid maintenance and losses
33
A 33 year old woman presents with severe abdominal pain radiating to the back. She is shocked and hyperventilating. There is no free gas on her erect chest x-ray. Opacity is noted at the level of the L1 vertebra
Pancreatitis
34
A 57 year old smoker presents with epigastric pain, sweating and is vomitting clear fluid. He has a ulse of 58bpm and a high JVP
MI | high JVP = right sided heart failure
35
A 43 year old man with MS presents with pulse of 120 and a rigid abdomen. He is apyrexial. There are no bowel sounds. He has recently completed a course of methylprednisolone
Perforated peptic ulcer
36
An 83 year old man presents following a collapse. He is not tachycardic but has a postural drop in blood pressure. He has mild epigastric discomfort. You not he has a history of arthritis and hypertension
Bleeding peptic ulcer
37
Causes dysphagia for liquids more than solids
Oesophageal dysmotility
38
Dysphagia, regurgitation, cough, halitosis
Pharyngeal pouch
39
Caseating granuloma in Crohn's or UC?
Crohn's
40
Caseating granuloma in Crohn's or UC?
Crohn's
41
A 36 year old man is seen at outpatients clinic with the complaint of altered bowel habit. He reveals a 3 month history of increased frequency of motions of up to 8 times a day with PR blood on occasion. On examination he is tender on the left iliac fossa. He was unable to tolerate a PR examination. Liver funcion test at his GP surgery revealed a raised alkaline phosphatase (ALP)
Ulcerative colitis
42
A 36 year old man is seen at outpatients clinic with the complaint of altered bowel habit. He reveals a 3 month history of increased frequency of motions of up to 8 times a day with PR blood on occasion. On examination he is tender on the left iliac fossa. He was unable to tolerate a PR examination. Liver funcion test at his GP surgery revealed a raised alkaline phosphatase (ALP)
Ulcerative colitis
43
Condition associated with primary sclerosing cholangitis?
Ulcerative colitis
44
Condition associated with primary sclerosing cholangitis?
Ulcerative colitis
45
Antimitochondrial antibody
PBC
46
Anti-smooth muscle antibody
Chronic active hepatitis | Primary sclerosing cholangitis
47
Anti-endomysial, gliadin, transglutamase
Coeliac disease
48
Anti-gastric parietal cell and anti-intrinsic factor
Pernicious anaemia
49
Anti-dsDNA
SLE
50
Anti-dsDNA
SLE
51
Gastric/duodenal ulcers and acid production
Gastric ulcers are due to lowered mucosal resistance Duodenal ulcers are associated with increased acid production
52
Which type of cancer increased risk in PSC?
Cholangiocarcinoma
53
Symptoms of PSC?
Deranged liver function tests, jaundice, itching, chronic fatigue (ERCP or MRCP may show intrahepatic biliary duct stricture and dilatation, often with extrahepatic duct involvement)
54
Who is commonly affected by autoimmune hepatitis?
Middle aged females
55
Ascending cholangitis triad
Jaundice Abdominal pain Fever
56
Symptoms of NASH?
Most are asymptomatic but some report feelings of tiredness or epigastric fullness

GI (11 decks)

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