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points to learn Flashcards

1
Q

what does GORD usually present with

A

hiatus hernia

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2
Q

what is the GS for hernia

A

BS

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3
Q

what is achalasia

A

abnormal relaxation of LOS

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4
Q

what is oesophageal carcinoma associated with

A

plummer vinson syndrome

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5
Q

what are oesopahgeal varices caused by

A

portal hypertension causes dilated collateral veins at the site of portosystemic anatomoses

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6
Q

what is the most common cause for portal hypertension

A

cirrhosis

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7
Q

what is the treatmetn for oesophageal varices

A
  1. resus, antibiotics, terlipressin, early OGD + EVL
  2. bleed stops = propranolol and banding
  3. bleed continues = EVL or SB tube
  4. bleed continues = TIPSS
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8
Q

what is a gastric lymphoma

A

derived from MALT and associated with B cell lymphomea

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9
Q

what are the symptoms of gastruc lymphoma

A

stomach pain, ulcers, >60, hpylori

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10
Q

what does GIST look like on histology

A

spindle cells

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11
Q

most common cause of PUD

A

h pylori

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12
Q

h pylori tests

A

urease breath test, faecal antigen test, serology IgG

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13
Q

GS for gastroparesis

A

oesophageal manometry

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14
Q

intestial failiure 1 causes

A

obstructin, surgical resection, congenital, malabsorption

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15
Q

intestinal failure 2 causes

A

sepsis, abdo surgery, coeliac, crohns, malignancy,short bowel syndrome

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16
Q

presentation of intestinal failure 2

A

abdo fistulae

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17
Q

causes of intestinal failure 3

A

short bowel syndrome

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18
Q

symptoms ofIBS

A

bloating, urgency, tenesmus, mucus, worrsening after food

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19
Q

tests for IBS

A

lower GI endoscopy if <50

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20
Q

treatment for IBS

A 
stop opiates and analgesia
loperamide
laxaiev
mebervine - anti spasmodic
amitryptiline - anti depressant
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21
Q

genes for coeliac disease

A

HLA DQ2 and DQ8

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22
Q

causes of coeliac

A

childhood diabetes, herpetitis formis

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23
Q

what happens if coeliac patients stops responding to gluten free diet

A

t celll lymphoma

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24
Q

pathophysiolgy of coeliac

A

mediated by t cells wihch exist in IELs, IEL ediated change leads to increasing loss of enterocytes wihch line intestines

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25
Q

tests for coeliac

A

biopsy

IgA anti TTA

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26
Q

what is the cause of mesenteric ischaeima

A

embolus from AF blocking SMA

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27
Q

symtpoms of acute mesenteric ishccaeimi

A

gassless abdomen and cramping pain

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28
Q

tests of mesenteric ishcamei

A

metabolic acidosiss,

CXR = bowel wall thickening

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29
Q

complications of mesenetic ischamei

A

repurfusion injury - causes inflammation

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30
Q

treatmnet for mesenteric ischaemia

A

fluids, met, gent

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31
Q

chronic mesenteric ischaemic symptoms

A

colicky post prandial pain, upper abdo bruit

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32
Q

tests for mesenteric ischaemi

A

CT angiogram, laparotomy

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33
Q

what causes meckels diverticulum

A

vitello - intestinal duct incomplete regression

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34
Q

rules of 2 for meckels diverticulum

A

2% of pop
2 inch long
2 feet from ileocaecal valve
males, presents before 2 years old

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35
Q

features of crohns

A

increased goblet cells, crypt absesses

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36
Q

where does crohns present

A

any part of GI tract but commonly the terminal ileum and proximal colon

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37
Q

tests for crohns

A

barium follow thorugh - shows cobblestoning

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38
Q

test for meckels diverticulum

A

radionucleotide scan, laparotomy

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39
Q

where does UC affectt

A

rectum

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40
Q

features of UC

A

goblet cell depletion

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41
Q

complications of UC

A

toxic megacolon - treat with IV hydrocortisone, LMWH, fluids
inx = abdo xray
tx = emergency colectomy

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42
Q

treatment of crohns and UC

A
  1. 5SAS (masalazine) - only Uc
  2. corticosteroids - prednisolone
  3. immunosuppressents - azathioprine
  4. anti TNF therapy - infliximab
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43
Q

treatment for smalll bowel obstruction

A

supine abdo xray

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44
Q

what genes are colorectal cancer assoc with

A

HPNCC and FAP iwth APC mutation

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45
Q

symtpoms of left sided colorectal canecr

A

fresh rectal bleeding and obstrctun, tenesmus

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46
Q

sympotms of right sided colorecatl cancer

A

anaemia, abdo pain

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47
Q

diagnostic scoring for colorectal canecr

A 
DUKES
a - limited to mucosa
b - extends through muscularis mucosae
c - reginal lymph node involvement
d - distal mets
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48
Q

how to determine cause of jaundice

A

radiology

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49
Q

when does chronic liver disease occur

A

when hepatic stellate cells become activtaed and casue fibrosis

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50
Q

what is the path of NAFLD

A

steatosis - steatohepatitis - fibrosis - cirrhosis

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51
Q

inx for staeatosis

A

US

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52
Q

inx for NASH

A

liver biopsy

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53
Q

what destroys bile ducts in PBC

A

T cells

54
Q

gillberts syndrome

A

congenital, unconjugated bilirubiemia

55
Q

inx for PSC

A

ERCP

56
Q

markers for autoimmune hep

A

SMA and ANA, IgG

57
Q

treatment for autoimmune hep

A

corticosteroids (predisolone), azathioprine, useodeoxycholic acid

58
Q

haemochrmatosis

A

increased ceruloplasm, iron overload

59
Q

wilsons disease

A

decreased ceruloplasim, neurological and heaptic symptoms

60
Q

A1AT symptoms

A

lung emphysema, liver deposition of mutant protein, cell damage

61
Q

budd chiari

A

thrombosis of hepatic veins due to hypercoagulation

62
Q

fulmaninat hepatic failure

A

severe hepatic failure in which encelopathy develops in under 2 weeks in a patient with a previously normal liver ,causedby hep a

63
Q

physiology of cirrhosis

A

bands of fibrous tissue separating nodules of regenerative hepatocytes

64
Q

invetsigations of haemangioma

A

US - echogenic spot, well demarcated
CT - venous enhancement form periphery to centre
MRI - high intensity area

65
Q

what is the most common benign liver tumour

A

hemangioma

66
Q

what is focal nodular hyperplasia

A

benign nodule formation of normal liver tissue - hyperplastic response to abnormal arterial flow

67
Q

what are the investigations for focal nodular hyperplasia

A

US - nodule with varying echogenicity
CT - hyperplasic mass with central scar
MRI - iso or hypo intense
FNA - normal hepatocytes and kupffer cells with central core

68
Q

what is hepatic adenoma

A

benign

composed of normal hepatocytes, no portal tract, central veins or bile duct.

69
Q

who normally gets hepatic adenoma

A

females

70
Q

invetsigations of hepatic adenoma

A

US - fillling defect
CT - diffuse arterial enhancement
MRI - hypo or hyper intense lesion
FNA - may be needed

71
Q

treatment of hepatic adenoma

A

stop hormones and lose weight
males = surgical excision
females <5cm/ reducing in size = annual MRI
>5cm/increasing = surgical excisoin

72
Q

in hepatic adenoma, which gender has a bigger risk of malignant transformatoin

A

males

73
Q

what is a hyatid cyst caused by

A

ecginococcus antibodies from undercoooked meat from street vendors or sheep parasites

74
Q

treatment for hyatid cyst

A

conservative- open cystectomy
radical - pericystectomy
medical - albendazole

75
Q

what is polystatic liver disease

A

embryonic ductal plate malforamtion of the intrahepatic biliary tree, numerous cysts throught liver parenchymal

76
Q

treatment for polystatic liver disease

A

surgyer - patients with advanced liver failure

pharmacological - somatostain analouges for symptom relief and liver volume reduction

77
Q

what are the symptoms of liver abscess

A

leukocytosis, high fever, abdo pain, complex liver lesion

78
Q

what causes liver abscesses

A

abdominal or biliary infection, dental procedure

79
Q

invetsigation for liver abscess

A

echo

80
Q

treamtent for liver abscess

A

broad spec empirical treatment with antibiotics + aspiration or drainage

81
Q

what causes HCC

A

cirrhosis from hep b, c, alcohol, alfatoxin

82
Q

how to investigate HCC

A

AFP >100

83
Q

treatment for HCC

A

<5mc or less than 3 tumours which are less than 3cm = surgeyr liver transplant

84
Q

cholethiasis def

A

stone formation in the gall bladder

85
Q

what is cholecystitis

A

inflam of gallbladder, usually assoaciated with gallstone

86
Q

symptoms of cholethiasis

A

colicky pain (comes and goes), worse with fatty foods

87
Q

treatment of cholethiasis

A

elective cholecystectomy

88
Q

symptoms of cholecystitis

A

made worse by eating, murphys sign

89
Q

treatment of cholecystsitis

A

urgent cholecystectomy - ursodeoxycyclic aicd if unfit for surgery

90
Q

choledocolithiasis def

A

gallstone lodged in common bile duct

91
Q

treatment of choledocolithiasis

A

ERCP

92
Q

treatment for gallstone ileus

A

urgernt laparotomy

93
Q

what is biliary colic

A

when a gallstone temporarily blocks the cystic duct - constricts sphincter of oddi

94
Q

how to treat biliary collic

A

morphine .. buprenophrine, lose weight

95
Q

diagnostic score for pancreatitis

A

glasgow prognostic score “pacnreas” >3 = severe

96
Q

how to treat pancreatitis

A

fluids, correct elecrolytes and P2

97
Q

what organism infects pancreas

A

e coli

98
Q

treatment for pacnreatic adenocarcinom

A

inoperable - ERCP or PTC adn stent insertion

operable - laparoscopy and staging, ECRP stent

99
Q

complete rectal prolapse treatment

A

bulking agent and education of manual reduction, delormes proceure, perineal rectopexy

100
Q

incomplete rectal prolapse treatment

A

dietry advice and treatment of conspitaion (children) , treatment similar to haemorrhoids - sclerotiontherapy (adults)

101
Q

GI bleeding scorea

A

blatchford score and rockall score

102
Q

what causes an epigasic heria

A

weakness in linea alba- males

103
Q

what is paediatric inguiinal hernia

A

<1 year olds males, common in preterm of LBW infants, processes vaginalis - <1s operate within 24 hours

104
Q

femoral hernia def

A

females

bowel enters femora canal, mass in upper medial thigh or above inguinal ligmanet, flattens groin crease

105
Q

order of bundle in femoral hernia

A

NAV (Lateral to medial)

106
Q

where is the femoral hernia in relatin to public tubercle

A

inferior and lateral

107
Q

where is inguinal hernia in realtion to pubic tubercle

A

above and medial

108
Q

if you cough and hernia returns, what is it

A

direct

109
Q

how to treat campylobacter

A

azithromycin

110
Q

complication of ecoli 1057

A

HUS

111
Q

how to treat c diff

A

severe = vanco

non- severe = oral metro

112
Q

treatment and investiation of acute travellers diarrhoea

A

fluoroquinole single dose or azithroycin, stool culture

113
Q

how to treat enteric fevre

A

empirical treatment - ceftriaxone

114
Q

how to investigate amoebas

A

stoop microscopy

115
Q

how to treat and investigate giardiasis

A

metro , stool microscopy

116
Q

what oral ulcer presents with genital warts

A

bechets

117
Q

what is hairy leukoplakia

A

shaggy, white, side of tongue HIV+ patietns and EBV

118
Q

white patch you can rub off

A

candidias

119
Q

gingivitis

A

vit c def, CCBs

120
Q

bullk lax

A

ispagula husk, hyprophobic agetns eg polysaccharides, cellulose
used in mild/chronic diarrhoea assoc with diverticular disease or IBS

121
Q

osmotic lax

A

lactulose/ macrogols
osmotically activae agents eg sugar, alcohol
use in bowel prop and hepatic encelopathy
caution in heart failure

122
Q

stimulative laxative

A

eg semma, bisacodyl
increase elcetrolytes and thus water secretion from the colonic mucosa
use in constipate secondary to opioid use

123
Q

anti emetics that act on CTZ

A

dopamine antagonists eg procholorperazine and metochloperamide
5HT3 receptor antagonists eg ondansetron
canabinoids

124
Q

anti emetics that act on VN

A

H1 antihistmaies eg cyclizine

anticholinergics eg hyosine

125
Q

glycogenosis

A

glycogen synthesis from glucose

glycogeniin, aloha4/6 glycosidic bonds, UDP glucose, glycogen synthase

126
Q

glycogenolysis

A

breakdown of glycogen to form glucose
glycogen phosphorylase, glucose 6 phosphotase
occur sbetween meals to maintain BGL

127
Q

glycogenolysis

A

the synthesis of glucose wihtin the body from non carb subsrates eg lactate, amino acids and glycerol
oxaloacetate 4c, TCA cycle, liver
occurs during prolonged periods of starvation eg overnight

128
Q

gonnorhoea

A

direct contact of mucosal surfaces with infectious secreion
low abdo pain, diarrhoea, recatl bleeding, anal discharge
protoscopy - inflammed mucosa, purulent exudate

129
Q

chlmaydia

A

anal discomfort / itch

doxycyline

130
Q

syphilus

A

oral sec

ulcers in mouth, warrt like lesions

131
Q

HSV

A

ano-genital or oral - genital
perianl mucosa
pain, ulcers, painful defacation, bleeding, mucus

132
Q

HPV

A

anal warts

GI (8 decks)

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