Prep 6 Flashcards
hyoceine
antimuscarinic (hydro is for nausea, but is antispasmotic for cramps)
prochlorperazine and metoclopramide
D2 antagonists
5ht antagonists
odansatron
cyclizine, promethazine
h2 antagonists
painless jaundice
pancreatic cancer (often at the head of the pancreas)
55 year old woman with known gallstones, presents with a 2 day history of jaundice, nausea and rigors. O/E she is pyrexial and is tender in the RUQ
ascending cholangitis (charcot triad - ruq pain, fever, jaundice)
grapefruit juice and statins
grapefruit is a cytochrome enzyme inhibitor (more statin in the blood can cause rhabdomyolysis and kidney damage)
plummer vinson
dysphagia and anaemia
dysphagia without pain
oesophageal web
gardia and amoeba
> 7 day incubation period
diarrhoea
stool microspoy
gardiasis treatment
metronidazole
courcoisiers law
non tender palpable gall bladder in presence of juandice is not likely to be due to gall stones
Is spironolactone hepatotoxic
no
undercooked poultry
salmonella
ill grandchild
rota virus most common cause of diarrhoea in <3yrs
bacillis cerus
rice
appendicitis diagnosis
clinical
if suspicious then surgery needed
cobble stone mucosa
crohns
murphys sign
cholecytisis (arrest of inspiration on palpation of RUQ)
UC treatment
mild to moderate mesalazine
severe IV steroids
Most common cause of travellers diarrhoea
ETEC
urea breath test
h pylorie
thumb printing at splenic flexure
ischaemic colitis
treatment of campylobacter and salmonella if comorbitity
ciproflaxacin
C diff infection
oral met (non-severe) oral vanc (severe)
Short bowel sydnrome
<200cm
Meckels diverticulum rule of 2
2% of population
2 feet from ileocelael valve
2 inches
Cheif cell produce
pepsinogen
how much water is reabosrbed in large and SI
10% in large
90% in small
treatment of ascites
spironolactone
dimeric antibodie ffound in secretions
IgA
what is zollinger ellison syndrome
high gastrin levels usually due gastrin secreting tumour of pancreas or duodenum (proximal wall common site)
what does psuedomembranous colitis look like and what can it casue
yellow white plaques following abx can lead to toxic megacolon
pseudopolyps
UC
diarrhoea in aids/hiv
crytosporidium
mouth ulcer with spidery web shite pattern
drug induced lichenoid plaque
apthous ulcer lesion
painful greyish ulcer with red halo
mouth cancer lesion
panless rolled ulcer
gastric resection and now unsteady on feet
b12 deficiency (loss of pareital IF) peripheral neuropathy
gastric resection and now unsteady on feet
b12 deficiency (loss of pareital IF) peripheral neuropathy
treatment of ascities
spironolactone
thumbprinting of the bowel on AXR
sign of large bowel wall thickening due to inflammation or infection (causes include - IBD, infection, ischaemia)
RUQ pain + elevated liver function test + fever
hepatitis
RUQ pain radiating to shoulder
acute cholecyctisis
Abdominal pain radiating to the back with a hx of gall stones
pancreatits
c.diff diagnosis
CDiff toxin in stool
where does diverticular disease commonly occur and why
between tinea coli where the vessels pierce the muscle to supply the mucosa (rectum lacks tinea so usually spared)
fat soluble vitamins
A D E K
what is given to prevent ecepalopathy in alcoholis
thiamine
difference between ureteric colic and biliary colic
ureteric: loin pain radiating to the groin
biliary: jaundice and RUQ
high alk phos is found calssically in what type of jaundice
post hepatic
keyser fleisher rings
wilsons
Investigation for competancy of arteries in legs
ABPI
dusky colon
venous stasis causes increased pressures in the intestinal walls (ischaemia)
why does antibiotic not help ulcer on foot
needs drainage
too painful to do PR exam
examine under anaesthesia
anal fissure
pain and bleeding
who is offered aaa screeening and what are the possible outcomes
men at 65
normal (<3cm) - discharged
<5.5: surveillance (3-4.5 annual, 4.5-4.5 3 monthly)
>5.5: surgery
colon screening
FOB
50-74 yrs every 2 yrs
FAP colonscopies every year and colon removal recommended by 25
lynch/hnpcc: start screening at 25 (or 5 years before age of affected relative) - colonoscopy every 2 yrs
strong fh (first degree relative): colonoscopy 35-45
investigating haemarrhoids
inspection
pr exam
rectoscopy
nutcfacker oesophagus
(peristalsis >180mmHg)
nitrates, nifidepine, sildenafil
Alcohol, gallstones PMH, and epigastric pain
pancreatitis
Woman bilateral lymphoedema, not hot/swollen, chest/rest/abdo exam all normal
pelvic uss
Retired chef for 40 years, leg lymphoedema, dark ankle discolourations
doppler USS
pulsatile mass not expansile in femoral area
femoral hernia (femoral aneurysm would be expansile)
Pancreatic Ca and jaundice investagtion
USS
