Quesmed GI 2 Flashcards
Which anti-constipation agent is ideal for IBS?
Isphagala husk
What is used to monitor treatment response in hepatitis?
Viral load which is ideally undetectable after 12 weeks
What should be performed following H.pylori infection eradication therapy?
Urea breath test
This should be done at least 4 weeks after completing antibiotics
2 weeks after stopping PPIs
What is the escalated treatment for severe chronic disease?
Inflixmab for biological therapy with anti-tumour necrosis factor therapy
What gene is caused by alpha 1 antitrypsin?
PiZZ
What is the normal genotype for alpha 1 antripysin of the liver?
PiMM
What does the PiSS genotype indicate?
50% normal alpha 1 antitrypsin disease and rarely presents with disease in young, healthy
What is the risk of Crohn’s disease ?
Bile acid malabsorption due to removal of terminal ileum
What imaging is used to confirm toxic megacolon?
Abdominal X-ray
Erect chest X-ray for pneumoperitoneum
What is contraindicated for imaging toxic megacolon?
Barium enema
Colonoscopy
How does toxic megacolon present?
temperature >38 degrees, heart rate >120bpm, neutrophilic leucocytosis or anaemia, plus one of: dehydration, altered consciousness, electrolyte disturbance and hypotension
What is the management of toxic megacolon?
Nil by mouth
Nasogastric tube
Intravenous fluids
Corticosteroids
Antibiotics
Wha is a complication of typhoid fever?
Intestinal perforation
What is the indication of spontaneous bacterial peritonitis in the ascitic fluid?
High numbers of WBCs mainly (PMNs) or of the fluid contains more than 250/mm^3 of neutrophils.
What is the features of Intraductal-abdominal malignancy with ascites?
Raised lymphocytes in ascitic fluid
What consideration should be given for traumatic ascitic tap?
one neutrophil is subtracted for every 250 red cells to correct for the serum contamination
What is the initial treatment for alcohol withdrawal?
Lorazepam
What is the chronic pharmacological management of alcohol?
Chlordiazepoxide
What is first line for primary biliary cholangitis?
Ursodeoxycholic acid
With cholestyramine for pruritus.
What organism causes GUillan-Barre syndrome?
Campylobacter jejuni
-> immune mediated demyelination of peripheral of the four limbs
What is considered a severe flare of UC?
6 or more stools a day and
Fever over 37.8 degrees
Over 90bpm
Anaemia
-> There is risk of VTE so prophylaxis is required with LMWH
What is the management of severe flare of UC?
IV fluids
IV hydrocortisone
Prophylactic LMWH
What aggravates duodenal ulcers?
Bisphosphonates
Immunosuppressive agents
Potassium chloride
SSRIs
What is the protocol for PPI therapy starting?
Repeat endoscopy after 6-8 weeks
What does dyspepsia with normal endoscopy and no H.pylori indicate?
Functional dyspepsia
Wbat are the symptoms of vitamin A deficiency?
Dry rough skin
White spots on conjuctiva called Bitot’s spots
What does Sjögren’s syndrome increase the risk of?
Anti-mitochondrial antibodies
What is the cause of CA125?
IBS
What is the time limit for investigating SBP?
Ascitic tap within 8 hours of clinical suspicion
What is indomethacin?
NSAID associated with peptic ulcer disease
What causes urobilinogen in urine?
Hepatic cause of jaundice
What causes jaundice in the absence of urobilinogen in urine?
Obstructive jaundice like pancreatic adenocarcinoma
What causes normal ALP and bilirubin but severely raised ALT?
Ischaemic hepatitis
What is the effect of giardiasis on the small intestine?
Causes malabsorption, especially of vitamin A, D, E, K and B12 and leads to weight loss
What modlaity is used to re-test for H.pylroi?
Carbon-13 urea breath test
What is the pharmacological treatment of IBS?
Mebeverine, an antispasmodic medication
What medication commonly causes dyspepsia?
NSAIDs
Bisphosphonates
What extra0intsitnal manifestation of IBD occurs even in remission?
Primary sclerosis in cholangitis
What is a complication of C.diff infection?
Toxic megacolon
What does the entire large bowel being dilated indicate?
Toxic megacolon
What does proximal dilation and distal restriction indicate?
Mechanical obstruction
What is assessed in the stool of a patient with IBS?
FAECAL CALPROTECTIN
How is anterior uveitis managed?
Cycloplegic mydriasis drops
What is given for septic C.diff?
IV metronidazole
Oral vancomycin
What antiemetic should be avoided in bowel obstruction?
Metoclopramide
What causes rice water stool, bloating and flatulence?
Giardiasis which has an incubation period of 1-3 weeks
What should be co-prescribed with patients starting opiates?
Senna
What is used to stage Crohn’s disease?
MRI of bowel
What causes fatigue, dry skin and itching with raised ALP?
PRIMARY biliary cholangitis associated with autoimmune conditions
What is given to reduce cerebral oedema in hepatic encephalopathy?
IV mannitol
What is the reccomendations for confirmed h.pylri infection?
Full dose PPI
