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Quesmed GI 3 Flashcards

1
Q

How does respiratory distress appear on CXR?

A

Ground glass opacities

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2
Q

What is the first line for Wilson’s disease?

A

D-penicillamine
-> zinc salts are an additive

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3
Q

What is first line for C.diff?

A

Oral vancomycin

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4
Q

What is secondary prophylaxis for GI bleeding?

A

Propanolol

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5
Q

What is the guideline for monitoring NAFLD?

A

Every 6 months, they require ultrasound and alpha-fetoprotein testing to ensure they have not developed hepatocellular carcinoma

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6
Q

What is used to screen for Zollinger-Ellison syndrome?

A

Fasting serum gastrin level

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7
Q

What is first line to maintain remission in UC?

A

Mesasalazine

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8
Q
A
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9
Q

Which infections are commonly spread in hospitals?

A

Norovirus
C.diff

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10
Q

Which type of IBD causes loss of goblet cells?

A

Ulcerative colitis a there is also mucin depletion.

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11
Q

What is given for dermatitis herpetiform coeliac disease?

A

Dapsone, an antibiotic

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12
Q

How does co-amoxiclav affect the liver?D

A

Drug-induced cholestasis

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13
Q

What is the AST:ALT ratio in alcoholic hepatitis?

A

Greater than 2:1

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14
Q

What is the imaging for toxic megacolon?

A

Blood cultures
Plain abdominal radiographic to detect megacolon

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15
Q

What imaging should be avoided with toxic megacolon?

A

Sigmoidoscopy

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16
Q

What is the imaging for Crohn’s disease?

A

Colonoscopy
MRI of the small bowel

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17
Q

What is the pharmacological management of perianal disease?

A

Metronidazole

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18
Q

What is small-bowel follow through used for?

A

Small bowel disease, useful for Crohn’s

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19
Q

What is an indicator of prognosis with NAFLD?

A

Degree of hepatic fibrosis

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20
Q
A
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21
Q

What causes epigastric pain to improve after eating?

A

Duodenal improves after Dinner

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22
Q

What causes epigastric pain to worsen after eating?

A

Gastric ulcers

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23
Q

Which antidepressant increases the risk of peptic ulcer disease?

A

SSRIs

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24
Q

What is the guideline for testing for coeliac disease?

A

Type 1 diabetes
New diagnosis of any autoimmune thyroid condition

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25
How does ulcerative colitis affect LFTs?
Causes Chloestatic jaundice and can lead to primary sclerosing cholangitis
26
What causes difficulty swallowing liquids and solids and new ptosis?
Myasthenia gravis
27
What is the treatment for shigella?
IV fluids
28
What is the medication for treating shigella?
Ciprofloxacin which inhibitors bacterial DNA gyrase
29
What is a contraindication for liver biopsy?
INR over than 1.5
30
Which autoimmune liver disease causes raised IgM?
Primary biliary cholangitis
31
Which autoimmune liver disease causes raised IgG?
Autoimmune hepatitis
32
How does autoimmune hepatitis Type II present?
Elevated ALT Positive anti liver/L kidney micros oral antibodies
33
How does autoimmune hepatitis type I present?
ALP raised Anti-mitochondrial antibodies
34
What causes hepatomegaly, worsening ascites and hypercoagulability?
Budd-Chiari syndrome
35
What are the features of Zollinger-Ellison syndrome?
Elevated calcium Bitemporal hemianopia
36
What is a gastric complication of enteral feeding?
Diarrhoea, exacerbated by antibiotic use and changes in gut hormones
37
What is second stage for moderate UC unresponsive to aminosalciylates?
Must be at least 4 weeks -> add topical aminosalicylate
38
How does alcoholic hepatits present?
Jaundice Nausea Vomiting Malaise Fever
39
What are the biochemical findings for alcoholic hepatitis?
Elevated bilirubin AST:ALT ratio over 1.5amna n
40
Which patients are at risk for listeria monocytogenes?
Immunosuppressed patients Elderly Neonates Pregnant women
41
Which food is transmitted from dairy products like milk and meat?
Staphylococcus aureus
42
What causes mucosal laceration and neutrophil exudate?
Acute appendicitis
43
When is oral mesalazine given for UC flare?
Oral mesalazine
44
What is a common blood abnormality with typhoid fever?
Neutropenia
45
How does whiple’s disease affect the gut?
Causes malabsorption diarrhoea confirmed by biopsy showing periodic acid-stiff positive macrophages
46
What imaging is necessary for perianal abscess with potenital fistula in Crohn’s disease?
Urgent MRI pelvis
47
What is the Trulove and Witt’s criteria for severe UC flare?
6 or more bloody stools per day One marker of systemic upset like anaemia
48
What is the definitive treatment of primary sclerosing cholangitis?
Liver transplantation
49
Which condition in the gall bladder is UC associated with?
Primary sclerosing cholangitis
50
What is the first line treatment for peptic ulcer disease?
7 days of Omeprazole and amoxicillin an clarithromycin
51
How to acutely reverse action of warfarin in patients with major haemorrhage
Prothrombin complex concentrate containing Factor II, VII, IX and X
52
How to reverse warfarin effect if over 6 hours?
Vitamin K is second line and takes 6-8 hours to work effectively
53
How does Wilson’s disease appear on diagnostic findings?
Low serum caeruloplasmin Low total serum copper Higher free copper
54
What is the cause of palmar erythema?
Hyperthyroidism Chronic liver disease Pregnancy
55
Which level of albumin is considered low in Child Pugh score
26 or more
56
What is the diagnostic findings for haemochromatosis?
Raised ferritin Raised transferrin
57
58
What is used to prevent reccurence of encephalopathy?
Rifaximin, antibiotic which reduces intestinal production and absorption of ammonia
59
Which prophyalxis can be given for patients at high risk of spontaneous bacterial peritonitis?
Ciprofloxacin
60
According to UK NICE guidelines, when should patients with Barrett's oesophagus but no dysplasia should undergo endoscopic surveillance
Every 3-5 years
61
How is toxic megacolon managed?
Nasogastric decompressoin
62
What indicates neurological cause of dysphagia?
Difficulty making swallowing motion
63
What is first line for delirium tremens?
Oral lorazepam ideally unless patient is reluctant to accept oral medication
64
What does Plummer-Vinson syndrome increase the risk of?
Squamousest cell carcinoma
65
What is an indication for emergency panproctocolectomy?
failure to respond to IV steroids in 72 hours
66
What induces remission in Crohn’s?
IV corticosteroids
67
What maintains remission in moderate to severe Crohn’s?
Azathriopine
68
What maintains remission in mild Crohn’s?
Aminosalicylates
69
What should be avoided when prescribing azathriopine?
Allopurinol: Ordinarily, azathioprine is metabolised to 6-mercaptopurine, which is then metabolised to inactive waste products by xanthine oxidase. Allopurinol is a xanthine oxidase inhibitor, resulting in higher levels of 6-mercaptopurine, which has toxic effects on bone marrow, leading to leukopenia.
70
What causes Howell-Jolly bodies with diarrhoea and bloating?
Basophilic DNA stain of purple indicating hypospelnism with coeliac disease association
71
What causes whitening of the nails?
Hypoalbuminaemia

Year 3 (168 decks)

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