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Gastroenterology > Random > Flashcards

Random Flashcards

1
Q

What is Meckel’s Diverticulum

A

a true congenital diverticulum
out-touching of the small bowel as an embryological remnant
can have gastric mucosa that produces acid like the stomach

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2
Q

What are some causes of vomiting?

A 
Gastroenteritis (Rotavirus, norovirus, E.coli, campylobacter)
Morning sickness
Abnormal blood pH- metabolic disturbance
Severe pain
Small bowel obstruction
Opioids
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3
Q

What symptom does salmonella normally cause?

A

Diarrhoea

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4
Q

What is achalasia?

A

The failure of the oesophageal peristalsis and relaxation of the lower oesophageal sphincter. This is due to degenerative loss of ganglia from Auerbach’s plexus.

In short the lower oesophageal sphincter is contracted and the oesophageal above is dilated

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5
Q

What is scurvy?

A

Scurvy is vit C deficiency. (Ascorbic acid)

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6
Q

what is clostridium difficile?

A

a gram postive spore forming anaerobe

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7
Q

what does C.diff release?

A

enterotoxins A and B

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8
Q

What are some risk factors for C.diff?

A 
abx e.g clindamycin, Cefs, augmentin, quinolones
increasing age
increased length of stay in hospital
contact with c.diff positive patient
PPIs
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9
Q

how does C.diff present?

A 
asymptomatic
mild diarrhoea 
colitis without pseudomembranes
pseudomemanous colitis 
fulminant colitis

NB it can present 2 months after stopping abx.

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10
Q

what is pseudomembranous colitis and how does it present?

A

swelling or inflammation of the large intestine (colon) due to an overgrowth of Clostridium difficile (C difficile) bacteria.
it presents with defer and dehydration, abdominal pain
diarrhoea (bloody diarrhoea and mucus on PR)
pseudomembranes on flexi sig

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11
Q

what are some complications of pseudomembranous colitis?

A

paralytic ileus
toxic megacolon–>perforation
multiorgan failure

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12
Q

what is the first line management for c.diff?

A

Stop offfending abx

give metronidazole 400mg TDS PO for 10-14 days

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13
Q

what is the second line treatment for C.diff or the first abx in severe c.dif?

A

Vancomycin 125mg QDS PO for 10-14days

you may add metronidazole in severe cases

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14
Q

what is the treatment for toxic megacolon?

A

urgent colectomy

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15
Q

what is dysentery?

A

bloody diarrhoea

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16
Q

what is bloody diarrhoea (dysentery) associated with?

A

shigella and e.coliO157

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17
Q

what is the usual cause of post BBQ diarrhoea?

A

campylobacter jejuni

18
Q

outbreaks of vomiting and diarrhoea in institutions usually due to what organisms?

A

small structured round virus e.g. norovirus

19
Q

what is a hiatus hernia?

A

when the upper part of the stomach moves through the diaphragm into the thorax

20
Q

what are the 2 main types of hiatus hernia?

A

sliding (80%)

paraoesophagheal or rolling (15%)

21
Q

which of the 2 types of hiatus hernia is associated with GORD?

A

sliding as the lower oesophageal sphincter moves up through the diaphragm.

22
Q

what investigations would reveal a hiatus hernia?

A

CXR- gas bubble and fluid level in chest

Barium swallow is often diagnostic

23
Q

what is Barrett’s oesophagus?

A

metaplastic change of the distal oesophageal mucosa secondary to prolonged acidic irritation

24
Q

what histological change occurs to the epithelium in Barrett’s oesophagus?

A

squamous epithelium to columnar epithelium (with goblet cells|)

25
Q

Does Barret’s oesophagus increase the risk of oesophageal cancer?

A

yes by 30-40 fold. it is a precursor lesion to adenocarcinoma

26
Q

what is the management of Barrett’s oesophagus?

A

periodic endoscopy with biopsy - surveillance.

27
Q

Which vitamin is teratogenic in high doses?

A

Vit A

28
Q

do SSRIs increase the risk of of duodenal ulcers?

A

yes

29
Q

What might decrease the accuracy of a urea breath test used in the diagnosis of H.pylori?

A

abx in the last 4 weeks, PPIs in last 2 weeks

30
Q

what is the best imaging to assess the mural invasion of oesophageal or gastric cancer?

A

Endoscopic USS

31
Q

what are 3 common cause of malabsorption in the UK?

A

Crohn’s, coeliacs disease and chronic pancreatitis

NB there are many other rare causes such as PBC, CF, post gastrectomy dumping etc

32
Q

Deficiency of which vitamin causes dry eyes and night blindness?

A

vit A

33
Q

Deficiency of which vitamin causes bone pain, proximal myopathy and osteomalacia?

A

Vit D

34
Q

Deficiency of which vitamin causes coagulopathy?

A

Vit K

35
Q

Deficiency of which vitamin causes diarrhoea, dermatitis, peripheral neuropathy and dementia?

A

Vit B

36
Q

Deficiency of which vitamin causes gingivitis, loose teeth, halitosis, corkscrew hair, bleeding into gums and joints?

A

Vit C (scurvy)

37
Q

which vitamins are the fat soluble vitamins?

A

ADEK

38
Q

Deficiency of which micronutrient causes pellagra?

A

Niacin/ nicotinic acid (B3)

39
Q

Why do patients with coeliac disease require regular immunisations?

A

functional hyposplenism

40
Q

which part of the colon is most affected by UC?

A

the rectum

Gastroenterology (10 decks)

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