Random revision Flashcards
Achalasia - definition and pathogenesis
Loss of oesophageal peristalsis due to failure of relaxation of the lower oesophageal sphincter due to degeneration of the ganglionic nerve cells of the myenteric plexus
Achalasia - investigation findings and management
Coeliac disease - investigations and management
Bloods - remember to screen for deficiencies, so vitamins, calcium and phosphate, iron and folate, U&E and albumin
FBC would should low haemoglobin
Serology - anti-TTG IgA and esp IgG as IgA deficiency is common
Stool culture to exclude infection
Endoscopic biopsy - villous atrophy and crypt hyperplasia
Management - remove gluten + replace vitamins iron and folate, consider steroids of gluten free diet does not help
Key signs of coeliac disease
Dermatitis herpetiformis
Short stature/muscle wasting as a result of malnutrition
Colonic polyps - definition and how would you classify
Outpouching of normally flat mucosa
Split into neoplastic and non-neoplastic
Non-neoplastic can be due:
Inflammatory pseudopolyp - IBD
Harmatomatous polyp - syndromes
Hyperplastic polyps- post H pylori
Also: FAP due to APC gene
Colonic polyps - symptoms and management
Usually asymptomatic, but can present with PR bleeding if near rectum
Management - colonoscopic polypectomy
Which bile duct condition is associated with UC and what’s the definition + symptoms
Primary sclerosing cholangitis - fibrosis of the INTRahepatic and EXTRAhepatic bile ducts, hence why you get liver disease symptoms:
hepatosplenomegaly
spider naevi
jaundice
palmar erythema
ascites
Investigations for PSC and what do you see on imaging?
Raised ALP and GGT
Decreased albumin and raised bilirubin
pANCA
Raised IgM in adults, IgG in children
ERCP beading due to strictures
MCRP
Liver biopsy for staging of the disease
PSC management - acute, chronic
Acute management - fluids, Abx
Medical - Symptom control - Colestyramine for pruritis, calcium, fat soluble vitamins, ECRP
Liver transplant
Primary sclerosing cholangitis - complications
Recurrent cholangitis, biliary cirrhosis, cholangiocarcinoma, portal HTN
