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GI and hepatology > Upper GI > Flashcards

Upper GI Flashcards

1
Q

Give 7 indications for 2 week referral to oral surgery

A

Unexplained ulceration/mass >3weeks
Unexplained painful/swollen/bleeding patches
Unexplained unilateral head/neck pain >4weeks with earache but normal otoscopy
Unexplained recent neck lump or change in neck lump
Unexplained persistent sore throat
Signs/symptoms in oral cavity>6weeks not definitively benign

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2
Q

Give 5 signs of scurvy

A 
Gingivitis
Easy bruising
Curly hair
Eye bulging
Brown flaky skin
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3
Q

Give 4 causes of gingival hyperplasia

A

Phenytoin
Ciclosporin
Calcium channel blockers especially nifedipine
AML (myelomonocytic/monocytic types)

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4
Q

What is the most common cause of leukoplakia?

A

Smoking

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5
Q

What is the cause of erythroplakia?

A

Irritation

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6
Q

What is the management of oral candidiasis?

A

Nystatin

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7
Q

What antibodies are associated with limited systemic sclerosis?

A

Anti-centromere

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8
Q

What antibodies are associated with diffuse systemic sclerosis?

A

Anti-Scl70

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9
Q

Which type of oesophageal cancer is associated with smoking?

A

Squamous cell carcinoma

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10
Q

What is the management of Barrett’s oesophagus?

A

Endoscopy and biopsy every 3-5 years

High dose PPI therapy

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11
Q

What is the first line antibiotic in suspected variceal bleeding?

A

Ceftriaxone

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12
Q

What are the indications for fluconazole in suspected variceal bleeding?

A

If at risk of fungal sepsis e.g. jaundice or renal impairment

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13
Q

What does the Glasgow-Blatchford score take into account?

A

Blood urea, Hb, pulse, systolic BP, comorbidities (melaena, syncope, heart failure, hepatic disease)

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14
Q

What is the first line management of gastric varices?

A

Endoscopic injection of N-butyl-2-cyanoacrylate

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15
Q

Give 3 contraindications of TIPSS

A

Portal vein thrombosis
Severe systemic infection
Severe pulmonary hypertension

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16
Q

What is the definitive management of acute non-variceal upper GI bleeds (e.g. Mallory-Weiss tears, bleeding peptic ulcers)?

A

Endoscopic clipping with/without adrenaline, thermal coagulation + adrenaline or fibrin/thrombin + adrenaline

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17
Q

What is the key investigation for Boorhaeve syndrome?

A

CT chest with oral contrast

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18
Q

What is Mackler’s triad?

A

Vomiting
Chest pain
Subcutaneous emphysema

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19
Q

Give 6 side effects of PPIs

A 
Hyponatraemia
Hypomagnesaemia
Osteoporosis
Diarrhoea
Increased risk of C difficile infection
Microscopic colitis
20
Q

Give 2 indications for hiatus hernia repair

A

Severe disease refractory to medical management

Complications e.g. Barrett’s oesophagus

21
Q

What blood group is at increased risk of gastric cancer?

A

A

22
Q

What is Sister Mary Joseph’s node?

A

Painful palpable umbilical node due to metastatic abdominal or pelvic cancer

23
Q

How soon should PPIs be stopped before endoscopy?

A

2 weeks

24
Q

What type of stomach cancer has signet ring cells?

A

Gastric adenocarcinoma

25
Q

What is the management of T1A gastric cancers?

A

Endoscopic mucosal resection

26
Q

Give 7 types of drugs that increase risk of peptic ulcers

A 
NSAIDs
SSRIs
TCAs
Steroids
Bisphosphonates
Nitrates
Anticholinergics
27
Q

What are Cushing’s ulcers?

A

Peptic ulcers secondary to neurosurgery

28
Q

What are Curling’s ulcers?

A

Erosions secondary to hypovolaemic shock in burns

29
Q

What are the key investigations for Zollinger-Ellison syndrome?

A

Fasting gastrin level

Secretin stimulation test (causes paradoxical increase in gastrin)

30
Q

What are the components of triple therapy for H. pylori?

A

Lansoprazole, clarithromycin, amoxicillin

31
Q

Give 1 neurological complication of Campylobacter infection

A

Guillaine-Barre syndrome

32
Q

What is the management of Campylobacter infection?

A

Erythromycin/ciprofloxacin

33
Q

When does pyloric stenosis present?

A

2-8 weeks

34
Q

How does duodenal atresia present?

A

Vomiting straight after birth before feeding

35
Q

What condition is associated with duodenal atresia?

A

Down’s syndrome

36
Q

What is the first line antibiotic for cholecystitis?

A

IV co-amoxiclav

37
Q

What is the first line antibiotic for cholecystitis (allergic to penicillin)?

A

Ciprofloxacin

38
Q

What are the first and second most common causes of ascending cholangitis?

A

E. coli

Klebsiella

39
Q

What are the indications for gallbladder polyp removal?

A 
>1cm
PSC
Certain ethnic minorities
Adjacent wall thickening
Symptomatic
40
Q

Name 9 drugs that can cause pancreatitis

A 
Azathioprine
Mesalazine
Didanosine
Bendroflumethiazide
Furosemide
Mentamidine
Steroids
Valproate
Cytotoxics
41
Q

What are the 8 factors in the modified Glasgow score for pancreatitis?

A 
PaO2<8kPa
Age>55
WCC>15
Calcium<2mM
Urea>16mM
LDH>600/AST>200
Albumin<32g/l
Glucose>10mM
42
Q

How does a trypsin R122H mutation lead to chronic pancreatitis?

A

Cationic trypsin produced and prematurely activated

43
Q

How is faecal elastase altered in chronic pancreatitis?

A

Low

44
Q

What is the gold standard investigation for chronic pancreatitis?

A

CT with IV contrast

45
Q

What is the management of pancreatic pseudocysts?

A

Initially conservative

If non-resolved after 12 weeks, endoscopic or surgical cystogastrostomy or aspiration

GI and hepatology (1 decks)

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