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GI > Week 3 > Flashcards

Week 3 Flashcards

1
Q

Where is the sphincter of Oddi?

A

Where the bile duct joins the duodenum

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2
Q

What is an ERCP?

A

Endoscopic retrograde cholangiopancreatography

Investigation used to study the biliary tree and pancreas and possibly treat pathologies associated with it

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3
Q

What is Grey-Turner’s sign?

What is Cullen’s sign?

What are they suggestive of?

A

Right or left flank bruising

Bruising around the umbilicus

Acute pancreatitis

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4
Q

Which is thicker, jejunum or ileum?

A

Jejunum

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5
Q

What is palatinus?

A

A bony protrusion from the hard palate

Normal

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6
Q

What is torus mandibularis?

A

A bony growth in the mandible along the surface near the tongue

It’s normal

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7
Q

What are some of the mouth abnormalities that can present in a patient with Crohn’s disease?

A

Oral ulceration - common

Mucosal tags

Cobblestone mucosa

Swollen lips

Angular cheilitis

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8
Q

What is angular cheilitis?

A

Bleeding and cuts in the corners of the mouth

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9
Q

What is one of the side effects of using Nicorandil?

A

Oral ulceration

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10
Q

What are some of the oral manifestations of HIV/AIDS

A

Hairy leukoplakia

Kaposi’s sarcoma

Candidosis

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11
Q

What is primary sclerosing cholangitis?

A

Chronic disease that slowly damages the bile ducts

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12
Q

What is an endoscopic mucosal resection?

A

Raises the lesion on a bed of adrenaline/saline

Loop and convert into polyp

Snare

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13
Q

How often does beta oxidation happen for the breakdown of a C14 fatty acid?

A

Six times

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14
Q

What are the products of the breakdown of a C14 fatty acid?

A

7 acetyl-CoA. 6NADH +H, 6 FADH2

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15
Q

What is formed in the liver mitchondria under fasting conditions? (hypoglycaemia)

A

Ketone bodies

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16
Q

What is the donor molecule of carbon atoms to a growing fatty acid?

A

Malonyl-CoA

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17
Q

What is the rate limiting step in glycogen breakdown?

A

When glycogen is converted to glucose-1-phosphate by glycogen phosphorylase

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18
Q

What is glycogenin?

A

Protein that sits at the centre of a glycogen polymer

It has catalytic activity and can covalently bind up to four glucose molecules to itself

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19
Q

During the formation of the gut, which layer do the epithelium of mucosa and ducts and glands come form?

A

Endoderm

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20
Q

What does the visceral mesoderm give rise to?

A

Lamina propria

Muscularis mucosa and muscularis externa

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21
Q

What layer does the liver come from?

A

Endoderm

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22
Q

Which is more common, acute oesophagitis or chronic oesophagitis?

A

Chronic

e.g. candida infection

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23
Q

What is Barrett’s Oesophagus?

A

Replacement of stratified squamous epithelium by columnar epithelium

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24
Q

What white blood cell causes allergic oesophagitis?

A

Eosinophils

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25
What disease is a corrugated or feline looking oesophagus associated with?
Allergic oesophagitis
26
What is the treatment used for allergic oesophagitis?
Steroids Chromoglycate Montelukast
27
Is a squamous papilloma tumour of the oesophagus benign or malignant?
Benign
28
What are some examples of malignant tumours of the oesophagus?
Squamous cell carcinoma Adenocarcinoma
29
What is cimetidine?
H2 antagonist
30
What are the ALARM Symptoms?
``` Anaemia Loss of weight Anorexia Recent onset/progressive Melaena/haematemesis Swallowing difficulty ```
31
What is ranitidine?
H2 antagonist
32
What is an EMR?
Endoscopic Mucosal Resection
33
What is gastroparesis?
Delayed gastric emptying No physical obstruction
34
What are some of the common symptoms of gastric paresis?
Feeling full Vomiting Nausea Weight loss Upper abdominal pain
35
What are some of the causes of gastric paresis?
Idiopathic Diabetes Cannabis Medicaton e.g. opiates, anticholinergics
36
What do you do for a patient that has gastroparesis?
Remove any drugs causing the problem Liquid/sloppy diet Eat little and often Promotility agents Gastric pacemaker
37
Are polyps benign or cancerous?
Benign
38
What is pernicious anaemia?
A type of vitamin B12 anaemia
39
What is Menetrier's disease?
Rugae become enlarged because of an overgrowth of mucous cells in the stomach wall Decrease in the number of acid secreting cells Hypoproteinemic hypertrophic gastropathy
40
What mediators e.g. 5-HT do cells release in the lead up to vomiting?
Enterochromaffin
41
What is retrograde?
Contractions from ileum to stomach
42
What other symptoms accompany vomiting?
Profuse salivation Sweating Elevated heart rate Nausea
43
What are the consequences of severe vomiting?
Dehydration Loss of gastric protons and chloride caused by METABOLIC ALKALOSIS Hypokalaemia Aspiration of vomitus Mallory-weiss tear
44
Where do H1 antagonists block H1 receptors?
Vestibular nuclei Medulla
45
Where is the vomiting centre?
Medulla
46
What are prochlorperazine, droperidol, trifluoperazine, chlorpromazine, haloperidol and levomepromazine all examples of?
Dopamine antagonists
47
How do dopamine antagonists work?
Block the chemoreceptor trigger zone Prophylaxis Taken during sedation
48
What is metoclopramide?
Prokinetic drug
49
What is domperidone?
Prokinetic Does not cross the blood-brain barrier
50
How do prokinetic drugs work?
Increase gastric peristalsis Increase lower oesophageal sphincter tone Block D2 receptors in CTZ (chemoreceptor trigger zone)
51
What are granisetron, ondansetron and palonsetron all examples of?
5HT3-receptor antagonists
52
When are 5HT3 receptor antagonists used?
Chemotherapy induced nausea Radiation induced emesis Post operative nausea and vomiting
53
What is a frequent side effect of using 5HT3-receptor antagonists?
Headache
54
What are promethazine, cyclizine and cinnarizine all examples of?
H1 antihistamines
55
When are H1 antihistamines used?
Motion sickness Morning sickness Post-op nausea and vomiting
56
What are hyosine and dicyclomine?
Anticholinergics
57
What are the frequent side effects of anticholinergics?
Blurred vision Urinary retention Dry mouth Sedation
58
What is used to treat chemotherapy-induced nausea and vomiting?
Triple-drug regimen 5HT3-receptor antagonist Dexamethasone Aprepitant
59
What is hyperemesis gravidarum?
Fluid and electrolyte disturbances or nutritional deficiency develops from intractable vomiting in pregnancy
60
What is the treatment for hyperemesis gravidarum?
1st line - antihistamine such as promethazine or cyclizine 2nd line - prochlorperazine and metoclopramide
61
What makes up the Rome III criteria for dyspepsia?
Epigastric pain or burning Postprandial fullness Early satiety
62
Where is the foregut?
Cricopharyngeus to the ampulla of Vater
63
What ways can H.pylori be diagnosed?
Urease breath test Faecal antigen test Serology (IgA antibodies) - not accurate with increasing patient age
64
What colour of cannula do you use for emergency access to replace fluids?
Grey
65
What drug can be used to stop bleeding from leaking varicose veins in the oesophagous?
Terlipressin
66
What is terlipressin and what is it used for?
Vasopressin analogue Splanchnic vasoconstrictor Used to stop bleeding from leeking varicose veins in the oesophagus
67
What is endoscopic variceal ligation (EVL, banding)?
When ulcers are banded to stop bleeding?
68
What is scleroptherapy?
Usually used in varicose veins Salt solution injected which causes the vein to stick together to itself
69
What is a Sengstaken-Blakemore tube?
The tube with the balloon on the end that can be inserted into the oesophagus to stop more bleeding

GI (22 decks)

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