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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
Q

What disease is a corrugated or feline looking oesophagus associated with?

A

Allergic oesophagitis

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26
Q

What is the treatment used for allergic oesophagitis?

A

Steroids

Chromoglycate

Montelukast

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27
Q

Is a squamous papilloma tumour of the oesophagus benign or malignant?

A

Benign

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28
Q

What are some examples of malignant tumours of the oesophagus?

A

Squamous cell carcinoma

Adenocarcinoma

29
Q

What is cimetidine?

A

H2 antagonist

30
Q

What are the ALARM Symptoms?

A 
Anaemia
Loss of weight
Anorexia
Recent onset/progressive
Melaena/haematemesis
Swallowing difficulty
31
Q

What is ranitidine?

A

H2 antagonist

32
Q

What is an EMR?

A

Endoscopic Mucosal Resection

33
Q

What is gastroparesis?

A

Delayed gastric emptying

No physical obstruction

34
Q

What are some of the common symptoms of gastric paresis?

A

Feeling full

Vomiting

Nausea

Weight loss

Upper abdominal pain

35
Q

What are some of the causes of gastric paresis?

A

Idiopathic

Diabetes

Cannabis

Medicaton e.g. opiates, anticholinergics

36
Q

What do you do for a patient that has gastroparesis?

A

Remove any drugs causing the problem

Liquid/sloppy diet

Eat little and often

Promotility agents

Gastric pacemaker

37
Q

Are polyps benign or cancerous?

A

Benign

38
Q

What is pernicious anaemia?

A

A type of vitamin B12 anaemia

39
Q

What is Menetrier’s disease?

A

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
Q

What mediators e.g. 5-HT do cells release in the lead up to vomiting?

A

Enterochromaffin

41
Q

What is retrograde?

A

Contractions from ileum to stomach

42
Q

What other symptoms accompany vomiting?

A

Profuse salivation

Sweating

Elevated heart rate

Nausea

43
Q

What are the consequences of severe vomiting?

A

Dehydration

Loss of gastric protons and chloride caused by METABOLIC ALKALOSIS

Hypokalaemia

Aspiration of vomitus

Mallory-weiss tear

44
Q

Where do H1 antagonists block H1 receptors?

A

Vestibular nuclei

Medulla

45
Q

Where is the vomiting centre?

A

Medulla

46
Q

What are prochlorperazine, droperidol, trifluoperazine, chlorpromazine, haloperidol and levomepromazine all examples of?

A

Dopamine antagonists

47
Q

How do dopamine antagonists work?

A

Block the chemoreceptor trigger zone

Prophylaxis

Taken during sedation

48
Q

What is metoclopramide?

A

Prokinetic drug

49
Q

What is domperidone?

A

Prokinetic

Does not cross the blood-brain barrier

50
Q

How do prokinetic drugs work?

A

Increase gastric peristalsis

Increase lower oesophageal sphincter tone

Block D2 receptors in CTZ (chemoreceptor trigger zone)

51
Q

What are granisetron, ondansetron and palonsetron all examples of?

A

5HT3-receptor antagonists

52
Q

When are 5HT3 receptor antagonists used?

A

Chemotherapy induced nausea

Radiation induced emesis

Post operative nausea and vomiting

53
Q

What is a frequent side effect of using 5HT3-receptor antagonists?

A

Headache

54
Q

What are promethazine, cyclizine and cinnarizine all examples of?

A

H1 antihistamines

55
Q

When are H1 antihistamines used?

A

Motion sickness

Morning sickness

Post-op nausea and vomiting

56
Q

What are hyosine and dicyclomine?

A

Anticholinergics

57
Q

What are the frequent side effects of anticholinergics?

A

Blurred vision

Urinary retention

Dry mouth

Sedation

58
Q

What is used to treat chemotherapy-induced nausea and vomiting?

A

Triple-drug regimen

5HT3-receptor antagonist

Dexamethasone

Aprepitant

59
Q

What is hyperemesis gravidarum?

A

Fluid and electrolyte disturbances or nutritional deficiency develops from intractable vomiting in pregnancy

60
Q

What is the treatment for hyperemesis gravidarum?

A

1st line - antihistamine such as promethazine or cyclizine

2nd line - prochlorperazine and metoclopramide

61
Q

What makes up the Rome III criteria for dyspepsia?

A

Epigastric pain or burning

Postprandial fullness

Early satiety

62
Q

Where is the foregut?

A

Cricopharyngeus to the ampulla of Vater

63
Q

What ways can H.pylori be diagnosed?

A

Urease breath test

Faecal antigen test

Serology (IgA antibodies) - not accurate with increasing patient age

64
Q

What colour of cannula do you use for emergency access to replace fluids?

A

Grey

65
Q

What drug can be used to stop bleeding from leaking varicose veins in the oesophagous?

A

Terlipressin

66
Q

What is terlipressin and what is it used for?

A

Vasopressin analogue

Splanchnic vasoconstrictor

Used to stop bleeding from leeking varicose veins in the oesophagus

67
Q

What is endoscopic variceal ligation (EVL, banding)?

A

When ulcers are banded to stop bleeding?

68
Q

What is scleroptherapy?

A

Usually used in varicose veins

Salt solution injected which causes the vein to stick together to itself

69
Q

What is a Sengstaken-Blakemore tube?

A

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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