Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

YEAR 2 GI > Week 5 > Flashcards

Week 5 Flashcards

1
Q

iron, fat, and monosaccharides is only absorbed where?

A

Duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which vitamins are ONLy absorbed in the jejunum?

A

Vitamin c and B6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Vitamin B12 is absorbed where?

A

Ileum
Same as bile acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where is magnesium absorbed?

A

Whole SB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Ileum is mainly water soluble vitamins absorbed, true or false

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cause of malnutrition in GI diseases?

A

Oesophageal structures/ malignancy
Gastric pathology- eg maybe stomach doesn’t empty?- malignancy/ gastroparesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Biggest cause of malabsorption in the biggest world?

A

Coeliac disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What’s happening in coeliac disease?

A

Trying to kill gliadin, but kills enterocytes instead ????

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Biggest sign of coeliac disease

A

Iron deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Complications of coeliac disease?

A

Refractory coeliac
Ulcerative jejunitis
Bone disease
Colon/ oesophagus/ adenoma lymphoma cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

4 infections related to coeliac disease?

A

Giardia
Tropical sprue
HIV
Whipples

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

4 treatments of IBD?

A

5ASA
Steroids
Biologics
Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pancreatic enzyme insufficiency affects which enzymes?

A

Protease
Lipase
Amylase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Diagnosis for pancreatic insufficiency?

A

Faecal elastase
Cross sectional imagez

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Could cystic fibrosis affect the pancreas?

A

Yes
Pancreatic insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Commonest reasons for surgery for small bowel disease?

A

Crohns/ ischaemia
Reducing length of SB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

For IBD why does malabsorption only occur in crohns Vs uc?

A

Because absorption happens in small bowel. Uc is only large bowel. However both result in diarrhoea because water absorption occurs in the large colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Diagnosis/ differential necessary for diagnosing between IBS Vs IBD?

A

For IBD need inflammatory markers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why would a fart relieve pain with bloating?

A

Because bloating stretches smooth muscle, fart stops distension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What imaging for gall stones?

A

Ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Definition of re-feeding syndrome?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Enteral Vs parental nutrition?

A

Parental - when gut is inaccessible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What’s a gastrostomy

A

Dk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Definition of intestinal failure?

A

State in which the absorptive function of the gut cannot meet the minimum needed to maintain macronutrients and or water and electrolytes necessary for organism survival

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How many types of intestinal failure is there?

A

3

Type 1) acute and short lasting
Type 2) acute but requiring nutritional support for weeks or months
Type 3) chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Drugs treating alimentary disease are mainly administered which way?

A

Orally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Parasympathetic Vs Sympa, mainly post or pre ganglionuc?

A

Para = very long pre
Sympa = mainly post

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which diseases need drugs that protect against acid damage to mucosa?

A

GORD, Barrett’s, peptic ulcer disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What do prostaglandins do

A

Inhibit acid, and increase mucus production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Which infection causes acid damage to mucous layer

A

H pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What pharmacological option for h pylori

A

Triple therapy (PPI and two antibacterial- amoxicillin and meth something)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

H2 receptor antagonist drugs do what

A

Inhibit activation of proton pump so decrease acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Biggest proton pump inhibitor?

A

Omeprazole - oral or IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

When are H2-RA and PPIs indicated?

A

GORD/peptic ulcer disease and h pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Adverse affects of drugs that raise pH/ lower gastric acid secretion, eg h2-RA and PPIs?

A

Vitamin b12 deficiency
More chance of infection eg C. difficile
Tumour?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What’s happening in vomiting?

A

Contraction and distal end, relaxation in proximal end

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Why nausea when dizzy?

A

Body thinks dizzy = poisoned. Poison often causes dizziness you see

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Is the cause of nausea known?

A

No
NB you can actually be nauseous without vomit and vice versa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What’s chronic functional nausea? What might it respond to?

A

Low dose antidepressants

No known cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Drugs that affect the motility of the GI tract?

A

Purgatives (accelerate passage of food)
Anti-diarrhoeal drugs that decelerate passage of food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Example of purgative?

A

Laxatives eg osmotic (poorly absorbed solutes- to encourage water to come in)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What’s a stimulant purgative?

A

Increase electrolyte secretion by the gut mucosa
Therefore increase water secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Side effect of stimulant purgative laxative (given as suppository)

A

Cramps

Very effective
Act on myenteric plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Drugs which directly affect drug motility?

A

Domperidone (D2 antagonist)
= lowers oesophageal sphincter pressure (GORD)- increases gastric emptying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Anti depressants could treat IBS?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Clinical management of inflammation of IBD?

A

Corticosteroids especially when acute
Given orally IV or rectallt

48
Q

Concerns of corticosteroid use in IBD

A

Osteoporosis and increased susceptibility to infection
also crises when you take drug away (look at this for more notes)

49
Q

Chronic treatment of IBD?

A

Aminosalicylates

50
Q

Drugs for GI system target what?

A

Gastric secretion
Vomiting and nausea
Gut motility and defecation
Formation and defecation of bile

51
Q

Anti muscarinics affect what?

A

Motility

52
Q

Sympathetic , which is mainly post-ganglionic- is it excitatory or is it inhibitory

A

Inhibitory

53
Q

Which cells in particular do H2-RAs and PPIs target?

A

Parietal cells
Because that’s where gastric acid production/secretion comes from

(Nb G cells are where gastrin comes from, that enzyme)

54
Q

Why do PPIs and H2-RAs cause a side effect of B12 deficiency?

A

Because they target parietal cells, that secrete acid. But they also secret intrinsic factor

55
Q

Treatment of diarrhoea?

A

Anti-infective agents
Anti-diarrhoeal drugs that decrease motility
Anti-spasmodic agents that decrease muscle tone

56
Q

The main agents for treatment of diarrhoea are?

A

Opioids
Main one is loperamide
Constipation is a problem with these

57
Q

How does the opiate loperamide work?

A

Opiate receptors decrease ACh release

58
Q

What do opioids do for smooth muscle contraction,
And
Anal sphincter tone

A

Reduces smooth muscle contraction
Increases anal sphincter tone

59
Q

Opioids inhibit ACh release. What does this do

A

Related to vagus nerve. It’s parasympathetic so ACh would normally increase gut motility

60
Q

Gall bladder pain can be referred where?

A

To the shoulders

61
Q

Diverticulitis results from what

A

Stagnation of faecal material

62
Q

L2,3,4 keeps…

A

Your bowels off the flood

63
Q

Pernicious anaemia and IBD?

A
64
Q

Gastric emptying is controlled by which nervous systems

A

Vagus and enteric nervous system

65
Q

State where each of the cells are produced?
Gastrin
CCK
Secretin
Motilin

A

Gastrin = G cells in the stomach
CCK = in duodenum
Secretin = duodenum
Motilin = intestine

66
Q

What does CCK do?

A

Delays gastric emptying?
Also it basically causes the gall bladder to contract

67
Q

Is a small bowel obstruction further up or down, if it’s a very high volume of vomit?

A

Further down. Might suggest its as far down as most of the duodenum.

68
Q

Green vomit meaning, related to obstruction

A

Green undigested bile typically comes from the upper duodenum (the first part of the small intestine). If a person vomits this substance, it may mean that there is an obstruction or other potential issue

69
Q

Out of:
Gastrin
HCL
Pepsin
Mucus
Secretin
CCK
Digestive enzymes

which come from where? (3)

A

Stomach =
gastrin (encourages HCL release)
HCL
Pepsin (protiens)
Mucus

Duodenum =
CCK
Secretin
(both inhibits gastrin and encourages release of digestive enzymes from pancreas)

Digestive enzymes = from pancreas

70
Q

Patient with history of recurrent pneumonia due to aspiration of food at night. What is this?

A

achalasia
relaxation of oesophageal sphincter, so oesophagus becomes dilated and filled with food over time.

71
Q

Why do we look for mouth ulcers in abdominal exam?

A

mouth ulcers occur in crohns and B12 deficiency

72
Q

Anemia affects the tongue how?

A

Affects the colour of the tongue

73
Q

What imaging for checking position of a nasogastric tube?

A

X-Ray

74
Q

When would an x ray be useful for a GI disease???

A

Exclusion of perforation, as you could see free gas in it

75
Q

X rays would be useful for exclusion of perforation, give some examples of what might be perforated?

A

Perforated duodenal ulcer, or perforated colonic diverticula

76
Q

Big three causes of bowel obstruction?

A

Adhesions (small bowel)
Hernias (small bowel)
Malignancy (large bowel)

Need to learn these without hesitation.

77
Q

Patient has an obstruction. You know the three biggest causes of obstruction. You find out part of the patient history is a previous abdominal surgery. What’s the most likely cause therefore?

A

Adhesion

78
Q

What are adhesions

A

Scar tissues that can bind abdominal content together

79
Q

What’s a closed loop obstruction? And therefore how might this lead to ischaemia and perforation?

A

Two points of obstruction.

Contents of middle section = don’t have an open end where they can drain and decompress- the closed-loop section will inevitably continue to expand, leading to:

ischaemia and perforation!!!!
Requires emergency surgery.

80
Q

Lack of flatulence, with absolute constipation- alongside green vomit and diffuse abdominal pain and distension?

A

Bowel obstruction

81
Q

When might NG tube be used for management of bowel obstruction?

A

Initially. With free drainage to allow stomach contents to freely drain and reduce the risk of vomiting and aspiration.

82
Q

Initial management of bowel obstruction ?

A

Nil by mouth

“Drip and suck”

83
Q

Why does iron deficiency anaemia and coeliac disease go together?

A

In celiac disease, due to the atrophy of the intestinal mucosa, there is a reduced intestinal absorption of iron and therefore reduced iron delivery to developing red cells.

84
Q

Peaks for diagnosing coeliac disease?

A

Infancy when first exposed to gluten
And then also
At age 40-50 years

Good to know this for thinking about diseases

85
Q

So investigations for coeliac disease- I know I’ll looks at bloods for anaemia. But most coeliacs are often positive in what?

A

HCL DQ8 - most coeliacs
But also DQ8

86
Q

Why does chronic inflammation occur in coeliac disease?

A

Basically gliadin isn’t broken down, and instead it goes through the withekium and causes an immune response. This immune response causes the chronic inflammation.

87
Q

What does the chronic inflammation in coeliac disease lead to?

A

Damages the epithelium and ultimately leads to malabsorption

88
Q

Could there be fistulas in crohns?

A

Yes

89
Q

Which IBD has inflammation that leads to non-caseating Granulomas?

A

Crohns

90
Q

A nasogastric tube would be used in obstructions. (Also for feeding and draining). What are the three biggest causes of obstructions?

A

Hernias
Malignancy
Adhesion

91
Q

Someone with a bowel obstruction, with PR bleeding. Knowing the three biggest causes of bowel obstruction, what is the likeliest cause?

A

Bowel cancer

92
Q

How do we check that a nasogastric tube has actually been inserted into the stomach?

A

A pH test

93
Q

A gas filled small bowel would show as what sign?

A

Abdominal distension

94
Q

Oesophageal cancer- what’s out imaging modality of choice?

A

Endoscopy to obtain biopsy

95
Q

Would you ever do a barium swallow study with x rays for study of small bowel? Give example.

A

Yes
Eg with crohns to visualise cobblestones.

96
Q

What imaging modality am I describing? Adding contrast to the biliary tree distally, using an endoscope, through the stomach into the duodenum.

A

ERCP
Endoscopic retrograde cholangio-pancreatograpgy

97
Q

When would you do ERCP for a patient with jaundice?

A

Imagine you think the reason is obstruction of the bile duct. We do the ERCP- contrast injected through into biliary tree, the x rays taken- and we can therefore see a dilated bike duct- confirms a big stone is blocking.

98
Q

What’s a PTC test?

A

Percutaneous transhepatic cholangiography
Long thin needle through skin into bile ducts. Inject contract. Look at pancreas, gallbladder and bile ducts (can also take biopsies)

99
Q

When would you have a PTC Vs an ERCP?

A

PTC if can’t have ERCP or if your ERCP didn’t work e.g. could t get biopsies or couldn’t unblock ducts

100
Q

ERCP is used for diagnosing and treating problems with the liver, gallbladder, bile ducts, and pancreas. What might it do to treat blockages in the bile ducts?

A

Remove stones
Bypass obstructions eg due to inflammation, tumour, infection

101
Q

Endoscopy Vs endoscopic ultrasound Vs ERCP??

A

Endoscopy = a thin, flexible tube with camera and light on the end

EUS = endoscopy with Ultrasound probe on the tube at the end to generate virtual image ( better than normal US cuz not from outside the body, but inside!)

ERCP = endoscopy with video camera, X-ray not ultrasound, and contrast

102
Q

Pain where would indicate specifically EUS image modality?

A

Pain in upper right quadrant e.g. clinician might think it’s gallstones

103
Q

If a tumour invaded the portal vein, can it be resected successfully?

A

No

104
Q

Why endoscopic ultrasound Vs normal ultrasound

A

Allows us to get closer to internal structures, which improves image resolution

105
Q

Why is CT good in an emergency situation?

A

Because it is very quick, and it’s accessible.

106
Q

CT’s are often used for acute emergency situations. When else might they be used?

A

Diagnosis and staging of cancer

107
Q

Put CO2 up the rectum, to distend colon. What do we do before and after

A

Bowel prep to clear the colon
Do a CT colonography

108
Q

Fresh blood in the stool or on wiping, with no pain during defecation, is classical for what

A

Haemorrhoids

109
Q

Fresh blood in the stool or on wiping with severe pain on defecation =

A

Anal fissure

110
Q

How does diverticulitis present?

A

Localised abdominal pain due to inflammation of the diverticula, along with fever nausea and decreased appetite

111
Q

Bloody diarrhoea and weight loss- is this is present in ulcerative colitis?

A

Yeah

112
Q

ALARMS symptoms of gastro oesophageal reflux disease ie GORD?

A

Anaemic, loss of weight, anorexia, recent onset of progressive symptoms, masses and malaena, swallowing difficulty

113
Q

Golden operative standard got gallstones?

A

Laparoscopic cholecystectomy

114
Q

Two day history of heartburn and epigastric pain, after excessive alcohol and smoking is what

A

GORD

115
Q

Immunosuppressives and they have a sore throat? = what (eg azathioprine)

A

Urgent full blood count

YEAR 2 GI (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions