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Gastroenterology > Year 4 > Flashcards

Year 4 Flashcards

1
Q

Which structure is the boundary between upper and lower GI tract?

A

Ligament of Treitz

Found at duodenojejunal flexure.

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2
Q

What is ‘apple core’ sign?

A

Barium swallow result associated with oesophageal cancer.

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3
Q

What is the investigation of choice in suspected pancreatic cancer?

A

Abdominal CT

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4
Q

What are 3 secondary causes of hypogonadotropic hypogonadism?

A

Haemochromatosis
Sarcoidosis
Amyloidosis

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5
Q

Is IgG or IgM the long-term antibody?

A

IgG

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6
Q

What should be looked for in suspected alcoholic hepatitis?

A

AST:ALT ratio of 2:1.

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7
Q

Which gene is linked with familial adenomatous polyposis (FAP)?

A

APC gene

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8
Q

Which gene is linked with HNPCC?

A

MSH2/MLH1 gene

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9
Q

What should be considered in a new onset neurological and liver issues?

A

Wilson’s disease

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10
Q

What is the spectrum of disease associated with alcoholic liver injury?

A

Alcoholic fatty liver disease > Alcoholic hepatitis > Cirrhosis

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11
Q

Besides elevated AST:ALT ratio, what is another LFT marker that is characteristically raised in alcoholic liver disease?

A

Gamma-GT

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12
Q

What is cirrhosis?

A

The end result of disease where replacement of functional liver tissue with scarring.

It is irreversible.

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13
Q

When do symptoms of alcohol withdrawal begin to develop?

A

6 hours

Will have tremor, sweating, headache, cravings and anxiety.

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14
Q

After how many hours may seizures begin to develop in alcohol withdrawal?

A

After 24-48 hours

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15
Q

What is delirium tremens?

A

A medical emergency associated with alcohol withdrawal.

Causes severe symptoms of alcohol withdrawal.

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16
Q

What receptors are impacted by chronic alcohol intake?

A

GABA - stimulates these receptors, resulting in CNS depression.
Glutamate - inhibits the excitatory response from these receptors.

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17
Q

Which criteria is used to grade alcohol withdrawal?

A

CIWA-ar

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18
Q

How is alcohol withdrawal managed?

A

Chlordiazepoxide (a long-acting benzodiazepine) - to inhibit the excitatory response
IV pabrinex

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19
Q

Which vitamin is often found to be deficient?

A

B1/thiamine

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20
Q

What are 3 key features of Wernicke’s encephalopathy?

A

Confusion
Oculomotor disturbances
Ataxia

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21
Q

Which sequelae of alcohol withdrawal causes BOTH anterograde and retrograde amnesia, alongside behavioural changes?

A

Korsakoff’s syndrome

22
Q

What are the 4 most common cause of cirrhosis?

A

Alcohol-related liver disease
NAFLD
Hepatitis B
Hepatitis C

23
Q

How does portal hypertension cause cirrhosis?

A

Increases resistance in the vessels leading to the liver, resulting in portal hypertension.

24
Q

What is caput medusae?

A

Distension of the para-umbilical veins due to portal hypertension.

25
Q

Why is albumin low in cirrhosis?

A

Due to synthetic liver function being lost.

Will also have raised INR as liver can no longer produce clotting factors.

26
Q

Which score is used to assess cirrhosis severity?

A

Child-Pugh score

27
Q

What is the pathology behind NAFLD?

A

Excessive fat deposition within liver cells, impacting their function.

Often asymptomatic, although can develop into hepatitis and cirrhosis.

28
Q

What are the 4 stages of NAFLD progression?

A

NAFLD
NASH
Fibrosis
Cirrhosis

29
Q

What may be the first presentation of NAFLD in LFTs?

A

Raised ALT

30
Q

What imaging method is used to diagnose NAFLD?

A

USS

Cannot determine severity, rather only shows that disease is present.

31
Q

What is the gold standard diagnostic test in NAFLD?

A

Liver biopsy

32
Q

How is NAFLD managed?

A

Lifestyle advice largely.

Consider other options if it has reached fibrosis stage.

33
Q

What is the most common complication of cirrhosis?

A

Ascites

34
Q

What blood test can be used to check for the presence of liver fibrosis?

A

Enhanced liver fibrosis

35
Q

What is the primary risk factor for developing hepatocellular carcinoma?

A

Cirrhosis

36
Q

Should cirrhotic patients be screened for hepatocellular carcinoma?

A

Yes, carry out USS and check AFP levels every 6 months.

37
Q

What should always be considered if patients presents with painless jaundice?

A

Pancreatic cancer

May also be cholangiocarcinoma.

38
Q

Monitoring of haemochromatosis is carried out using which markers?

A

Ferritin
Transferrin saturation

39
Q

Why should intrahepatic cholestasis of pregnancy lead to IOL at 37 weeks gestation?

A

As risk of stillbirth increased.

40
Q

How should suspected perforation of diverticulitis be investigated?

A

Erect CXR

41
Q

Which antibodies are positive in primary biliary cholangitis?

A

AMA

42
Q

How should itch in PBC be managed?

A

Colestyramine

43
Q

What is primary biliary cholangitis?

A

A chronic autoimmune granulomatous inflammation resulting in cholestasis.

44
Q

What 3 components may develop in primary biliary cholangitis?

A

Cirrhosis
Fibrosis
Portal hypertension

45
Q

What is primary sclerosing cholangitis?

A

Progressive cholestasis with bile duct inflammation and strictures.

46
Q

Which condition is associated with primary sclerosing cholangitis?

A

Ulcerative colitis

47
Q

Which LFT marker is often raised in isolation in those with obstructive jaundice?

A

ALP

48
Q

Which gender suffers from PSC more commonly?

A

Males

49
Q

Which form of investigation is used to diagnose PSC?

A

MRCP

50
Q

How should PSC be treated?

A

No definitive treatment.

Use ERCP to ease strictures present - may need stents to keep it open therafter.

51
Q

What are the 4F’s of biliary colic?

A

Fat
Female
Fertile
Forty

52
Q
A

Gastroenterology (1 decks)

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