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FINALS > GI > Flashcards

GI Flashcards

1
Q

Liver cirrhosis causes

A
  • Alcohol related liver disease
  • NAFLD
  • Hep B
  • Hep C
  • Autoimmine hep
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2
Q

Non-invasive liver screen

A
  • USS liver
  • Hep B+C
  • Autoantibodies
  • Immunoglobulins
  • Caeruloplasmin
  • Alpha 1 antitrypsin
  • Ferritin and transferrin
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3
Q

4 key features of decompensated liver disease

A
  • Ascites
  • Hepatic encephalopathy
  • Oesophageal varices bleeding
  • Jaundice
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4
Q

what causes ascites

A
  • Fluid in peritoneal cavity
  • Increased pressure in portal system causes fluid to leak out of capillaries
  • Drop in circulating volume causes reduced BP in kidneys
  • Renin released therefore increased aldosterone = reabsorption of fluid and sodium in kidneys
  • cirrhosis = most common cause
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5
Q

2 types of ascites

A
  • transudate <25
  • exudate = more protein >25
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6
Q

what causes transudative ascites

A
  • HF
  • malnutrition
  • ## portal HTN
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7
Q

what causes exudative ascites

A
  • malignancy
  • TB
  • pancreatic ascites
  • budd chiari
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8
Q

Mx ascites

A
  • low na diet
  • aldosterone antagonist = spiro
  • paracentesis (drain)
  • Abx proph = cipro or norfloxacin
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9
Q

Hepatic encephalopathy caused by

A
  • build up of neurotoxic substances that affect the brain e.g. ammonia
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10
Q

S+S hep enceph

A

Acutely
- reduced cosnciousness
- confusion
Chronically
- personality change

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11
Q

Mx hep enceph

A
  • lactulose
  • abx to reduce bacteria producing ammonia (rifaximin)
  • nutrition support
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12
Q

Metabolic functions of liver and what goes wrong

A
  • Gluconeogenesis (using lactate)
  • Glycogen metabolism
    Failure:
  • Hypoglycaemia
  • High lactate
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13
Q

Synthetic functions of liver and what goes wrong

A
  • Vit K dependent clotting factors
  • Albumin
  • TPO
    Failure:
  • increased PT/INR
  • Ascites
  • thrombocytopenia
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14
Q

Excretion/detoxification functions of liver and what goes wrong

A
  • toxins/drugs
  • ammonia
    Failure:
  • build up of liver excreted drugs
  • High ammonia –> hepatic encephalopathy
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15
Q

blood findings in decompensated cirrhosis

A

Raised:
- Bili
- ALT
- AST
- ALP
- low albumin
- High PT

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16
Q

1st line investigation for fibrosis in NAFLD

A
  • Enhanced liver fibrosis blood test
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17
Q

ELF resuts

A
  • 10.51 or more = advanced fibrosis
  • <10.51 unlikely advanced fibrosis
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18
Q

USS findings in cirrhosis

A
  • Nodularity
  • corkscrew hepatic arteries
  • enlarged portal vein with reduced flow
  • ascites
  • splenomegaly
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19
Q

5 factos in child pugh score

A
  • albumin
  • bilirubin
  • clotting (INR)
  • dilation (ascites)
  • encephalopahty
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20
Q

Mx cirrhosis

A
  • treat underlying
  • MELD score 6m to assess severity
  • monitor complications (USS and AF every 6m)
  • manage complications
  • transplant
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21
Q

4 features decompensated liver disease

A

ascites
hepatic encephalopathy
oesophageal varices bleeding
yellow
= consider transplantation when decompensated

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22
Q

prophylaxis of bleeding in stable oesophageal varices

A
  • non-selective BB = propranolol
  • ligation
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23
Q

Mx bleeding oesophagela varices

A
  • ABCDE
  • major haemorrhage protocol
  • coagulopathy treated woth FFP
  • vasopressin analogues = terlipressin
  • broad spectrum abx
  • urgent endoscopy with ligation
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24
Q

SBP S+S

A
  • fever
  • abdo pain
  • deranged bloods
  • ileus
  • hypotension
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25
Q

SBP common organisms

A
  • E coli
  • Klebsiella pneumoniae
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26
Q

SBP Ix

A

diagnostic aspiration = raised neutrophil count

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27
Q

Mx SBP

A
  • Culture ascitic fluid pre abx
  • IV broad spectrum abx
  • ceftriaxone or cefotaxime
  • IV human albumin
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28
Q

how many units per week

A

14

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29
Q

blood resuts in alchohol related liver disease

A
  • increased MCV
  • increased ALT and AST
  • AST:ALT >1.5
  • raised GGT
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30
Q

CAGE questions

A

Cut down
Annoyed
Guilty
Eye opener

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31
Q

time in withdrawal for hall, seizures and DT

A
  • 12-24 hrs = hallucinations
  • 24-48hrs = seizures
  • 24-72hrs delerium tremens
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32
Q

Mx withdrawal in hospital

A
  • chlordiazepoxide reducing regime
  • Pabrinex then thiamine
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33
Q

wernickes encephalopathy

A
  • confusion
  • oculomotor distirbance
  • ataxia
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34
Q

korsakoff sx

A
  • memory impairement = retrograde and anterograde
  • behaviour changes
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35
Q

Hep A - TTVT and sx

A
  • Type = RNA
  • Transmission = faeco-oral
  • Vaccine available
  • supportive Tx
  • Can cause cholestasis with pruritus,jaundice, dar wee and pale stool
  • Dx based on IgM
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36
Q

Hep B TTVT

A
  • Type = DNA
  • Transmission = blood/fluids
  • Vaccine available
  • Tx = supportive/antiviral
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37
Q

Hep C TTVT

A
  • Type = RNA
  • Transmit = blood/body fluids
  • No vaccine
  • Direct acting AV tx
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38
Q

Hep D TTVT

A
  • Type = RNA
  • Transmitted with Hep B
  • NO vaccine
  • Tx = pegylated interferon alpha
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39
Q

Hep E TTVT

A
  • Type = RNA
  • Transmit = faeco-oral
  • No vaccine
  • tx supportive
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40
Q

S+S hepatitis

A
  • abdo pain
  • fatigue
  • flu like
  • pruritus
  • N+V
  • Jaundice
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41
Q

LFTs in hepatitis

A
  • AST and ALT high
  • Less of a rise in ALP
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42
Q

HBsAg

A

active infection

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43
Q

HBeAg

A

high infectivity

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44
Q

HBcAB

A

past or current infection

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45
Q

HBsAB

A

vaccination or past/current infection

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46
Q

type 1 autoimmune hep

A
  • WOmen in late 40s/50s
  • Around or after menopause
  • fatigue, liver disease features
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47
Q

type 2 autoimmune hep

A
  • young girls
  • acute hep
  • high transaminases
  • jaundice
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48
Q

autoantibodies in type 1

A

ANA
Anti-actin
Anti SLA/LP

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49
Q

autoantibodies i tyoe 2

A

Anti LKM1
anti LC1

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50
Q

key histology findings in AH

A
  • Interface hepatitis
  • Plasma cell infiltration
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51
Q

Mx AH

A
  • high dose steroids
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52
Q

inheritance of haemochromatosis

A
  • autosomal recessive
  • affects HFE gene on csome 6
  • leads to iron overload
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53
Q

S+S haemochromatosis

A
  • chronic tiredness
  • joint pain
  • bronze skin
  • testicular atrophy
  • erectile dysfunction
  • amenorrhoea
  • cognitive
  • hepatomegaly
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54
Q

initial ix for HH

A

serum ferritin

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55
Q

other ix HH

A
  • transferrin saturation
  • genetic test
  • liver biopsy with perls stain
  • mri
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56
Q

mx HH

A
  • venesection
  • monitor ferritin
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57
Q

inheritance of wilsons

A

autosomal recessive
- wilson diesase protein on csome 13
- copper accumulation

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58
Q

S+S wilsons

A
  • teens
  • chronic hepatitis
  • tremor, dysarthria, dystonia
  • parkinsonism
  • deression
  • kayser-fleischer rings
  • haemolytic anaemia
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59
Q

Ix wilsons

A
  • serum caeruloplasmin low
  • 24hr urine copper assay
  • biopsy
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60
Q

mx wilsons

A
  • copper chelation with penicillamine or trientine
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61
Q

inheritance of alpha 1 antitrypsin

A

autosomal co-dominant
- csome 14

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62
Q

presentation of primary biliary cholangitis

A
  • white woman 40-60
  • fatigue
  • pruritus
  • GI sx
  • pale greasy stool
  • jaundice
  • dark urine
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63
Q

what is pbc

A

autoimmune damage to small bile ducts inside the liver

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64
Q

PBC S+S

A
  • Similar PSC
  • Raised cholesterol = xanthelasma
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65
Q

autoantibodies in PBC

A
  • AMA = key
  • ANA
    ALP also raised
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66
Q

Mx PBC

A
  • ursodeoxycholic acid
  • cholestyramine (maybe check)
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67
Q

what is primary sclerosing cholangitis

A
  • sclerosis and inflammation of biliary tree
  • associated with UC
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68
Q

primary sclerosing cholangitis S+S

A
  • RUQ pain
  • itching
  • fatigue
  • jaundice
  • hepato and splenomegaly
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69
Q

Ix and Mxfor PSC

A
  • MRCP
  • raised ALP first
  • bilirubin raised next
  • Mx = ERCP
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70
Q

what can psc cause

A
  • cholangiocarcinoma
  • cirrhosis
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71
Q

screening for Ca in cirrhosis

A
  • every 6 months
  • USS
  • alpha fetoprotein
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72
Q

S+S liver cancer

A
  • weight loss
  • abdo pain
  • anorexia
  • N+V
  • jaundice
  • Pruritus
  • mass on palp
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73
Q

key presenting feature in cholangiocarcinoma

A
  • obstructive jaundice = pale stool, dark wee, itching
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74
Q

tumour marker for cholangiocarcinoma

A
  • CA19-9
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75
Q

contraindication for liver transplant

A
  • significant co-morbidities
  • current illicit drug use
  • continuing alcohol misuse
  • untreated HIV
  • current or prev cncer
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76
Q

lining of stomach

A

columnar epithelial lining

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77
Q

red flag features in gord

A
  • dysphagia
  • > 55
  • weight loss
  • upper ando pain
  • reflux
  • tx resistant dyspepsia
  • N+V
  • mass
  • anaemia
  • high platelets
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78
Q

GORD patho

A
  • acid from stomach flows through lower oesophageal sphincter
  • irritates lining of oesophagus
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79
Q

oesophagus lining

A

squamoue epithelial lining

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80
Q

Ix GORD

A
  • endoscopy
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81
Q

Mx GORD

A
  • lifestyle changes
  • med review
  • antacids
  • PPI
  • Histamine H2 receptos antagonists
  • laparoscopic fundoplication
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82
Q

H pylori type of bacteria

A

gram negative aerobic bacteria
- produces ammonium hydroxide

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83
Q

h pylori ix

A
  • stool antigen
  • urea breath test
  • antibody test
  • rapid urease test
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84
Q

triple therapy for h pylori

A
  • PPI = omeprazole
  • amoxicillin
  • clarithromycin
    7 days
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85
Q

barrets oesophagus

A
  • lower oesophageal epithelium changes from squamous to columnar epithelium
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86
Q

tx barrets

A
  • endoscopic monitoring
  • PPI
  • endoscopic ablation
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87
Q

RF peptic ulcer

A
  • NSAIDs
  • H pylori
  • increased stomach acid
88
Q

RF duodenal ulcer

A
  • HP
  • Steroids
  • SSRI
  • Smoking
89
Q

RF gastric ulcer

A
  • NSAIDs
  • HP
  • Smoking
  • Stress
90
Q

presentation peptic ulcer

A
  • epigastric discomfort
  • N+V
  • dyspepsia
  • duodenal = pain improves on eating
  • gastric = painful to eat = increase acid splash up
91
Q

px upper gi bleed

A
  • haematemesis
  • coffee ground vomit
  • melaena
  • haemodynamic instability
92
Q

mx upper gi bleed

A

ABATED
- A-E
- Bloods
- Access
- Transfusions
- Endocsopy in 24hrs
- Drugs = stop offending
surgery = clips, thermal coagulation, ligation

93
Q

Crohns features

A
  • No blood or mucus
  • Entire GI tract affected
  • Skip lesions
  • Transmural inflammation
  • smoking is a RF
  • strictures and fistulas
  • non caseating granulomas
94
Q

UC features

A
  • Continuous inflammation
  • limited to colon and rectum
  • only superficial mucosa affected
  • Smoking protective
  • Excrete blood and mucus
  • PSC
95
Q

UC S+S

A
  • gradual onset diarrhoea
  • crampy pains
  • bowel frequency related to severity
  • systemic symptoms in attacks
96
Q

Ix UC

A
  • stool to exclude infection
  • FBC
  • pANCA may be +ve
  • colonoscopy biopsy gold standard
  • faecal calprotectin
97
Q

UC Mx

A

Mild-mod
- aminosalicylate (oral or rectal e.g. mesalazine)
- 2nd line corticosteroids
Severe
- IV steroids

98
Q

UC maintaining remission

A
  • 1st line oral or rectal mesalazine
  • azathioprine
  • mercaptopurine
99
Q

UC complications

A

Colon = blood loss, toxic dilatation, colorectal cancer
Joints = ankylosing spondylitis, arthritis
Eyes = iritis, uveitis, episcleritis
Skin = EN
Liver = fatty change, chronic pericholangitis, sclerosing cholangitis

100
Q

S+S crohns

A
  • ulcers
  • RIF mass
  • perianal abscess, fistulae, tags
  • diarrhoea, abdo pain, weight loss
101
Q

Ix crohns

A
  • pANCA -ve
  • colonoscopy biopsy
  • faecal calprotectin
102
Q

UC surgery

A
  • removing large bowel and rectum
  • permanant ileostomy or J pouch
103
Q

Mx Crohns

A

Induce remission
- steroids
maintaining remission
- Azathioprine or mercaptopurine

104
Q

crohns surgery

A
  • resecting distal ileum
  • treat stricutres and fistulas
105
Q

key features IBS

A
  • Intestinal discomfort
  • Bowel habit abnormalities
  • stool abnormalities
106
Q

NICEIBS Dx

A
  • Exclude DD
  • at least 6m pain or discomfort with 1 of:
    . Relief on BO
    . Bowel habit abnormalities
    . Stool abnormalities
  • And 2 of
    . Straining, incomplete emptying or urgency
    . Bloating
    . Worse after eating
    . Mucus
107
Q

IBS1st line emds

A
  • Loperamide for diarrhoe
  • Bulk forming laxatives if const
  • Antispasmodics - mebeverine
108
Q

3 antibodies relating to coeliacs

A
  • Anti -TTG
  • Anti EMA
  • Anti DGP
109
Q

coeliac affect on villi

A
  • villous atrophy
  • crypt hypertrophy
110
Q

S+S coeliac

A
  • fail to thrive
  • diarrhoea
  • bloat
  • fatigue
  • weight loss
  • ulcers
  • dermatic herpetiformis
  • anaemia
111
Q

Dx coeliac

A
  • Total IgA levels
  • Anti TTG
  • ENdoscopy and jejunal biopsy = crypt hyperplasia and villous atrophy
112
Q

signs of peritonitis

A
  • guarding
  • rigidity
  • rebound tenderness
  • coughing test
  • percussion tenderness
113
Q

S+S appendicitis

A
  • central to RIF pain
  • N+V
  • Low grade fever
  • Rovsings
  • Guarding
  • Rebound tenderness
114
Q

where is mcburneys point

A
  • 1/3 of the distance from ASIS to umbilicus
115
Q

Dx appendicitis

A
  • Clinical
  • CT
116
Q

causes of bowel obstruction

A
  • adhesions (small bowel)
  • hernias (small bowel)
  • malignancy (large bowel)
117
Q

S+S pbstruction

A
  • \Vomiting = green bilious
  • abdo distension
  • diffuse pain
  • absolute constipation and lack of flatulence
  • tinkilng bowel sounds
118
Q

initial mx obstruction

A

-A-E
- bloods
- drip and suck = NBM, IV fluids, NG tube with free drainage
- AXR
- Contrast CT
- surgery

119
Q

key to look out for in obstruction

A
  • electrolyte imbalance
  • metabolic alkolosis
  • bowel ischameia
120
Q

causes of ileus

A
  • injury
  • surgery
  • inflammation or infection
  • electrolyte imblance
121
Q

S+S ileus

A
  • vomiting green
  • distension and pain
  • absent boel sounds
    treat underlying cause
122
Q

volvulus definition

A
  • bowel twists around itself and the mesentery it is attached to = closed loop obstruction
123
Q

sigmoid volvulus

A
  • older pt
  • cause = chronic constipation = overloaded with faeces = sinks
124
Q

RF volvulus

A
  • neuropsychiatric disorders
  • chronic constipation
  • high fibre
  • pregnancy
  • adhesions
125
Q

Ix volvulus

A
  • AXR = coffee bean sign in sigmoid volvulus
  • Contrast CT
126
Q

Mx volvulus

A
  • same as bowel obstruciton
  • endoscopic decompression
  • surgery
127
Q

3 complications hernias

A
  • incarceration = ireducible
  • obstruction
  • strangulation
128
Q

Dx SBP

A
  • Paracentesis = neutrophil count >250
129
Q

SBP prophylaxis

A
  • Give iv fluid protein <15
  • Ciprofloxacin
130
Q

what is an indirect inguinal hernia

A
  • Bowel herniates through inguinal canal
  • When reduced and pressure applied to deep inguinal ring hernia will remain reduced
131
Q

what is a direct inguinal hernia

A
  • Weakness in abdominal wall at Hesselbach’s triangle = protrudes through abdo wall
  • pressure of inguinal ring will not stop herniation
132
Q

Hesselbach’s triangle boundaries

A

RIP
- Rectus abdominis muscle
- Inferior epigastric vessels
- Pouparts ligament

133
Q

Boundaries of femoral canal

A
  • Femoral vein
  • Lacunar ligament
  • Inguinal ligament
  • Pectineal ligament
134
Q

4 types of hiatus hernia

A

1 = sliding
2 = rolling
3 = combo
4 = large opening with an additional abdoman organs entering

135
Q

what is a HH

A

herniation of stomach up through diaphraghm

136
Q

classification of haemorrhoids

A

1st = no prolapse
2nd = prolapse when straining, return relax
3rd = prolapse, don’t return relax, push back
4 = permanent prolapse

137
Q

Mx haemorrhoids

A
  • Topical = anusol, HC, germoloids
  • Fibre, fluids, laxatives
  • rubber band
  • surgery
138
Q

what is diverticulosis

A
  • presence of diverticula without inflammation or infection
139
Q

what is diverticulosis and itis

A
  • symptoms experienced
  • itis = inflammation and infection
140
Q

patho of diverticulosis

A
  • Increased pressure causes gap to form in circular muscle = mucosa herniates
141
Q

RF diverticulosis

A
  • age
  • low fibre
  • obesity
  • NSAIDs
142
Q

Dx and mx diverticulosis

A
  • Colonoscopy
  • CT
  • bulk forming laxatives = avoid stimulant
143
Q

S+S acute diverticulitis

A
  • Pain in LIF
  • fever
  • diarrhoea
  • N+V
  • rectal bleed
  • Abdo mass
  • Raised inflam
144
Q

Diverticulitis mx in GP

A
  • oral co-amox 5 days
  • analgesia
  • clear liquids
  • 2 day follow up
145
Q

mesenteric ischaemia

A
  • lack of blood flow through mesenteric vessels
146
Q

3 main branches of abdominal aorta

A
  • Coeliac artery = foregut
  • SMA = midgut
  • IMA = hindgut
147
Q

triad of mesenteric ischaemia

A
  • colicky central abdo pain after eating
  • weight loss
  • abdominal bruit
148
Q

Dx and mx mesenteric ischaemia

A
  • CT angiography
  • modifiable RF
  • secondary prevention = statin, aps
  • revascularisation
149
Q

key RF of acute mesenteric ischaemia

A
  • AF
150
Q

Ix for acute MI

A
  • contrast CT
  • Met acidosis and raised lactate
  • Surgery
151
Q

RF bowel cancer

A
  • FHx
  • FAP
  • HNPCC
  • IBD
  • age, diet etc.
152
Q

inheritance of FAP

A
  • autosomal dominant
  • lafunctioning of tumour suppressor genes
153
Q

RF bowel cancer

A
  • CIBH
  • weight loss
  • Rectal bleeding
  • Abdo pain
  • ID anaemia
  • Mass
154
Q

2ww criteria bowel ca

A
  • > 40 with pain and weight loss
  • > 50 with unexplained bleeding
  • > 60 with CIBH or IDA
155
Q

when to use FIT test in GP

A
  • > 50 with unexplained weight loss and no other sx
  • <60 with CIBH
156
Q

age screening

A

60-74

157
Q

Ix bowel ca

A
  • colonoscopy
  • sigmoidoscopy
  • CT colonography and staging scan
  • CEA
158
Q

1st line ix for gallstones

A
  • USS
  • then MRCP
159
Q

treatemnt gallstones

A

ERCP
cholecystectomy

160
Q

cholecystitis patho

A
  • gallstone stuck in cystic duct
161
Q

S+S cholecystitis

A
  • RUQ and shoulder pain
  • Fever
  • N+V
  • murphys
162
Q

Ix and Mx cholecystitis

A
  • USS
  • MRCP
    Mx = same as stones
  • Cholecystectomy within 1 week
163
Q

2 main causes of cholangitis

A
  • obstruction in bile duct stopping flow
  • infection during ERCP
164
Q

Most common organisms for cholangitis

A
  • E coli
  • Klebsiella
  • Enterococcus
165
Q

S+S cholangitis

A
  • RUQ
  • Fever
  • Jaundice
166
Q

Mx cholangitis

A

ERCP

167
Q

RF for cholangiocarcinoma

A
  • Primary sclerosing cholangitis
  • Liver flukes
168
Q

S+S cholangiocarcinoma

A
  • Obstructive jaundice = pale stool, dark urine, itching
  • weight loss
  • RUQ
  • palpable gallbladder
169
Q

tumour marker raised in cholangiocarcinoma

A

CA 19-9

170
Q

key presenting feature pancreatic cacner

A
  • painless obstructive jaundice
    = yellow skin, dark urine, pale stools, itch
171
Q

NICE referral for pancreatic ca

A
  • 2WW = >40 and jaundice
  • > 60 with weight loss and another sx = ct abdo
172
Q

3 main causes pancreatitis

A
  • Gallstones
  • Alcohol
  • ERCP
173
Q

S+S pancreatitis

A
  • Epigastric pain
  • Radiates to back
  • Vomiting
  • Tender
  • Unwell
174
Q

Ix pancreatitis

A

full bloods
- amylase
- lipase
- abg
- erect CXR to exclude gastrodueodenal perforation
- contrast CT post 72 hrs for prognosis

175
Q

Glasgow score criteria

A

PaO2 <8
Age >55
Neurophils >15
Calcium <2
Urea >16
Enzymes AST.ALT >200
Albumin <32
Sugar >10

176
Q

score results

A

0-1 = mild
2 - mod
3 = severe

177
Q

Mx acute pancreatitis

A
  • A-E
  • treat cause
  • Abx
178
Q

Courvoisiers sign

A
  • Painless enlarged gallbladder and mild jaundice = pancreatic cancer likely
179
Q

What drug can cauae cholestasis

A

Co-amoxiclav

180
Q

what does a right hemicolectomy remove

A
  • caecum
  • ascending colon
  • proximal transvere colon
181
Q

what does a left hemicolectomy remove

A

distal transverse and descending colon

182
Q

high anterior resection removes

A

sigmoid colon

183
Q

low anterior resection removes

A

sigmoid colon and upper rectum

184
Q

abdomino-perineal resection removes

A

rectum and anus (permament colostomy)

185
Q

Hartmanns procedure

A
  • rectosigmoid colon
  • colostomy created
186
Q

mx in acute alcoholic hepatitis

A
  • glucocorticoids = prednisolone
  • pentoxyphylline
187
Q

isolation time in c diff

A

48 hours

188
Q

site most commonly affected in uc

A

rectum

189
Q

what is haemachromatosis

A
  • iron overload
  • autosomal recessive
190
Q

S+S haemachromatosis

A
  • chronic tiredness
  • joint pain
  • pigmentation
  • erectile dysfunction
  • amenorrhoea
  • bronze skin
  • cognitive
  • hepatomegaly
191
Q

blood tests haemachromatosis and ix

A
  • high ferritin
  • transferrin saturation high
  • genetic testing
  • MRI
  • used to biopsy with perls stain
192
Q

hyposplenism

A
  • less or no spleen action
193
Q

causes hyposplenism

A
  • coeliac
  • sickle cell
  • ibd
  • ald
194
Q

hyposplenism blood film

A

pitted erythrocytes and howell jolly bodies

195
Q
A
196
Q

paed jaundice <24hr after birth means

A

pathological reason = bad

197
Q

how long paed jauncidce ongoing before prolonged

A
  • term babies = >14d
  • > 21 in prem babies
198
Q

biggest cause in first 24 hrs

A
  • neonatal sepsis
  • haemolytic disease of newborn
  • abo incompatibility
199
Q

> 24 hour jaundice causes

A
  • breastmilk jaundice = suboptimal milk levels
  • physiological jaundice
  • infection
  • haemolysis
200
Q

prolonged baby jaundice causes

A
  • biliary atresia
  • high gi obstruction
  • hypothyroidism
201
Q

tx options neonatal jaundice

A
  • plot on gestation specific chart
  • phototherapy
  • exchange transfusion
202
Q

ix neonatal jaundice

A
  • direct coombes test
  • fbc and film
  • conj bili
  • blood type testing
  • cultures for infection
    thyroid
    g6pd
203
Q

artery supplying foregut

A

coeliac trunk

204
Q

artery supplying midgut

A

SMA

205
Q

artery supplying hindgut

A

IMA

206
Q

S+S colorectal cancer

A
  • Rectal bleeding
  • Weight loss
  • Abdo pain
  • IDA
  • Obstruction
207
Q

2ww in colorectal when

A
  • Abdo mass
  • CIBH
  • IDA
  • <40 unexplained weight loss
  • < 50 w rectal bleed + pain/wl
  • > 50 with any sx
208
Q

colon cancer mx stage 1-3

A
  • Surgical resection
  • Adjuvant chemo
209
Q

what surgery if tumour >8cm from anal canal

A

Anterior resection

210
Q

When is ALT released

A
  • Hepatocellular damage as found in hepatocytes
  • If increased = intrahepatic cause
211
Q

when is AST released

A
  • Intrahepatic injury
  • AST:ALT >2:1 = ALD
212
Q

when is ALP released

A
  • Obstructive picture
  • Found in bone, gut, placenta
213
Q

when is GGT released

A
  • GGT found in bile duct cells
  • Increased in biliary disease
214
Q

LFTs indicating liver synthetic function

A
  • PT
  • Albumin
  • Bilirubin
215
Q

RF for refeeding syndrome

A
  • BMI <16
  • Excessive exercise
  • rapid weight loss
  • dehydration or water loading
  • Fasting 5+ days
216
Q

Brief overview refeeding

A
  • Caused by sudden intro of glucose after starving
  • Glucose causes insulin release = pushes glucose into cells
  • Causes demand for P,K, Mg
  • Therefore hypop, hypok, hypomg
217
Q

transjugular intrahepatic portosystemic shunt connects what 2 vessels

A

hepatic vein and portal vein

FINALS (31 decks)

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