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gast path lumen Flashcards

1
Q

buzzword for allergic opesophagitis

A

feline or corrugated/spotty oesophagus

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2
Q

treatment of allergic oesophagitis

A

steroids/montelukast/ sodium cromoglicate

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3
Q

associations of squamous cell carcinoma of oesophagus (not barrets assoc)

A

vit A/ZINC deficiency
HPV
Smoking

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4
Q

what type of Ig is produced in H.pylori infection

A

IgA

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5
Q

treatment of barrets oesophagus

A

radiofrequency ablation - 1st line
resection if high grade

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6
Q

how does h.pylori survive in the gastric environment - whta mechanisms

A

chemotaxis away from low pH areas, using its flagella to burrow into the mucous lining to reach the epithelial cells underneath
secretes urease → urea converted to NH3 → alkalinization of acidic environment → increased bacterial survival

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7
Q

how does h.pylori cause disease

A

releases CagA toxin that disrupts the gastric mucosa

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8
Q

associations of h.pylori - what does it casue

A

peptic ulcer
gastric cancer
b cell MALT lymphoma
atrophic gastritis

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9
Q

what % of duodenal ulcers does h.pylori cause

A

95%

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10
Q

managemnet of h.pylori infection (+ pen allergic) and time duration

A

7 days
PPI + AMOX + (CLARY or MET)
pen allergic = PPI + CLARY+ MET

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11
Q

in urease breath test how long after drinking solution if test performed

A

30 mins

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12
Q

how long shoudl PPI be stopped for before commencing urease breath test

A

2 weeks

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13
Q

what test is used to indetify h.pylori infection

A

CLO test (rapid urease test)
breath test checks for eradication

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14
Q

what particular lymph nodes may been seen in gastric cancer if lymphatic spread

A

virchows node- left supraclavicular
sister mary joseph node - peri-umbilical

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15
Q

diagnostic test for gastric cancer

A

OGD with biopsy

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16
Q

what cells would you expect to see in gastric cancer biopsy

A

signet ring cells due to large mucin vaculoe pushing nucleus to the side

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17
Q

what infection is assoicated with a gastric MALT tumour

A

h.pylori

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18
Q

casues of gastroparesis

A

idiopathic
cannabis
diabetic neuropathy
opiates

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19
Q

treatment of gastroparesis

A

food little and ofte
metoclopramid
castric pacemakes

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20
Q

features of achalasia

A

dysphagia to BOTH liquid and food
variation in symptom severity
heartburn
regurg of food

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21
Q

diagnostic test in achalasia

A

oesophageal manometry

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22
Q

first line treatment of achalasia

A

pneumatic balloon dilatation

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23
Q

if first line treatment for achalasia doesnt succeed what surgicla intervention is available

A

heller cardiomyotomy

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24
Q

most common cause of GI bleed

A

duodenal ulcer

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25
Q

what is the rockall score used for

A

moratality of gi bleed

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26
Q

what is blatchford score used for

A

likelyhood of gi rebleed

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27
Q

treatment of peptic ulcer

A
  1. adrenaline into ulcer to cause vasoconstriction
  2. heater probe coag
  3. clips
    4.haemospray
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28
Q

what is given post endoscopic intervention in peptic ulcer

A

PPI AND H.PYLORI ERADICATION

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29
Q

treatment of variceal bleed pre-endoscopy

A

ABCDE - resus before endoscopy
clotting factors
Terlipressin
prophylactiv IV -quinolones

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30
Q

what shoudl be given BEFORE endoscopy in variceal bleed

A

Terlipressin and ABX

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31
Q

treatment of variceal bleed in endoscopy

A

band ligation and sclerotherpay

32
Q

options of variceal bleed treatment if endoscopy tx failed or not feasible

A

sengstak-blakemore tube
TIPPS procedure

33
Q

what is involved in a TIPPS procedure

A

Transjugular intrahepatic portosystemic shunt-
a shunt/stent is placed to attached portal veins to systemic- heaptic vein (bypassing liver) to reduce pressure

34
Q

complication of TIPPS procedure

A

exacerbation of hepatic encephalotpathy

35
Q

prophylactic management of variceal bleed

A

propanalol
band ligation

36
Q

for prophylactic band ligation of oesophageal varices how often is this performed and what medication is given

A

performed every 2 weeks and a PPI id given to preveent ulcer

37
Q

what length of bowel is classed as short gut

A

<200cm

38
Q

normal length of small bowel

A

6-7m

39
Q

what type of intestinal failure is short bowel syndrome

A

type 3

40
Q

investigation of choice for suspected bowel ischamia

A

CT

41
Q

thumbing printing and ischaemic abdo pain

A

ischaemic colitis

42
Q

cause of mesenteric ischaemia

A

emboli

43
Q

which type of bowel ischaemia causes bloody diarrhoea

A

ischaemic colitis

44
Q

cause of ischaemic collitis in younger adults

A

cocaine use

45
Q

what investigation findings would you expect in a lower GI tract ischaemia

A

raised WCC and lactic acidosis

46
Q

treamtnet of acute mesenteric ischaemia

A

laparotomy

47
Q

what type of IBD causes inflammation through all layers

A

Chrons

48
Q

in chrons transmural inflammation - what does this predispose individuals to

A

strictures
fistula
adhesions

49
Q

what presents wiht peir-anal disease chrons or UC

A

chrons

50
Q

what IBD is granulomatous

A

Chrons

51
Q

whch IBD has the higher cancer ris

A

UC

52
Q

which IBD would show thumbprinting on X-ray

A

UC

53
Q

which IBD is assoc with psuedopolyps

A

UC

54
Q

what is the most common extra-intestinal feature of Chrons and UC

A

Arthritis

55
Q

PSC is more related to which IBD

A

UC

56
Q

describes the common eye features of chrons and uc respectively

A

Chrons - episcelritis
UC - uveitis

57
Q

what skin manifstations are assoc with IBD

A

pyoderma gangrenosum and erythema nodosum

58
Q

which IBD is assoc with crypt abscesses

A

UC

59
Q

features of UC

A

abdo pain partic LIF
urgency
bloody diarrhoea
tenesmus

60
Q

features of chrons

A

abdo pain
weight loss
diarrhoea
peri-anal disease

61
Q

loss of haustra markings IBD

A

UC

62
Q

what blood test is a good marker of disease activity in chrons

A

CRP

63
Q

what is the investigation of choice for chrons

A

colonoscopy and biopsy

64
Q

what should be done in UC in a flare of colitis instead of colonoscopy adn why

A

flexi sig as colonscopy may casue perforation

65
Q

goblet cells on histology would be indicative of what IBD

A

chrons

66
Q

what secondary investigation is good for IBD after colonscopy

A

barium enema

67
Q

what would barium enema show in UC

A

loss of haustra,
pseudopolyps
drainpipe colon

68
Q

what is kantor strign sign ? when and why is it seen

A

seen on barium enema in chrons diease
looks like beads on long string- with the sting beinglong segments of strictures from disease

69
Q

what IBD are rose thorn ulcers seen

A

Chrons

70
Q

relationship between smoking and IBD

A

worsens Chrons protective for UC

71
Q

what faecal test can be done in IBD

A

faceal calprotectin

72
Q

what test shoudl be done before starting azathioprine or metocarpurine

A

TPMT

73
Q

treatment of parianal abscess in chrons

A

incision and drainage

74
Q

what drugs are used to maintain remission in chrons

A

azzathiprine or mercaptopurine

75
Q

what is the investigation of choice for suspected peri-anal fistula in chrons

A

MRI

76
Q

treatment for symptomatic peri-anal fistula in chrons

A

oral metronidazole

77
Q

durgical options in UC

A

permanent ileostomy or
restorative proctocoloectomy and J pouch

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