GI Bible Flashcards

1
Q

which nerve supplies the rectum?

A

S4

inferior rectal nerve

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2
Q

how is H. Pylori diagnosed/treated?

A

diagnosed via Urea breath test
Treated with triple therapy:
- PPI + amoxy (metronidazole if allergic) + clarythromicin

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3
Q

what differentiates a gastric vs duodenal ulcer?

A

duodenal relieved by milk

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4
Q

what is the sign of achalasia and how is it treated?

A

birds beak appearance on barium swallow

hellers cardiomyotomy or balloon dilatation

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5
Q

what is the acute presentation of oesophageal varices?

A

massive bleeding - haematomesis and malaena

history of liver disease or portal hypertension

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6
Q

how is an oesophageal variceal bleed treated?

A
recuscitation (correct clotting abnormalities)
IV terlipressin/vasopressin
Banding
Sengstaken Blakermore Tube
TIPSS?
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7
Q

How are oesophageal varices prevented?

A

TIPSS
Beta blockers
Endoscopy and banding

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8
Q

what are some trademarks of crohns?

A

cobblestone mucosa
recurrent oral stomatitis
deep fissuring ulceration of mucosa

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9
Q

what is the treatment for crohns?

A

Mesalazine (5-ASA)
immunosuppression - Azathioprine
Steroids - Prednisolone?

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10
Q

what is barrets oesophagus?

A
replacement of normal stratified squamous epithelium by simple columnar epithelium with goblet cells
- development of goblet cells = adenocarcinoma risk
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11
Q

what is murphy’s sign?

A

Tests for gallbladder inflammation
Examiner hooks fingers under liver and asks patient to exhale, if gallbladder descends into hands causing pain = inflammation

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12
Q

what is duke’s classification?

A

staging system for colorectal cancer
A = confined to submucosa
B1 = not crossed bowel wall
B2 = crossed bowel wall
C = not crossed bowel wall + lymph node metastases
D = crossed bowel wall + lymph node metastases

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13
Q

how is ascites managed?

A

spironolactone

paracentesis

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14
Q

what are the side effects of spironolactone?

A

gynaecomastia

hyperkalaemia

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15
Q

what can hyperkalaemia cause?

A

risk of arrhythmais

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16
Q

what does thumb printing at the splenic flexure indicate?

A

ischaemic colitis

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17
Q

what is another name for the external urethral orifice?

A

meatus

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18
Q

which foods take the longest to digest?

A

fatty foods

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19
Q

what is the difference between haemorrhoids and rectal prolapse?

A

haemorrhoids:
- prolapse of rectal venous plexus due to chronic constipation/pregnancy/portal hypertension
Rectal prolapse = the actual rectal tissue comes out

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20
Q

What does BUFALO stand for (sepsis management)?

A
Bloods
Urine output (measure)
Fluids
Antibiotics
Lactate (measure)
Oxygen
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21
Q

what is wilsons disease?

A

autosomal recessive disease of copper metabolism
Low caeruloplasmin
Kayser-fleischer rings

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22
Q

what is grey turner’s sign?

A

bruising of flanks

acute pancreatitis

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23
Q

what is Cullen’s sign?

A

umbilical bruising

acute pancreatitis

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24
Q

what are the symptoms of acute pancreatitis?

A
cullens sign
grey turner's sign
epigastric pain radiating to the back
vomiting
raised amylase
raised lipase
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25
Q

what is virchows node?

A

left supraclavicular lymph node

enlarged in gastric cancer

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26
Q

what do signet ring cells on biopsy indicate?

A

diffuse stomach cancer (linitis plastica)

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27
Q

what does high AFP (alphafeto protein) indicate?

A

hepatocellular carcinoma

28
Q

what will oesophageal spasm look like on barium swallow?

A

corkscrew oesophagus

29
Q

abdominal pain and diarrhoea after sour milk or shellfish?

A

campylobacter

30
Q

what is charcot’s triad?

A

fever, jaundice, abdominal pain

indicates acute cholangitis

31
Q

what is short bowel syndrome?

A

bowel <2m due to surgical resection

32
Q

what is the blood supply to the foregut?

A

coeliac trunk:

  • common hepatic
  • left gastric
  • splenic
33
Q

what is the blood supply to the midgut?

A

superior mesenteric:

  • ileal and jejunal arteries
  • ileo colics
  • right colics
  • middle colics
34
Q

what is the blood supply to the hindgut?

A

inferior mesenteric:

  • left colics (goes up becoming marginal artry which anastomoses with middle colics)
  • sigmoid arteries
35
Q

where is the adrenal gland?

A

suprarenal (above kidney)

36
Q

what cells produce each substance in the GI tract?

A
CCK = I cells
Gastrin = G cells
Somatostatin = D cells
GIP = K cells
GLP-1 = L cells
HCl = 
Secretin = S cells
Motilin = M cells
Ghrelin = Gr cells
37
Q

what is Zollinger Ellison Syndrome?

A

recurrent peptic ulcers due to gastrin secreting tumour

38
Q

antibiotics are always used in gastroenteritis, true or false?

A

false
not given and stopped if they are causing it
especially in Ecoli

39
Q

what is HUS?

A
haemolytic uraemic syndrome
- haemolytic anaemia
- acute kidney failure
- low platelets
caused by E.Coli
40
Q

what often causes toxic megacolon?

A

UC

41
Q

what is haemochromatosis and how is it treated?

A

Iron overload disease

treated with phlemotomy and blood letting (regular blood removal)

42
Q

what is leukonychia?

A

white nails

sign of hypoalbuminaemia

43
Q

what is koilonychias?

A

nail spooning

sign of iron deficiency anaemia

44
Q

what can cause prehepatic jaundice?

A

gilberts
haemolytic anaemia
newborn
trauma

45
Q

what can cause intrahepatic jaundice?

A
viral hepatitis
alcoholic hepatitis
autoimmune hepatitis
decompensated cirrhosis
PSC
PBC
46
Q

what can cause post hepatic jaundice?

A

obstruction:

  • gallstones
  • head of pancreas cancer
  • gallbladder cancer
47
Q

what are Mallory hyaline bodies?

A

darker splodges in cytoplasm of liver cells

indicate alcoholic lover disease

48
Q

which muscle is important in urination and defaecation?

A

levator ani

must relax to allow urination and defaecation

49
Q

what vertebral level does the coeliac trunk arise?

A

T12

50
Q

at what vertebral level does the vena cava pass through the diaphragm?

A

T8

8 letters

51
Q

at what vertebral level does the oesophagus pass through the diaphragm?

A

T10

10 letters

52
Q

what is the aortic hiatus?

A

hole in diaphragm at T12 where aorta, azygous vein and hemiazygous vein pass through
(12 letters)

53
Q

what is PSC and what are the signs?

A
primary sclerosing cholangitis
beading of the bile ducts
assoc with UC
"onion skinning fibrosis"
pANCA +ve
54
Q

what is the lowest part of the peritoneal cavity when lying supine?

A

hepatorenal recess/Morrison’s pouch

55
Q

what is the rectouterine pouch/pouch of douglas?

A

area between rectum and uterus in females

56
Q

what is the rectovesical pouch?

A

area between rectum and bladder in males

57
Q

what does a very high creatinine indicate?

A

renal problem

58
Q

what is the buccinators?

A

muscle of cheek that moves food during mastication

59
Q

antibody for PBC?

A

anti-mitochondrial antibody

60
Q

antibody for autoimmune hepatitis?

A

anti-smooth-muscle antibody

61
Q

antibody for coeliac disease?

A

Anti transglutaminase antibody

endomysial antibody

62
Q

antibody for UC and PSC?

A

pANCA

also cANCA in PSC

63
Q

what does CA-125 cause?

A

ovarian cancer

64
Q

how does hemochromatosis present?

A

pigmentation

diabetes

65
Q

what is PBC assoc with?

A

rheumatoid disease

thyroid disease

66
Q

what is PSC assoc with?

A

IBD, esp. UC