Abdo Flashcards

1
Q

List the triad of Sx in Budd Chari

A

Acute abdominal pain
Hepatomegaly
Ascites

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2
Q

What is Tx for Gilberts?

A

Reassure and discharge

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3
Q

Raised ALP and BR. Dx?

A

Cholestasis - probs due to gallstones

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4
Q

What is the imaging of choice for gallstones?

A

Abdo USS

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5
Q

List drugs that can cause cholestasis

A
Clavulanic acid 
Penecillin 
Oestrogens 
Erythromycin 
Chlorpromazine
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6
Q

What type of laxative is lactulose?

A

Osmotic

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7
Q

Name stimulant laxatives

A

Senna

Docusate sodium

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8
Q

Which type of laxative is indicated for intestinal obstruction?

A

Osmotic

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9
Q

What is Ispaghula husk?

A

Bulking agent to increase faecal mass and peristalsis

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10
Q

List GIT causes of clubbing

A
IBD 
Liver cirrhosis 
Primary biliary cirrhosis 
Oesophageal leiyomyoma 
Coeliac 
Achalasia
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11
Q

Outline Tx of upper GI bleed

A

Cannulate and give IV fluids
Take bloods for culture
Nil by mouth
OGD

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12
Q

What are the 3 most common causes of upper GI bleeds?

A

Peptic ulcers (50%)
Mallory Weiss tear (15%)
Oesophagitis / gastritis (5-15%)

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13
Q

List Mx of oesophageal varices

A
PRIMARY = beta blockers 
SECONDARY = band ligation
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14
Q

What causes oesophageal varices?

A

Portal HTN

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15
Q

List drugs which are known to cause liver cirrhosis

A

Amiodarone
Methyldopa
Methotreaxate

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16
Q

List signs of chronic liver disease

A
Leuconychia 
Clubbing 
Palmar erythema 
Dupuytren's contracture 
Spider naevi 
Xanthelasma 
Gynaecomastia 
Loss of body hair
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17
Q

How can you manage ascites?

A

Fluid restriction, low salt diet, diuretics

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18
Q

What is Tx for liver disease?

A

Liver transplant

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19
Q

What is the cause of koilonychia?

A

Iron deficiency anaemia

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20
Q

What is leuconychia?

A

Whitening of nails due to hypoalbuminaemia

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21
Q

List 2 causes of macrocytosis

A

Megaloblastic anaemia due to Vit B12/folate deficiency

Alcoholic liver disease

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22
Q

Anti-mitochondrial AB positive. Dx?

A

Primary biliary cirrhosis

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23
Q

Low copper and caeruloplasmin levels. Dx?

A

Wilsons disease

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24
Q

What is Wilsons?

A

Recessive disorder resulting in accumulation of copper in liver/CNS

25
Q

What is haemochromatosis?

A

Disorder in iron metabolism

Increased intestinal absorption of iron, resulting in deposition into organs

26
Q

List Sx of haemochromatosis

A

Asymptomatic to start
Arthralgia, tiredness, slate-grey skin pigmentation
Diabetes

27
Q

How do you diagnose PSC?

A

MRCP

28
Q

What inheritance pattern is alpha 1 antitripsin deficiecny?

A

Autosomal recessive

29
Q

What conditions are caused by alpha 1 antitrypsin deficiency?

A

Emphysema, chronic liver disease, hepatocellular carcinoma, pancreatitis

30
Q

Anti soluble liver angiten positive. Dx?

A

Autoimmune hepatitis Type 3

31
Q

Anti smooth muscle ABs positive. Dx?

A

Autoimmune hepatitis Type 1

32
Q

Which condition is associated with PSC?

A

UC

33
Q

What 3 conditions are associated with PBC?

A

Thyroid disease
Systemic sclerosis
Rheumatoid arthritis

34
Q

Which type of cancer are pts with PBC more susceptible to getting?

A

Cholangiocarcinoma

35
Q

List benign liver tumours

A
-OMAS
Haemangiomas 
Adenomas 
Fibromas 
Leiyomyomas
36
Q

List malignant liver tumours

A
-COMAS / -CARCINOMAS
Carcinoma 
Hepatoblastoma 
FIbrosarcomas 
Leiyomyosarcoma
37
Q

What does a serum-ascites albumen gradient of >1.1 g/dL indicate?

A

Portal hypertension

38
Q

List causes of portal hypertension

A

cirrhosis, alcoholic hepatitis, portal vein thrombosis and heart failure

39
Q

What does a serum-ascites albumen gradient of <1.1 g/dL indicate?

A

Cancer, infections (including TB), pancreatitis and nephrotic syndrome

40
Q

High alpha fetoprotein. Dx?

A

Hepatocellular carcinoma

41
Q

High CEA. Dx?

A

Colorectal carcinoma

42
Q

High CA 15-3. Dx?

A

Breast carcinoma

43
Q

High HcG or CA 125. Dx?

A

Ovarian cancer

44
Q

What is Courvoisier’s law?

A

Palpable gallbladder in pt with painless jaundice is unlikely to be gallstones

45
Q

Triad of Sx of pancreatic cancer?

A

Painless jaundice, diabetes, weight loss

46
Q

Ix for ?carcinoma of head of pancreas?

A

Abdo USS

47
Q

Mucosal ulcers, inflammatory infiltrate, crypt abcesses and goblet cell depletion. Dx?

A

UC

48
Q

Transmural, non caseataing granulomatous inflammation, fissuring ulcers, neutrophil infiltrates. Dx?

A

Crohns

49
Q

What is classed as severe UC flare up?

A

Opening bowels 6+ times a day with lots of PR blood

50
Q

Radiological features of Crohns?

A

Cobblestoning

Rose thorn ulcers

51
Q

Using what medium do you get rose thorn ulcers in Corhns?

A

Barium follow through meal and abdo XR

52
Q

What is Mx of a patient with moderate UC flare up but is systemically well?

A

Steroids
5-ASA (mesalazine)
Per rectum steroid foams

53
Q

Mx for severe UC flare up?

A

Admit for IV fluids and steroids

54
Q

For which IBD is smoking protective?

A

UC

55
Q

Which part of the gut is responsible for Vit B12 absorption, and is also affected by Crohns?

A

Terminal ileum

56
Q

Ix for iron deficiency anaemia with weight loss?

A

OGD and colonoscopy

57
Q

Serum-ascites albumin gradient (SAAG) >1.1g/dL indicates what?

A

Portal hypertension

58
Q

List causes of serum-ascites albumin gradient (SAAG) >1.1g/dL

A
cirrhosis
alcoholic hepatitis
portal vein thrombosis
massive hepatic metastases
heart failure
59
Q

List causes of serum-ascites albumin gradient (SAAG) <1.1g/dL

A
NOT portal HTN:
peritoneal carcinomatosis
infection (including TB)
pancreatitis
nephrotic syndrome
serositis (including lyphoma)