Abdo Flashcards

(59 cards)

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
What is haemochromatosis?
Disorder in iron metabolism | Increased intestinal absorption of iron, resulting in deposition into organs
26
List Sx of haemochromatosis
Asymptomatic to start Arthralgia, tiredness, slate-grey skin pigmentation Diabetes
27
How do you diagnose PSC?
MRCP
28
What inheritance pattern is alpha 1 antitripsin deficiecny?
Autosomal recessive
29
What conditions are caused by alpha 1 antitrypsin deficiency?
Emphysema, chronic liver disease, hepatocellular carcinoma, pancreatitis
30
Anti soluble liver angiten positive. Dx?
Autoimmune hepatitis Type 3
31
Anti smooth muscle ABs positive. Dx?
Autoimmune hepatitis Type 1
32
Which condition is associated with PSC?
UC
33
What 3 conditions are associated with PBC?
Thyroid disease Systemic sclerosis Rheumatoid arthritis
34
Which type of cancer are pts with PBC more susceptible to getting?
Cholangiocarcinoma
35
List benign liver tumours
``` -OMAS Haemangiomas Adenomas Fibromas Leiyomyomas ```
36
List malignant liver tumours
``` -COMAS / -CARCINOMAS Carcinoma Hepatoblastoma FIbrosarcomas Leiyomyosarcoma ```
37
What does a serum-ascites albumen gradient of >1.1 g/dL indicate?
Portal hypertension
38
List causes of portal hypertension
cirrhosis, alcoholic hepatitis, portal vein thrombosis and heart failure
39
What does a serum-ascites albumen gradient of <1.1 g/dL indicate?
Cancer, infections (including TB), pancreatitis and nephrotic syndrome
40
High alpha fetoprotein. Dx?
Hepatocellular carcinoma
41
High CEA. Dx?
Colorectal carcinoma
42
High CA 15-3. Dx?
Breast carcinoma
43
High HcG or CA 125. Dx?
Ovarian cancer
44
What is Courvoisier's law?
Palpable gallbladder in pt with painless jaundice is unlikely to be gallstones
45
Triad of Sx of pancreatic cancer?
Painless jaundice, diabetes, weight loss
46
Ix for ?carcinoma of head of pancreas?
Abdo USS
47
Mucosal ulcers, inflammatory infiltrate, crypt abcesses and goblet cell depletion. Dx?
UC
48
Transmural, non caseataing granulomatous inflammation, fissuring ulcers, neutrophil infiltrates. Dx?
Crohns
49
What is classed as severe UC flare up?
Opening bowels 6+ times a day with lots of PR blood
50
Radiological features of Crohns?
Cobblestoning | Rose thorn ulcers
51
Using what medium do you get rose thorn ulcers in Corhns?
Barium follow through meal and abdo XR
52
What is Mx of a patient with moderate UC flare up but is systemically well?
Steroids 5-ASA (mesalazine) Per rectum steroid foams
53
Mx for severe UC flare up?
Admit for IV fluids and steroids
54
For which IBD is smoking protective?
UC
55
Which part of the gut is responsible for Vit B12 absorption, and is also affected by Crohns?
Terminal ileum
56
Ix for iron deficiency anaemia with weight loss?
OGD and colonoscopy
57
Serum-ascites albumin gradient (SAAG) >1.1g/dL indicates what?
Portal hypertension
58
List causes of serum-ascites albumin gradient (SAAG) >1.1g/dL
``` cirrhosis alcoholic hepatitis portal vein thrombosis massive hepatic metastases heart failure ```
59
List causes of serum-ascites albumin gradient (SAAG) <1.1g/dL
``` NOT portal HTN: peritoneal carcinomatosis infection (including TB) pancreatitis nephrotic syndrome serositis (including lyphoma) ```