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Flashcards in As it says on the tin Deck (105):
1

What is cholecystitis

Inflammation of the gallbladder

2

Describe the pain present in cholecystitis

Sharp epigastric pain that moves to the RUQ and can radiate to the shoulder blades. It is worse on inspiration

3

What are the two types of cholecystitis

Calculous and acalculous

4

What is calculous cholecystitis caused by

Gallstones

5

What is acalculous cholecystitis caused by

Complication of severe illness, infection or injury that damages the gallbladder

6

Describe murphy's sign

Hand/stethoscope is placed just below the rib cage on the right side of patient, ask patient to breath in and as they do the diaphragm pushed gallbladder down causing sharp pain

7

What will increase in the blood results in cholecystitis

CRP, neutrophills, ALP and conjugated bilirubin

8

What is used to diagnose cholecystitis

US

9

Treatment of cholecystitis

Fasting, fluids to prevent dehydration and analgesia

10

Surgical removal of the gallbladder name

Cholecystectomy

11

Describe ascending cholangitis

Inflammation of the common bile duct due to blockage of common bile duct and allowing gut commensals to infect the common bile duct

12

Main causes of blockage of the common bile duct

Gallstones and tumour

13

What are the symptoms in charcot's triad

Fever, RUQ pain and jaundice

14

What are the symptoms in reynolds pentad

Fever, RUQ pain, jaundice, hypotension and confusion

15

Effect on urine and stools in ascending cholangitis

Dark urine and clay coloured stools

16

Diagnosis of ascending cholangitis

Inflammation/infection of bloods, abdominal US, MRCP and ERCP

17

Treatment ascending cholangitis

Manage symptoms, remove obstruction (ERCP), stent and possible cholecystectomy (gallstones)

18

What is pancreatitis (simple)

Inflammation of the pancreas

19

What does the mnemonic I GET SMASHED used for and what do the letters stand for

Causes of pancreatitis. Idiopathic, gallstones, ethanol (alcohol), trauma, steroids, mumps, autoimmune, hypertriglyceridaemia and hyperlipidaemia, ERCP and drugs.

20

Describe the pain in pancreatitis

Excruciating epigastric pain that radiates to the hypochondrium and centre of the back that can get worse after eating

21

Other symptoms of pancreatitis (excluding pain)

Nausea, vomiting, fever, rapid pulse, grey turner's and cullen's sign.

22

Diagnosis of pancreatitis

US, ERCP and high serum amylase and lipase

23

What is the most specific serum test for pancreatitis

Serum lipase

24

Treatment of pancreatits

Pain management, hydration, balancing electrolytes, fasting, IV food, oxygen therapy and antibiotics

25

Describe gastroenteritis (simple)

Inflammation of the stomach and intestines

26

What is gastroenteritis usually caused by

Bacterial or viral infection. Usually norovirus or food poisoning

27

Symptoms of gastroenteritis

Diarrhoea, nausea, vomiting, fever, anorexia, malaise

28

Treatment of gastroenteritis

Fluids, bed rest and pain relief

29

Describe mesenteric (lymph)adenitis

Inflammation and swelling of the lymph nodes in the abdomen usually due to viral infection

30

Who is mesenteric (lymph)adenitis more common in

Children

31

What disease if often hard to rule out in mesenteric (lymph)adenitis

Appendicitis

32

Symptoms of mesenteric (lymph)adenitis

Abdo pain (umbilical) and fever

33

How to rule out appendicitis in mesenteric (lymph)adenitis

Laproscopy

34

Treatment of mesenteric (lymph)adenitis

Pain management

35

Describe intussusception

Intestine telescopes in on itself causing an obstruction

36

Where is the most common position of an intussusception

Ileum entering the caecum

37

What age is the most common for intussusception to present

Infancy

38

Why is an intussusception a medical emergency

Risk of necrosis due to infarction

39

Symptoms of intussusception

Nausea, vomiting, vomiting, abdo pain, constipation or diarrhoea

40

Diagnosis of intussusception

US or air/barium enema

41

Treatment of intussusception

Air/barium enema usually fixes the problem and if not use surgery

42

What cells mediate primary biliary cirrhosis

T cells (reactive CD4+ cells)

43

Presentation of primary biliary cirrhosis

Fatigue, pruitis without rash, jaundice and xanthelasma

44

Specific blood test for primary biliary cirrhosis

Postitive anti mitochondrial antibody

45

Treatment for primary biliary cirrhosis

Urseo-deoxycholic acid

46

Describe autoimmune hepatitis

Inflammatory liver disease mediated by the immune system

47

What immunoglobulin increases in autoimmune hepatitis

IgG

48

What specific antibody increases in autoimmune hepatitis

Anti smooth muscular antibody

49

Immune cells present on histology of autoimmune hepatitis

Plasma cells

50

Treatment of autoimmune hepatitis

Prednisolone

51

What is haemochromatosis

Excess iron in the body

52

5 complications of haemochromatosis

(restrictive) Cardiomyopathy, HF, pancreatic failure, cirrhosis and liver failure

53

Symptoms of haemochromatosis

Fatigue, arthralgia, erectile dysfunction and absent periods

54

What increases in blood in haemochromatosis

Transferrin % sats and ferrin

55

Treatment of haemochromatosis

Regular bloods and chelation (molecule that binds to iron)

56

What is wilson's disease

Massive tissue deposits of copper in the body

57

What are the signs for Wilson's disease that occur in the eyes

Kaiser fleisher rings

58

What are both neurological and hepatic signs that show wilson's may be present

Parkinsons symptoms and chronic hepatitis/cirrhosis

59

What things would occur in bloods in wilson's

Decreased ceruloplasmin and increased copper

60

How to treat wilson's

Copper chelation=Penicillamine

61

What are two key signs in alpha 1 anti-trypsin deficiency

Emphysema and cirrhosis

62

What is budd chiari syndrome

Occlusion of the hepatic veins

63

What happens to the back in budd chiari

Prominent venous collaterals in the back

64

Treatment for budd chiari

TIPS, thrombolytic therapy and anticoagulants

65

What can budd chiari cause (in the portal venous system)

Portal hypertension

66

What drug are benign hepatic adenomas associated with

Oral contraceptives

67

Hepatocellular carcinoma specific marker

Alpha feroprotein

68

Two types of IBD

UC and crohns

69

Describe UC

Small ulcers forming in the mucosal lining of the large intestine causing inflammation

70

What can the ulcers in UC produce

Blood or pus

71

Blood in diarrhoea is common in UC. True or false

True

72

What will be seen in bloods of UC

Anaemia and CRP

73

How frequent are bowel movements in UC

Very frequent (6 or more a day)

74

What is proctitis and what is a key symptom

Inflammation of the rectum only and fresh blood in the stool

75

What is inflamed in left sided colitis

Rectum and descending colon

76

What is total colitis

Inflammation of the whole large intestine

77

What is toxic megacolon

Digestive enzymes get trapped in the colon and cause swelling

78

4 main complications of UC

Arthritis, PSC, anaemia and bowel cancer

79

What will be seen on UC colonoscopy

Glandular mucosa, ulcers, bleeding and loss of vessel pattern

80

What will be seen on AXR in UC

Thumb printing and mucosal oedema

81

4 types of drugs that have anti-inflammatory use in UC

Steroids, immunosuppressants, 5-ASAs and anti-TNF therapy

82

Example of 5 ASA

Mesalazine

83

Example of anti-TNF therapy drug

Infliximab

84

Three drugs that are used in symptomatic treatment of crohns

Laxatives, anti-motility and analgesia

85

Is crohns one single lesion

Often skips lesions

86

How to describe the amount of inflammation across the gut wall in crohn's

Transmural

87

Specific symptoms for terminal ileum and ileocaecal crohn's

Lower right abdominal pain and watery stools/failure to absorb bile salts

88

Specific symptoms for colonic crohn's

Frequent bowel movements

89

Specific symptoms for gastroduodenal crohns

Indigestion pain

90

5 complications of peri-anal crohns

Fissures, fistula, skin tags, haemorrhoids and abscesses

91

Symptoms for oral crohns

Swollen lip, mouth fissues and mouth ulcers

92

Colonoscopy of crohns

Thickened walls and cobble stoning

93

Is smoking good for UC or crohns

UC

94

Treatment order for IBD

1) 5-ASAs (UC)
2) Steroids
3) Immunosuppression
4) Anti-TNF therapy
5) Surgery

95

Most common type of hernia

Inguinal

96

Which inguinal hernia is replaceable on the cough

Indirect inguinal hernia

97

What hernia is most common with females with kids

Femoral

98

What hernia is congenital and most common in males

Epigastric

99

What hernia is most common in old, obese and pregnant people

Paraumbilical

100

What hernia is related to previous surgery

Incisional hernia

101

Spread of hep A

Faecal oral

102

How is hep B spread

Blood, fluids and mother to baby

103

Treatment of hep C

Antivirals

104

What other hepatitis is hep D related to

Hep B

105

Treatment of autoimmune hepatitis

Flare up=Steroids
Management=Azathropine