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Flashcards in BIBLE GI Deck (99)
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1
Q

Name of the nerve that supplies the rectum

A

S4, inferior rectal nerve

2
Q

What is the treatment of H. Pylori?

A

TRIPLE THERAPY
Omeprazole + Amoxicillin + Clarithromycin
(Metronidazole if Pen allergic)

3
Q

Which ulcer type does food worsen the symptoms of?

A

Gastric Ulcer

4
Q

Which ulcer type does food relieve symptoms of?

A

Duodenal Ulcer

5
Q

What is the treatment for acute hepatitis?

A

Supportive

6
Q

What is the treatment for chronic hepatitis?

A

interferon alpha or antiviral (tenofovir)

7
Q

How is Hep C transmitted and tested for?

A

Blood borne and sexual transmission

PCR

8
Q

What is present in all infectious individuals with Hep B?

A

HbsAg

9
Q

What does the presence of HBsAg mean?

A

Had previous infection, acute or chronic

10
Q

What does the presence of AntiHBsAg mean?

A

Clinical recovery and immunity

11
Q

What does the presence of HBeAg mean?

A

Highly infectious individual

12
Q

What does the presence of IgM antiHBc mean?

A

Acute infection

13
Q

What does the presence of IgG antiHBc mean?

A

Chronic Infection

14
Q

Where is Hepatitis E found and how is it spread?

A

Contaminated/undercooked food
Faecal/oral route
Tropics - Pigs

15
Q

Hep D only occurs with what hepatitis?

A

Hep B

16
Q

What is Bird beak appearance indicative of?

A

Achalasia

17
Q

What are the treatment options for achalasia?

A

Hellers cardiomyotomy

Balloon Dilatation

18
Q

List treatment of oesophageal varices and acute presentation

A

Correct clotting abnormalities
IV Terlipressin
Banding
Sengstaken blakemore tube

19
Q

List prophylactic measures taken for oesophageal varices and acute presentation

A

Beta-blockers
Upper GI endoscopy (EGD) and banding
TIPSS

20
Q

List features of Crohn’s disease

A

Cobblestone mucosa
Recurrent oral stomatitis
Deep fissuring ulceration of mucosa

21
Q

List the treatment of Crohn’s Disease in order

A

Corticosteroids - Prednisolone
Immunosuppression - Azathioprine
Anti TNF - infliximab
Surgery - Bowel resection

22
Q

What is the treatment of a severe flare up of Crohn’s Disease

A

IV corticosteroids - methylprednisolone

23
Q

What is Barret’s Oesophagus?

A

Stratified squamous epithelium metaplasia to simple columnar epithelium with goblet cells

24
Q

What can be related to positive murphy’s sign?

A

Cholecystitis, ascending cholangitis

25
Q

Define dukes stage A

A

Tumour confined to mucosa

26
Q

Define Dukes stage B

A

Tumour invaded through bowel wall

27
Q

Define Dukes stage C

A

Involvement of local lymph nodes

28
Q

Define Dukes stage D

A

Distant metastasis

29
Q

How is ascites treated ?

A

Spironolactone

30
Q

What are the side affects of spironolactone?

A

Gynaecomastia

Hyperkalaemia (risk of arrhythmias)

31
Q

What is thumb printing at the splenic fixture indicative of?

A

Ischaemic colitis

32
Q

What type of food take longest to digest?

A

Fatty foods

33
Q

Sepsis - BUFALO (give 3, take 3)

A
Take Bloods 
Measure Urine output 
Give fluids 
Give antibiotics 
Measure lactate 
Give Oxygen
34
Q

What is Wilsons disease and what can be seen?

A

Excess copper

Kayser-Fleischer rings

35
Q

What is Grey turners sign (lumbar redness) and cullens signs (umbilical redness) indicative of?

A

Acute Pancreatitis

36
Q

What does acute pancreatitis cause a high raise in?

A

Very raised Amylase + Vomiting

37
Q

List the causes of Pancreatitis (I GET SMASHED)

A
Idiopathic 
Gallstones 
Ethanol
Trauma 
Steroids 
Mumps 
Autoimmune 
Scorpion sting 
Hypothermia/hyperlipidaemia 
ERCP
Drugs
38
Q

What is Virchows node?

A

Left supraclavicular lymph node

39
Q

What does the presence of Virchows node indicate?

A

gastric cancer

40
Q

What is the most common type of gastric cancer?

A

Adenocarcinoma

41
Q

What does intestinal gastric cancer form?

A

polypoid mass

42
Q

What type of cancer forms signet ring cells on biopsy?

A

Diffuse gastric cancer

43
Q

What gastric cancer can develop into a high grade B cell lymphoma?

A

Maltoma

44
Q

What does GISTS stand for?

A

Gastrointestinal Stromal Tumours (type of sarcoma)

45
Q

Hepatocellular carcinoma can be identified by measuring what?

A

Alphafeto protein

46
Q

What is indicated by a corkscrew oesophagus on barium swallow?

A

Diffuse oesophageal spasm

47
Q

Abdominal pain and diarrhoea after sour milk or shellfish is caused by?

A

Campylobacter

48
Q

What is Charcot’s triad?

A

Fever
Jaundice
Abdominal pain

49
Q

What is Charcot’s triad indicative of?

A

Acute Cholangitis

50
Q

What is short bowel syndrome?

A

<2m of functional small intestine mostly due to surgical resection

51
Q

What is secreted by parietal cells and what stimulates them?

A

Secrete HCl
Intrinsic factor (absorption of B12)
Gastrin stimulates parietal cell to secrete HCl

52
Q

What do Chief cells release?

A

Pepsinogen (inactive precursor to pepsin)

53
Q

What cells secrete histamine?

A

Enterochromaffin like cell (stimulate HCl production)

54
Q

What cells secrete Gastrin?

A

G cells (stimulate HCl production)

55
Q

What cells secrete somatostatin?

A

D cell (inhibit HCl secretion)

56
Q

What result does vagal stimulation have on acid production?

A

Increases secretion of substances in favour of acid production

57
Q

What is Zollinger-Ellison syndrome?

A

Gastrin secreting tumour resulting in overproduction of gastric acid and recurrent peptic ulcers

58
Q

How is Zollinger-Ellison syndrome managed?

A

High dose PPI

59
Q

Name a common complication of IBD

A

Toxic Megacolon

60
Q

List the management for UC in order

A
1st line 5-ASA (Mesalazine)
Corticosteroids (prednisolone, budesonide)
Immunosuppression (Azathioprine)
Anti TNF (Infliximab)
Curative surgery
61
Q

What is the treatment for haemochromatosis?

A

Phlebotomy

62
Q

What is Leukonychia and what causes it?

A

White marks on nails caused by hypoalbuminaemia

63
Q

What is Koilonychia and what causes it?

A

Nail spooning caused by iron deficiency anaemia

64
Q

What is pre-hepatic jaundice?

A

Excess haemolysis

65
Q

What is intra-hepatic jaundice?

A

Defects in the conjugation of bilirubin within the liver leading to hepatocellular damage and intrahepatic cholestasis

66
Q

What is Post hepatic jaundice?

A

Obstruction to the bile outflow

67
Q

What would be the expected test results for pre-hepatic jaundice? (LFT, Stool & Urine)

A

LFT - Normal, raised unconjugated bilirubin
Stool - Normal
Urine - Normal

68
Q

What would be the expected test results for intra-hepatic jaundice? (LFT, Stool & Urine

A

LFT - Raised AST/ALT, raised conjugated/unconjugated bilirubin
Stool - Normal
Urine - Dark, raised urobilinogen

69
Q

What would be the expected test results for post-hepatic jaundice? (LFT, Stool & Urine

A

LFT - Raised ALP/GGT, raised conjugated bilirubin
Stool - Pale
Urine - Dark, reduced urobilinogen

70
Q

What are Mallory hyaline bodies (histology) indicative of?

A

Alcoholic liver disease

71
Q

What is the pelvic floor muscle important in urination and defecation

A

Levator ani muscle (it must relax)

72
Q

At what vertebral level does the Coeliac trunk arise?

A

T12

73
Q

What does the coeliac trunk split into? (trifurcates)

A

Splenic artery
Hepatic artery
Left gastric artery

74
Q

At which vertebral level does the Vena Cava pass through the diaphragm?

A
T8
Vena Cava (8 letters)
75
Q

At which vertebral level does the oesophagus pass through the diaphragm?

A

T10

Oesophagus (10 letters)

76
Q

At which vertebral level does the aortic hiatus pass through the diaphragm?

A
T12
Aortic Hiatus (12 letters)
77
Q

What is the lowest part of the peritoneal cavity when supine?

A

Hepatorenal recess

78
Q

What is the area between the rectum and uterus in females?

A

Rectovesical pouch

79
Q

The muscle of the check that moves during mastication

A

Buccinator

80
Q

What is the antibodies associated with Primary Biliary Cirrhosis?

A

Anti-mitochondrial antibody (AMA)

81
Q

What is the antibodies associated with Autoimmune Hepatitis?

A

Anti-smooth muscle antibody (ASMA)

82
Q

What is the antibodies associated with Hepatocellular Carcinoma?

A

Alphafeto protein

83
Q

What are the antibodies associated with Coeliac Disease?

A

Anti-transglutaminase antibody, anti-endomysial antibody

84
Q

What are the antibodies associated with UC and PSC?

A

perinuclear-ANCA (pANCA)

85
Q

What is the antibodies associated with Primary Sclerosing Cholangitis?

A

Antineutrophil Cytoplasmic Antibodies (ANCA) (cANCA)

86
Q

What antibodies and symptoms can be associated with Pancreatitis?

A

Raised amylase, lipase, vomiting, pain

87
Q

What antibody is associated with Ovarian Cancer?

A

CA-125

88
Q

Colicky pain radiating to the groin

A

Ureteric Colic

89
Q

Jaundice and constant right upper quadrant (RUQ) pain

A

Biliary Colic

90
Q

Severe Epigastric pain radiating to the back

A

Acute Pancreatitis

91
Q

Abdominal or back pain with a pulsatile mass

A

Abdominal Aortic Aneurysm

92
Q

Iliac fossa pain, positive pregnancy test

A

Ectopic Pregnancy

93
Q

What are the true LFT’s?

A

Albumin
Billirubin
Prothrombin Time

94
Q

Which type of bilirubin is insoluble?

A

Unconjugated

95
Q

What LFT’s are liver damage tests?

A

ALP
ALT
GGT
AST

96
Q

What LFT is also raised in bone problems?

A

ALP

97
Q

What LFT is raised in liver problems?

A

ALT

98
Q

What LFT is an acute liver marker?

A

Prothrombin time (acute hepatocyte function marker)

99
Q

What LFT is a chronic liver marker?

A

Albumin (Chronic hepatocyte function)