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BIBLE GI Flashcards

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1
Q

Name of the nerve that supplies the rectum

A

S4, inferior rectal nerve

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2
Q

What is the treatment of H. Pylori?

A

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

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3
Q

Which ulcer type does food worsen the symptoms of?

A

Gastric Ulcer

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4
Q

Which ulcer type does food relieve symptoms of?

A

Duodenal Ulcer

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5
Q

What is the treatment for acute hepatitis?

A

Supportive

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6
Q

What is the treatment for chronic hepatitis?

A

interferon alpha or antiviral (tenofovir)

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7
Q

How is Hep C transmitted and tested for?

A

Blood borne and sexual transmission

PCR

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8
Q

What is present in all infectious individuals with Hep B?

A

HbsAg

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9
Q

What does the presence of HBsAg mean?

A

Had previous infection, acute or chronic

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10
Q

What does the presence of AntiHBsAg mean?

A

Clinical recovery and immunity

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11
Q

What does the presence of HBeAg mean?

A

Highly infectious individual

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12
Q

What does the presence of IgM antiHBc mean?

A

Acute infection

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13
Q

What does the presence of IgG antiHBc mean?

A

Chronic Infection

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14
Q

Where is Hepatitis E found and how is it spread?

A

Contaminated/undercooked food
Faecal/oral route
Tropics - Pigs

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15
Q

Hep D only occurs with what hepatitis?

A

Hep B

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16
Q

What is Bird beak appearance indicative of?

A

Achalasia

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17
Q

What are the treatment options for achalasia?

A

Hellers cardiomyotomy

Balloon Dilatation

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18
Q

List treatment of oesophageal varices and acute presentation

A

Correct clotting abnormalities
IV Terlipressin
Banding
Sengstaken blakemore tube

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19
Q

List prophylactic measures taken for oesophageal varices and acute presentation

A

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

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20
Q

List features of Crohn’s disease

A

Cobblestone mucosa
Recurrent oral stomatitis
Deep fissuring ulceration of mucosa

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21
Q

List the treatment of Crohn’s Disease in order

A

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

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22
Q

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

A

IV corticosteroids - methylprednisolone

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23
Q

What is Barret’s Oesophagus?

A

Stratified squamous epithelium metaplasia to simple columnar epithelium with goblet cells

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24
Q

What can be related to positive murphy’s sign?

A

Cholecystitis, ascending cholangitis

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25
Define dukes stage A
Tumour confined to mucosa
26
Define Dukes stage B
Tumour invaded through bowel wall
27
Define Dukes stage C
Involvement of local lymph nodes
28
Define Dukes stage D
Distant metastasis
29
How is ascites treated ?
Spironolactone
30
What are the side affects of spironolactone?
Gynaecomastia | Hyperkalaemia (risk of arrhythmias)
31
What is thumb printing at the splenic fixture indicative of?
Ischaemic colitis
32
What type of food take longest to digest?
Fatty foods
33
Sepsis - BUFALO (give 3, take 3)
``` Take Bloods Measure Urine output Give fluids Give antibiotics Measure lactate Give Oxygen ```
34
What is Wilsons disease and what can be seen?
Excess copper | Kayser-Fleischer rings
35
What is Grey turners sign (lumbar redness) and cullens signs (umbilical redness) indicative of?
Acute Pancreatitis
36
What does acute pancreatitis cause a high raise in?
Very raised Amylase + Vomiting
37
List the causes of Pancreatitis (I GET SMASHED)
``` Idiopathic Gallstones Ethanol Trauma Steroids Mumps Autoimmune Scorpion sting Hypothermia/hyperlipidaemia ERCP Drugs ```
38
What is Virchows node?
Left supraclavicular lymph node
39
What does the presence of Virchows node indicate?
gastric cancer
40
What is the most common type of gastric cancer?
Adenocarcinoma
41
What does intestinal gastric cancer form?
polypoid mass
42
What type of cancer forms signet ring cells on biopsy?
Diffuse gastric cancer
43
What gastric cancer can develop into a high grade B cell lymphoma?
Maltoma
44
What does GISTS stand for?
Gastrointestinal Stromal Tumours (type of sarcoma)
45
Hepatocellular carcinoma can be identified by measuring what?
Alphafeto protein
46
What is indicated by a corkscrew oesophagus on barium swallow?
Diffuse oesophageal spasm
47
Abdominal pain and diarrhoea after sour milk or shellfish is caused by?
Campylobacter
48
What is Charcot's triad?
Fever Jaundice Abdominal pain
49
What is Charcot's triad indicative of?
Acute Cholangitis
50
What is short bowel syndrome?
<2m of functional small intestine mostly due to surgical resection
51
What is secreted by parietal cells and what stimulates them?
Secrete HCl Intrinsic factor (absorption of B12) Gastrin stimulates parietal cell to secrete HCl
52
What do Chief cells release?
Pepsinogen (inactive precursor to pepsin)
53
What cells secrete histamine?
Enterochromaffin like cell (stimulate HCl production)
54
What cells secrete Gastrin?
G cells (stimulate HCl production)
55
What cells secrete somatostatin?
D cell (inhibit HCl secretion)
56
What result does vagal stimulation have on acid production?
Increases secretion of substances in favour of acid production
57
What is Zollinger-Ellison syndrome?
Gastrin secreting tumour resulting in overproduction of gastric acid and recurrent peptic ulcers
58
How is Zollinger-Ellison syndrome managed?
High dose PPI
59
Name a common complication of IBD
Toxic Megacolon
60
List the management for UC in order
``` 1st line 5-ASA (Mesalazine) Corticosteroids (prednisolone, budesonide) Immunosuppression (Azathioprine) Anti TNF (Infliximab) Curative surgery ```
61
What is the treatment for haemochromatosis?
Phlebotomy
62
What is Leukonychia and what causes it?
White marks on nails caused by hypoalbuminaemia
63
What is Koilonychia and what causes it?
Nail spooning caused by iron deficiency anaemia
64
What is pre-hepatic jaundice?
Excess haemolysis
65
What is intra-hepatic jaundice?
Defects in the conjugation of bilirubin within the liver leading to hepatocellular damage and intrahepatic cholestasis
66
What is Post hepatic jaundice?
Obstruction to the bile outflow
67
What would be the expected test results for pre-hepatic jaundice? (LFT, Stool & Urine)
LFT - Normal, raised unconjugated bilirubin Stool - Normal Urine - Normal
68
What would be the expected test results for intra-hepatic jaundice? (LFT, Stool & Urine
LFT - Raised AST/ALT, raised conjugated/unconjugated bilirubin Stool - Normal Urine - Dark, raised urobilinogen
69
What would be the expected test results for post-hepatic jaundice? (LFT, Stool & Urine
LFT - Raised ALP/GGT, raised conjugated bilirubin Stool - Pale Urine - Dark, reduced urobilinogen
70
What are Mallory hyaline bodies (histology) indicative of?
Alcoholic liver disease
71
What is the pelvic floor muscle important in urination and defecation
Levator ani muscle (it must relax)
72
At what vertebral level does the Coeliac trunk arise?
T12
73
What does the coeliac trunk split into? (trifurcates)
Splenic artery Hepatic artery Left gastric artery
74
At which vertebral level does the Vena Cava pass through the diaphragm?
``` T8 Vena Cava (8 letters) ```
75
At which vertebral level does the oesophagus pass through the diaphragm?
T10 | Oesophagus (10 letters)
76
At which vertebral level does the aortic hiatus pass through the diaphragm?
``` T12 Aortic Hiatus (12 letters) ```
77
What is the lowest part of the peritoneal cavity when supine?
Hepatorenal recess
78
What is the area between the rectum and uterus in females?
Rectovesical pouch
79
The muscle of the check that moves during mastication
Buccinator
80
What is the antibodies associated with Primary Biliary Cirrhosis?
Anti-mitochondrial antibody (AMA)
81
What is the antibodies associated with Autoimmune Hepatitis?
Anti-smooth muscle antibody (ASMA)
82
What is the antibodies associated with Hepatocellular Carcinoma?
Alphafeto protein
83
What are the antibodies associated with Coeliac Disease?
Anti-transglutaminase antibody, anti-endomysial antibody
84
What are the antibodies associated with UC and PSC?
perinuclear-ANCA (pANCA)
85
What is the antibodies associated with Primary Sclerosing Cholangitis?
Antineutrophil Cytoplasmic Antibodies (ANCA) (cANCA)
86
What antibodies and symptoms can be associated with Pancreatitis?
Raised amylase, lipase, vomiting, pain
87
What antibody is associated with Ovarian Cancer?
CA-125
88
Colicky pain radiating to the groin
Ureteric Colic
89
Jaundice and constant right upper quadrant (RUQ) pain
Biliary Colic
90
Severe Epigastric pain radiating to the back
Acute Pancreatitis
91
Abdominal or back pain with a pulsatile mass
Abdominal Aortic Aneurysm
92
Iliac fossa pain, positive pregnancy test
Ectopic Pregnancy
93
What are the true LFT's?
Albumin Billirubin Prothrombin Time
94
Which type of bilirubin is insoluble?
Unconjugated
95
What LFT's are liver damage tests?
ALP ALT GGT AST
96
What LFT is also raised in bone problems?
ALP
97
What LFT is raised in liver problems?
ALT
98
What LFT is an acute liver marker?
Prothrombin time (acute hepatocyte function marker)
99
What LFT is a chronic liver marker?
Albumin (Chronic hepatocyte function)

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