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PA YEAR 1 > CASE 9 & 10: GI > Flashcards

CASE 9 & 10: GI Flashcards

(56 cards)

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1
Q

What is the most common side effects of bisphonates (drug for osteoporosis)

A

dyspepsia (indigestion)

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2
Q

What is re-feeding syndrome?

A

electrolyte disturbance secondary to reintroduction of nutritions following a starved state, (eating after a period of starvation).

Hypophosphatemia (reduction in phosphates)

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3
Q

What is diverticulitis

A

inflammation of the diverticula that is caused by infection

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4
Q

what is diverticular disease?

A

herniation of the colonic wall (outpouching)

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5
Q

risk factors of pernicious anaemia

A

previous h.pylori infection and hypothyroidism

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6
Q

how do you diagnose pernicious anaemia (low vitamin b12)

A

test for serum intrinsic factor antibodies

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7
Q

treatment for acute gastroenteritis

A

advise monitor fluid intake and reassure self limiting

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8
Q

what is charcots triad and which condition has all 3

A

pain jaundice and fever, cholangitis

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9
Q

antibiotic choice for clostridium difficle

A

oral vanomycin

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10
Q

what are the consitipation NICE guidelines

A

1) self manage: fluids, high fibre, exercise etc
2) bulk forming laxative: ispaghula
3) osmotic laxative: macrogol
4) stimulant laxativie: senna

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11
Q

what common drugs can cause upper gi bleeds

A

NSAIDS

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12
Q

Presentation of mallory weiss tear

A

vomiting red blood (haematisis) and epigastric pain

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13
Q

which blood test would show acute pancreatitis

A

raised serum lipase (x3)

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14
Q

acute pancreatitis presentation

A 
G: gallstones
E: Ethanol
T:  trauma
S: steroids
M:mumps/malignancy
A: autoimmune
S:scorpion sting
H: hypocalcaemia or hyperlipidaemia
E: ERCP
D:drugs
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15
Q

management of acute pancreatits with no signs of sepsis

A

fluid resus
analgesia
antiemetics

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16
Q

management for acute pancreatitis with cholangitis

A

endoscopic retrograde cholangiopanreatography and/or cholecystectomy

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17
Q

35yr woman
abdo pain
whats the first investigation to do

A

urine dip to test for beta HCG, to check if she is preganant.
When womann presents with abdo pain at child bearing age , ectopic pregnancy must be ruled out first

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18
Q

painless blood in stool

A

haemorrohids

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19
Q

1st line meds for apthous ulcer

A

topical corticosteroid (hydrocortisone oro-mucosoal tablets)

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20
Q

test to diagnose h.pylori

A

carbon 13- urea breath test

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21
Q

what is sepsis 6

A 
give antibiotics
give iv fluids
give oxygen
take lactate
take urine output measurement
take blood clutures
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22
Q

abdo pain radiating to back

A

acute pancreatits

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23
Q

which peptic ulcer is worse after eating foods

Study These Flashcards
A

gastric ulcer

24
Q

which peptic ulcer is better after eating food

Study These Flashcards
A

duodenal ulcer

25
anal fissure management (5 steps)
1) dietary advice 2) simple analgesia 3) advise shallow soaking in bath 4) topical anaesthetic 5) rectal GTN ointment
26
management for paracetamol overdose
Acetylcystenine intravenously
27
what must be done for coeliac testing?
reintroduce gluten at least once a day in diet for at least 6 weeks
28
right upper quadrant pain radiating to back
acute cholecystitis
29
4F's of acute cholesystitis
female, forty, fat, fertile
30
where is the pain felt for appendicitis
right illiac fossa (right lower quadrant)
31
burning epigastric pain that occurs either after eating or with hunger
peptic ucler
32
what is manometry
measurement of pressure within various parts of GI tract
33
how do you differentiate between small and large bowel obstruction
small bowel obstructions: colicky pain with spasms lasting few mins. Visible valvulae (Kerkrig folds), central dilated bowel loops large bowel obstructions: pain felt lower in abdomen and spasms last longer
34
patient has acute pain, swelling of perianal area, unable to sit down, receptive anal sex
anorectal abscess (collection of pus)
35
sudden onset of sever abdo pain, left illiac fossa, tachycardia, fever
perforated diverticulum
36
recurrent non specific abdo pain, nausea, vomiting
intussusception
37
moderate-mild severe colicky or constant pain. early stages: minimal tenderness, no signs of peritonitis later stages: pertionitis symptoms appear, reboung guarding and tenderness AF in history
Bowel ischaemia
38
sigmoid voluvulus
``` coffee bean shape x-ray sudden colicky lower abdo pain sever abdo distension unable to pass stool vomiting in later stages ```
39
what is Zenker's diverticulum
diverticulum in the pharyngeal pouch, doesn't present with abdo pain.
40
what is rovsings sign
RLQ pain caused when pressure applied on LLQ
41
Positive Rovsing's sign
acute appendicitis
42
laproscopic appendicetomy, which patient and when do they undergo treatment
young, male, fit: no ct, straight to theatre young female: at least USS before theatre, to rule out gynae >50yr: ct to look for cancer
43
what is barrets oesophagus
when oesophagus becomes damaged by acid reflux causing lining to thicken and become red
44
what is first line investigation if you suspect gallstones (billary colic, cholecystits)
US, but not if sepsis is suspected | CT of abdo if sepsis suspected
45
direct inguinal hernia
passage of intestine through ecternal inguinal ring at Hesselbach triangle, rarelt enter scrotum
46
indirect inguinal hernia
- Most common - Involve the passage of intestine though internal inguinal ring, down inguinal canal and may pass into scrotum, - often congential
47
femoral hernia
femoral canal most common in women
48
ventral hernia
noted at site of previous surgery
49
umbilical hernia
found at naval and are seen in babies
50
investigation for biliary colic
abdo ultrasound
51
acute mesenteric ischaemia: vbg and abg findings
VBG shows high lactate | ABG shows metabolic acidosis
52
what is hiatus hernia
when part of your stomach moves up into your chest
53
faelcal calprotectin test positive
IBD: Ulcerative colitis and Crohn's Disease
54
what test is used to test for coeliac disease
serum tissue transglutaminase antibodies (tTg-IgA)
55
pyloric stenosis management
same day admission to hospital for surgery
56
barrets oesphagus cell changes
squamous to columnar cells

PA YEAR 1 (10 decks)

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