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Z Year 3 Misc > CCC - Liver and Renal 2 > Flashcards

CCC - Liver and Renal 2 Flashcards

1
Q

Which LFTs go up in obstructive jaundice?

A

ALP and GGT

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2
Q

Which LFTs go up in hepatitis?

A

ALT and AST

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3
Q

What goes up in pancreatic tumour?

A

Ca19-9

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4
Q

What does blood diarrhoea mean?

A

loss of epithelial integrity

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5
Q

What is DDx for bloody diarrhoea?

A
  1. infective colitis
  2. Inflammatory colitis: young, extra GI manifestations (uveitis)
  3. Ischamic colitis: elderly
  4. Diverticulitus, Malignancy
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6
Q

What organisms can cause infective colitis?

A
  • Campylobacter
  • Haemorrhagic E coli
  • Entamoeba histrolytica
  • Salmonella
  • Shigella
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7
Q

How does UC show up on abdo xray?

A

ulcerative colitis: featureless abdo xray

lead pipe

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8
Q

How does toxic megacolon show on abdo xray?

A

(dilation>6cm), systemic illness (tachycardia, tachypnoea, fever)

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9
Q

What is the management of an acute GI bleed?

A
  1. ABC
  2. IV access (large bore cannulae)
  3. Fluids
  4. G&S, X-match blood
  5. OGD
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10
Q

What is the management of a Variceal bleed: e.g. chronic liver disease or varices?

A
  • antibiotics

- terlipressin (causes vasoconstriction)

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11
Q

What are the investigations of an acute abdomen?

A
  1. FBC
  2. U+Es
  3. LFTs
  4. CRP
  5. Clotting
  6. G+Ss
  7. X match
  8. Erect CXR
  9. CT
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12
Q

What is the management of an acute abdoment?

A
  1. NBM
  2. fluids
  3. analgesic
  4. anti-emetics
  5. antibiotics
  6. monitor vitals and UO
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13
Q

What investigations do you do for a patient presenting with jaundice?

A
  1. Blood: FBC, LFTs, CRP

2. Abdominal USS: after a fast (gallstones better visualised in a distended, bile-filled gallbladder)

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14
Q

What investigations should you do with a patient presenting with dysphagia or weight loss?

A
  1. OGD

2. Biopsy

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15
Q

What investigation should you do with a patient presenting with PR bleed and weight loss?

A

colonoscopy

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16
Q

What is the management plan of a patient with ascites?

A
  1. Diuretics (spironolactone ± furosemide)
  2. Dietray sodium restriction
  3. fluid restriction in patients with hyponatraemia
  4. monitor weight daily
  5. therapeutic paracentesis (with IV human albumin)
17
Q

How do you calculate ascites cause?

A

Serum albumin - ascites albumin

18
Q

What may the cause of ascites be if albumin difference >11g/L?

A

cirrhosis (low albumin in ascites), cardiac failure (transudate)

19
Q

What may the cause of ascites be if albumin difference <11g/L?

A

TB, Cancer, (nephrotic syndrome) - high level of protein in ascites (exudate)

20
Q

What is the management of encephalopathy?

A
  1. lactulose: bacteria make ammonia so reducing transit time so less ammonia
  2. phosphate enema
21
Q

What must you avoid and exclude in management of encephalopathy?

A
  • Avoid sedation
  • treat infections
  • exclude a GI bleed
22
Q

In post-op GI what are wound infection features?

A
  1. erythematosus

2. discharge

23
Q

In post-op GI what are anastomotic leak features?

A
  1. diffuse abdo tenderness
  2. guarding, rigidity
  3. hypotensive/tachycardiac
24
Q

In post-op GI what are pelvic abscess e.g. post-appendectomy features?

A
  1. pain
  2. fever
  3. sweats
  4. mucus
  5. diarrhoea
25
Q

How do you manage a perianal abcess?

A
  • tender red swelling

- incision and drainage

26
Q

How do you manage anal fissure?

A
  1. rectal pain (defaecation)
  2. stool coated with blood
  3. advice re diet (fluids fibre)
  4. GTN cream
27
Q

What is the presentation of IBS like?

A
  1. Reccurent abdo pain, bloating
  2. Improves with defecation
  3. Change in frequency/form of stool
    - No PR bleed anaemia, weight loss or nocturnal symptoms, need to exclude coeliac
28
Q

What is the treatment of IBS?

A
  1. Diet and lifestyle modification
  2. Symptomatic treatment
    - Abdo pain: antispasmodics
    - Laxative for constipation
    - Anti-diarrhoeals
29
Q

What are AKI features?

A

high urea and high creatinine

30
Q

What are pre-renal causes of AKI?

A
  1. Hypovolaemia

2. Sepsis

31
Q

What are renal cause of AKI?

A

glomerulonephritis (blood and protein in urine)

32
Q

What are the post-renal causes of AKI?

A
  1. malignancy (prostate cancer)

- Abdominal USS

Z Year 3 Misc (11 decks)

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