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Flashcards in Exam Deck (47):
1

Gastroenteritis- bacteria with short incubation?

Staph aureus
Bacillus cereus
Clostridium perfringens

2

Norovirus- how long after symptoms pass are patients still infective for?

48 hours

3

Risk factors for C diff? (5)

Age
Prolonged hospital stay
PPI use
Recent surgery particularly bowel
Immunosuppression

4

Motile, flagellated trophozoites in the stool?

Giardiasis

5

Transient episode of diarrhoea followed fever, sweats and rose spot rash?

Typhoid fever

6

C difficile treatment? (2)

Non severe- metronidazole
Severe- metronidazole + vancomycin

7

Investigation of coeliac disease? (3)

Unexplained IDA/B12/folate deficiency
Tissue TTG
Jejunal biopsy

8

Non-pharmacological treatment of IBS? (3)

Low FODMAP diet
Peppermint oil
Probiotic yoghurts

9

Investigations to rule other causes in IBS?

TTG
ESR and CRP
Faecal calprotectin

10

Chronic granulomatous inflammation of interlobular bile ducts

Primary biliary cirrhosis

11

Antibody association in PBC?

anti-mitochondrial Ab M2

12

Treatment of itch in PBC?

Cholestyramine, ursodeoxycholic acid

13

Inflammation, fibrosis and stricture of the extra and intra-hepatic bile ducts

Primary sclerosing cholangitis

14

Classical skin sign of PBC?

Xanthelasma of eyelid

15

Risk factors for peptic ulcer? (3)

H. pylori infection
NSAIDs
Smoking

16

ALARMS in dyspepsia?

Anaemia
Loss of weight
Anorexia
Recent onset and progressive
Malaena
Swallowing difficulty

17

Management of dyspepsia?

a) ALARMS or older than 55
b) no alarms

a) upper GI endoscopy
b) stop exacerbating drugs, encourage lifestyle changes, OTC antacids

18

What is the indication for H pylori breath testing?

Failure of symptoms to respond to conservative management

19

Treatment of
a) H pylori -ve dyspepsia
b) H pylori +ve dyspepsia

a) PPI/H2 blocker for 4 weeks
b) Eradication therapy- PPI + amox + erythro

20

Multiple gastric ulcers, diarrhoea, refractory o treatment?

? possible gastrinoma

21

Peptic ulcer disease + gastrinoma....syndrome name?

Zollinger Ellison

22

Underlying cause of most gastric MALT?

H pylori infection

23

Main risk factor for the development of HCC?

Liver cirrhosis secondary to hepatitis, alcohol

24

Screening for HCC in at risk patients? (2)

Liver USS and alpha fetoprotein

25

Jaundice is an early feature in ....cancer and a late feature in....

Cholangiocarcinoma

HCC

26

Triad of symptoms in HCC?

Hepatomegaly + ascites + jaundice

27

Tumours which commonly metastazise to liver? (3)

Breast, bronchus, colorectal

28

Young/middle aged woman with acute hepatitis + amenorrhoea?

Autoimmune hepatitis

29

Antibodies implicated in autoimmune hepatitis? (4)

ANA, anti-smooth muscle, LKM1, soluble liver-kidney antigen

30

Management of autoimmune hepatitis? (3)

Steroids to induce and maintain remission
AZT as steroid-sparing agent
Liver transplantation

31

Toxic accumulation of copper in the liver and CNS>

Wilson's disease

32

Pathognomonic sign in Wilson's disease?

Kayser-Fleischer rings

33

Diagnostic tests for Wilson's disease? (2)

High 24hr urinary copper excretion
Low serum copper and ceruloplasmin

34

Management of Wilson's disease? (3)

Avoidance of foods with high copper content
Lifelong penicallamine
Liver transplantation

35

Commonest cause of an acute hepatitis, spread by the faecal-oral route?

Hepatitis A

36

Complications of hepatitis B and C? (2)

Chronic carrier state in 85% for HCV, 10% for HBV
Hepatocellular carcinoma

37

Hepatitis B serology:
a) Anti-HBS
b) implies high infectivity
c) defines chronic infection

a) recovery/vaccinated
b) HBeAg
c) persistence of HBsAg for 6 months

38

Treatment of HCV? (2)

Ribavarin + PEGinterferon alpha

39

Spread of HBV and HCV? (3)

Sexually, IVDU, blood transfusions

40

In chronic liver disease, symptoms resulting from:

a) reduced synthetic function
b) reduced detox
c) portal hypertension

a) ascites, bruising, peripheral oedema (3)
b) jaundice, encephalopathy, amenorrhoea (3)
c) ascites, haematemesis, PR bleeding/melaena (3)

41

Stigmata of chronic liver disease? (8)

Asterixis
Bruising
Dupuytren's contracture
Palmar eyrthema
Jaundice
Spider naevi
Caput medusae
Splenomegaly

42

Accounts for 50% of liver failure in the UK?

Paracetamol overdose

43

Definition of liver failure?

Severe liver dysfunction leading to jaundice, encephalopathy and coagulopathy

44

Liver failure management of:
a) ascites
b) hepatic encephalopathy
c) cerebral oedema
d) hepatorenal syndrome

a) salt and fluid restriction, spironolactone, furosemide, parecentesis, IV albumin
b) lactulose
c) mannitol
d) IV albumin + terlipressin

45

Jaundice + diabetes + arthritis

Hereditary haemochromatosis

46

Tests for hereditary haemochromatosis? (2)

Increased serum ferritin
HFE genotyping

47

Management of hereditary haemochromatosis?

Venesection