Flashcards in Exam Deck (67):
Functions of bile salts? (2)
Excretion of cholesterol
Emulsification of fat
Commonest causes of gallstones? (2)
Excess of cholesterol excretion
Chronic haemolysis (pigment stones)
Signs associated with cholecystitis?
RUQ tenderness and rigidity
Murphy's sign- catching of breath at maximal inspiration while RUQ is being palpated
Antibiotic therapy for biliary tree infection?
Amox met gent
Investigations in suspected gallstones?
Surgical treatment of gallstones? (2)
Laparoscopic or open cholecystectomy if causing cholecystitis;
ERCP if impacted in the CBD
a) sudden pain that is constant
b) pain on coughing/moving
c) helped by drawing knees up to chest; patient writhes around
a) suggests perforation of a viscus
c) colicky pain
Higher volume, frequency and pitch of bowel sounds?
Absence of bowel sounds?
a) Bruising around the umbilicus
b) bruising in the left flank
c) LIF palpation producing RIF pain
a) Cullen's sign (pancreatitis)
b) Grey Turners sign (pancreatitis)
c) Rosving's sign appendicits
Condition which presents similarly to appendicitis and may follow an URTI?
Inflammatory bowel disease: cobblestoning, fissures, transmural inflammation
Inflammatory bowel disease: rose-thorn ulcers, non-caseating granulomas, mucosal inflammation
Systemic manifestations of IBD? (4)
Investigation of suspected IBD? (3)
Colonscopy and biopsy
Scoring system used to assess the severity of a flare of UC?
Truelove and Witt's
Treatment of perianal fistula?
Medical management of IBD?
Induction of remission (steroids, mesalamine)
Maintenance of remission (AZT, mercaptopurine, mesalamine)
Transverse colon diameter greater than 6cm indicates...
The levels of which enzyme should be assayed before commencing azathioprine?
What are haemorrhoids?
Prolapsed and enlarged anal cushions containing AV communications
How are haemorrhoids clinically classified? (4)
I- don't prolapse
II- prolapse during defaecation, reduce spontaneously
III- always prolapsed, manually reducible
Management of haemorrhoids?
a) fluids, stool softener, dietary fibre
Management of anal fissure? (3)
Conservative management of constipation
GTN/diltiazem cream to relax sphincter
Rectal bleeding + abnormal vessels on colonoscopy?
Angiodysplasia of the colon
Causes of acute pancreatitis (6)
Radiological investigation in suspected pancreatitis?
Contrast enhanced CT abdomen
Management of acute pancreatitis? (3)
Opiate pain relief
Enteral feeding if unable to eat/drink within 48-72 hrs
Complications of acute pancreatitis? (3)
Epigastric pain worsened by eating + steatorrhoea + diabetes in an alcoholic
CT finding in chronic pancreatitis?
Speckles of calcification
Diameter cut-off for surgery in AAA?
Investigation of AAA? (3)
Surgical options for AAA repair? (2)
Open aneurysm repair
Jaundice with elevated ALP, moderately elevated ALT/AST
Pyrexia + rigors + jaundice + tender liver
Pyogenic liver abscess
How can chronic liver disease cause anaemia, thrombocytopenia and leucopenia?
Portal hypertension leading to splenomegaly
Definitive management of bleeding oeseophageal varices (3)
Endoscopic variceal band ligation
(Sengstaken-Blakemore tube as a temporary holding measure)
Procedure which can be used to decompress the portal system?
Transjugular intrahepatic portosystemic shunt (TIPSS)
Prevention of variceal bleeding (3)
Herniation of mucosa through the circular colon wall at the sites of arterial penetration
Complications of diverticular disease? (4)
Dysuria + cloudy urine + pneumaturia
Definitive treatment of diverticular haemorrhage?
or surgical resection
Solitary thyroid nodule- DDx? (3)
Four types of thyroid cancer in order of prevalence?
Epithelial: Papillary and Follicular
Rapidly-growing, highly malignant thyroid cancer
Which thyroid cancer has the highest cure rate?
Thyroid tumour arising from parafollicular cells, secretes calcitonin?
Medullary cancer and pharochromocytoma often arises as part of what syndrome?
Primary hyperparathyroidism is usually due to...
Solitary adenoma of the parathyroid gland
Psammoma calcification is diagnostic of...
Papillary thyroid cancer
Chovstek and Trosseau are signs of...
Parathyroid, pancreatic and pituitary adenomas- which MEN?
Diffuse adrenal haemorrhage
AXR- central gas shadows with valvulae conniventes
Small bowel obstruction
AXR- peripheral gas shadows with haustra (do not cross lumen)
Large bowel obstruction
Management of bowel obstruction?
Keep NBM, NG tube and IV fluids
"Coffee bean" sign
Commonest locations of colorectal Ca? (2)
Rectum (45%) and sigmoid (25%)
Staging for confirmed colon Ca?
Contrast enhanced CT chest, abdo pelvis
Colorectal cancer- surgery for low sigmoid or high rectal cancer?
Colorectal cancer- surgery for tumours low in the rectum?
Abdominoperineal resection + permanent colostomy
Numerous hamartmaous polyps in GI tract + pigmented lesions on lips, oral mucosa, face, palm and soles
Peutz Jeugher syndrome
Abd pain + bloody diarrhoea + fever in a known vasculopath
Adhesions usually cause obstruction of which segment of bowel?