Gastro Flashcards
(122 cards)
1
Q
Stains for antral biopsies for h.pylori
A
Giesma
Haematoxylin
Eosin
2
Q
Test for h pylori eradication
A
Urea breath test
3
Q
Zollinger-Ellison - what is secreted?
A
Gastrin
4
Q
Which MEN in ZE?
A
MEN1
5
Q
Marker in GIST?
A
CD117 (C-KIT)
6
Q
Staging for ZE?
A
Somatostatin receptor-scintigraphy
7
Q
Insulinoma - which cells?
A
Islets of Langerhans
8
Q
Glucagonoma - which cells?
A
Alpha cells
9
Q
Triad of glucagonoma?
A
Diabetes
MNE
Weight loss
10
Q
MNE?
A
Migratory Necrolytic Erythema
11
Q
Massive diarrhoea and electrolyte deficiency?
A
VIPoma
12
Q
HLA in coeliac?
A
HLA-BQ2, BQ8
13
Q
Specific GI cancer risk increased in coeliac?
A
Small bowel lymphoma
14
Q
Carcinoid - which cells?
A
Enterochromaffin cells
15
Q
Carcinoid - what is secreted?
A
Serotonin
16
Q
What does serotonin cause in carcinoid?
A
Bronchospasm and increased GI motility
17
Q
SIgns of carcinoid?
A
Diarrhoea
Bronchospasm
Local effects of tumour
FLUSHING
RH disease
18
Q
Treatment for diarrhoea in carcinoid?
A
Somatostatin analogue
19
Q
Treatment of flushing in carcinoid?
A
Phenoxybenzamine
20
Q
Phenoxybenzamine used for?
A
Flushing in carcinoid
21
Q
GI bleeding, iron def., aortic stenosis?
A
Angiodysplasia
22
Q
Test for bile salt malabsorption
A
SeHCAT
23
Q
Risk factors for small bowel overgrowth?
A
Post-SB resection
Systemic sclerosis
Jejunal diverticulae
24
Q
Where does Crohns affect
A
Particularly terminal ileum and colon but any part of the GI tract
25
Layers affected in CD?
Transmural (all layers)
26
Pathology findings in CD
Transmural inflammation
Mucosal/fissuring ulcers
Lymphoid aggregates
Neutrophil infiltrates
27
Clinical features of CD
Abdominal pain
Fever
Rectal bleeding
Anal/perianal/oral lesions
Obstructive symptoms
28
Associations of CD
Smoking
Skin - pyoderma, nodosum
Arthritis
Eye disease
Cholelithiasis
29
BMI cutoffs for weight loss surgery?
35 with complications
40 without
30
Most common cause of HCC in Europe, and worldwide?
Europe - Hep C
World - Hep B
31
Protein cutoff for Abx prophylaxis in ascites and what antibiotic?
Patients with ascites (and protein concentration <= 15 g/L) should be given oral ciprofloxacin or norfloxacin as prophylaxis against spontaneous bacterial peritonitis
32
Coeliac disease HLA?
HLA-DQ2
33
Chronic pancreatitis preferred imaging modality?
CT abdo
34
Strongest risk factor in CD?
Genetic
35
Which enzyme breaks starch into sugars?
Amylase
36
Arrhythmia from low magnesium in refeeding?
Torsades des Pointes
37
Pancreatitis causes
Popular mnemonic is GET SMASHED
Gallstones
Ethanol
Trauma
Steroids
Mumps (other viruses include Coxsackie B)
Autoimmune (e.g. polyarteritis nodosa), Ascaris infection
Scorpion venom
Hypertriglyceridaemia, Hyperchylomicronaemia, Hypercalcaemia, Hypothermia
ERCP
Drugs (azathioprine, mesalazine*, didanosine, bendroflumethiazide, furosemide, pentamidine, steroids, sodium valproate)
38
Hepatocelluar LFT injury
The following drugs tend to cause a hepatocellular picture:
paracetamol
sodium valproate, phenytoin
MAOIs
halothane
anti-tuberculosis: isoniazid, rifampicin, pyrazinamide
statins
alcohol
amiodarone
methyldopa
nitrofurantoin
39
Cholestatic LFT picture (drugs)
The following drugs tend to cause cholestasis (+/- hepatitis):
combined oral contraceptive pill
antibiotics: flucloxacillin, co-amoxiclav, erythromycin*
anabolic steroids, testosterones
phenothiazines: chlorpromazine, prochlorperazine
sulphonylureas
fibrates
rare reported causes: nifedipine
40
T2DM and abnormal LFTs?
NAFLD
41
First line treatment for NAFLD?
Weight loss
42
FAP gene?
APC
43
Small bowel overgrowth test?
Hydrogen breath test
44
Monoclonal antibody for c.diff?
bezlotoxumab
45
Life threatening c.diff?
Oral vanc + IV metro
46
Second line c.diff?
Oral fidaxomicin
47
AI hepatitis Ig?
IgG
48
Heart failure and significant skeletal muscle weakness in refeeding?
Hypophosphataemia
49
Hep B - anti-HBs positive, all other negative
Immunised
50
Scoring system for LIKELIHOOD of acute pancreatitis?
Alvarado
51
Scoring system for SEVERITY of acute pancreatitis?
Glasgow
52
Most common extra-colonic manifestation of HNPCC in female patients?
Endometrial cancer
53
First symptom of carcinoid?
Flushing
54
Finding indicative of active (or chronic) hepatitis?
HsAg
55
Treatment of small bowel overgrowth?
Rifaximin (co-amox and metro also used)
56
Fulminant hepatitis pathological cellular mechanism?
Necrosis
57
Gene implicated in CD?
NOD-2
58
Biopsy findings in CD?
Cobblestone mucosa
String sign stricturing
Skip lesions
Rose-thorn ulcers
59
1st line in CD?
Steroids, orally
Topically acting budesonide in terminal ileal disease
60
Second line in CD? What should you check first?
Azathiaprine/mercaptopurine/MTX as alternative
TPMT activity
61
Risks of azathiprine/mercaptopurine
Marrow suppression, hepatotoxicity
62
Anti-TNF alpha in CD? Which is indicated for fistulating disease?
Infliximab - for fistulating also/adalibumab
63
Treatment for perianal fistulae in CD?
Oral metronidazole
64
FAP mode of inheritance?
AD
65
Peutz-Jeghers clinical associations?
Mucocutaneous pigmentation, perioral freckles
66
Classification system for colorectal Ca?
Duke's
67
Diagnostic criteria for IBS?
Rome III
68
Skin finding in salmonella?
Rose Spots (chest)
69
Unconjugated bilirubin inherited causes of jaundice?
Gilberts
Crigler-Najjar
70
Conjugated bilirubin inherited causes of jaundice?
Rotor syndrome
Dubin-Johnson
71
Gene in Dubin-Johnson
cMOAT
72
Nasty drug in paracetamol OD?
Carbamazepine
73
Terlipressin mechanism of action?
Constriction of the splanchnic vessels
74
Prophylaxis of variceal bleeds?
Propranolol
75
First line bariatric surgery?
Gastric sleeve
76
H. pylori eradication?
PPI + amoxicillin + clarithromycin, or
PPI + metronidazole + clarithromycin
77
Ongoing diarrhoea in Crohn's patient post-resection with normal CRP - treatment?
Cholestyramine
78
Test for Gilbert's?
Nicotinic acid test
79
Treatment of eosinophillic oesophagitis?
Dietary modification and TOPICAL steroids
80
Severe hepatitis in pregnant woman?
Hep E
81
Unwell sewage worker, renal impairment?
Leptospirosis
82
Class of virus - hep C?
RNA flavavirus
83
Vertical transmission rate from mother to child in Hep C?
6%
84
Can mothers with Hep C breatfeed?
Yes
85
Proportion of Hep C which becomes chronic?
50-80%
86
Treatment of Hep C?
Currently a combination of protease inhibitors (e.g. daclatasvir + sofosbuvir or sofosbuvir + simeprevir) with or without ribavirin are used
87
Infection in recent solid organ transplant?
CMV
88
Typically presents with flu like illness → brief remission→ followed by jaundice and haematemesis
Yellow fever
89
Which hepatitis C test first?
Antibodies, then RNA if positive
90
Telbivudine mechanism of action?
Synthetic thymidine nucleoside analogue
91
Cut-off for prophylactic Abx in ascites in cirrhosis?
15g/L or less
92
Most commom SBP isolate
Cefotaxime
93
Treatment of type 2 Crigler-Najjar?
Phenobarbitol
94
Treatment of hepatorenal syndrome?
Terlipressin
HAS
TIPS
95
Most commonly affected site in ischaemic colitis?
Splenic flexure
96
What to D cells produce?
Somatostatin
97
What do G cells produce?
Gastrin
98
What do I cells produce?
CCK
99
What do S cells produce?
Secretin
100
Treatment for Wilson's disease?
Penicillamine
101
Drug induced dyspepsia?
NSAIDs
Bisphosphonates
Steroids
102
Serum finding in Wilson's disease
LOW serum caeruloplasmin
103
Wilson's gene
ATP7B
104
Wilson's chromosome
13
105
Double duct sign?
Panc Ca
106
Ix of choice in PSC?
MRCP/ERCP
107
Drug-induced cholestasis?
combined oral contraceptive pill
antibiotics: flucloxacillin, co-amoxiclav, erythromycin*
anabolic steroids, testosterones
phenothiazines: chlorpromazine, prochlorperazine
sulphonylureas
fibrates
rare reported causes: nifedipine
108
Drug-induced hepatitis?
paracetamol
sodium valproate, phenytoin
MAOIs
halothane
anti-tuberculosis: isoniazid, rifampicin, pyrazinamide
statins
alcohol
amiodarone
methyldopa
nitrofurantoin
109
What are two reversible complications in Haemachromatosis?
Cardiomyopathy
Skin pigmentation
110
Inheritance in Wilson's?
AR
111
Major ribavarin side effect?
Haemolytic anaemia
112
First line Ix for PSC?
MRCP
113
Malabsorptive symptoms with prev GI surgery and oxalate stones?
Short bowel syndrome
114
H pylori cancer association?
MALT (B-cell lymphoma)
115
Food poisoning 2-4 hours of ingestion?
S aureus
116
Best dietary source of vitamin D?
Oily fish
117
Meckel's congenital association?
Downs
118
Homozygosity for HLA-DQ2 in coelic - assoc with what malignancy?
Small bowel lymphoma
119
Young woman, headache, vertigo, weak/absent pulses, vasculitis-sounding question?
Takayasu's
120
Strongest influencer on peak bone mass attainment?
Genetic factors
121
Bowing of the tibia
Paget's
122
Typical age of onset in Wilson's disease?
!0 to 25 years
