gastro Flashcards
(39 cards)
Right-sided tenderness on PR exam, think
appendicitis
what type of FBC/CRP results do you get in appendicitis?
a neutrophil-predominant leucocytosis is seen in 80-90% in appendicitis
The diagnostic investigation for necrotising enterocolitis is
The diagnostic investigation for necrotising enterocolitis is an abdominal x-ray
Men who have sex with men should be offered immunisation against
Hep A
management of Crohn’s patients who develop a perianal fistula
Oral metronidazole is useful in the management of Crohn’s patients who develop a perianal fistula
most common symptom of Crohn’s disease in children?
abdo pain
first-line to maintain remission in patients with Crohn’s
Azathioprine or mercaptopurine is used first-line to maintain remission in patients with Crohn’s
Patients with hyposplenism should be vaccinated against
Patients with hyposplenism should be vaccinated against pneumococcal (5-yearly booster), Haemophilus type B and meningococcus type C
causes of megaloblastic and normoblastic
macrocytic anemia
Isolated rise in GGT in the context of a macrocytic anaemia suggests
Isolated rise in GGT in the context of a macrocytic anaemia suggests alcohol excess as the cause
Methotrexate therapy may result in
megaloblastic macrocytic anaemia secondary to folate deficiency
Patients….. should be given oral ciprofloxacin or norfloxacin as prophylaxis against spontaneous bacterial peritonitis
Patients with ascites (and protein concentration <= 15 g/L) should be given oral ciprofloxacin or norfloxacin as prophylaxis against spontaneous bacterial peritonitis
which parameters are used to monitor treatment of haemochromatosis
Ferritin and transferrin saturation are used to monitor treatment in haemochromatosis
DPP4 mode of action
Gliptins (DPP-4 inhibitors) reduce the peripheral breakdown of incretins such as GLP-1
The AST/ALT ratio in alcoholic hepatitis is
2:1
The characteristic clinical features of alcoholic hepatitis are
- jaundice, anorexia, fever, and tender hepatomegaly.
- AST:ALT ratio of 2 or greater
- may also present with right upper-quadrant/epigastric pain, hepatic encephalopathy, and signs of malnutrition.
- Patients often stop drinking as they become ill, so it is common for patients to have stopped drinking alcohol several weeks prior to presentation.
alcoholic liver disease investigations
- gamma-GT is characteristically elevated
- the ratio of AST:ALT is normally > 2, a ratio of > 3 is strongly suggestive of acute alcoholic hepatitis
alcoholic liver disease management
- glucocorticoids (e.g. prednisolone) are often used during acute episodes of alcoholic hepatitis
- pentoxyphylline is also sometimes used
common causative agent for ascending cholangitis
E.coli
nail changes in anemia
Koilonychia, or spooning of nails, is a classic clinical sign of hypochromic anemia, especially iron-deficiency anemia.
Patients must eat gluten for at least…before they are tested
Patients must eat gluten for at least 6 weeks before they are tested
In life-threatening C. difficile infection treatment is with
In life-threatening C. difficile infection treatment is with ORAL vancomycin and IV metronidazole
People with coeliac disease receive the pneumococcal vaccine due to
People with coeliac disease receive the pneumococcal vaccine due to hyposplenism
Patients with ascites secondary to liver cirrhosis should be given
Patients with ascites secondary to liver cirrhosis should be given an aldosterone antagonist like spiranolactone
