Gastro Flashcards
(295 cards)
1
Q
Virchows triad
A
Inflammation
Endothelial injury
Hypercoagulability
2
Q
Position of splenic vein in relation to pancreas
A
Posterosuperior border of pancreas
3
Q
causes of raised amylase
A
Acute pancreatitis
Pancreatic psuedocyst
Mesenteric infract
DKA
Perforated viscus
Acute cholecystitis
4
Q
Factors indicating severe pancreatitis
A
age >55 years
Hyperglycemia
Hyperlipidemia
Hypoxia
Hypocalcemia
elevated LDH and AST
Neutrophilia
5
Q
Viruses causing pancreatitis
A
Mumps
Coxsacki B virus
6
Q
Autoimmune cause of pancreatitis
A
PAN
7
Q
Metabolic causes ofpancreatitis
A
hyperglycemia
Hypertriglycridemia
Hypothermia(by inducing SIRS and reducing blood flow to pancreas and initiating inflammatory response)
Hypercalcemia
8
Q
Drugs causing pancreatitis
A
azathioprine, mesalazine*, didanosine, bendroflumethiazide, furosemide, pentamidine, steroids, sodium valproate
Pt taking mesalazine are 7 times more prone to disease than on sulfasalazine
9
Q
how pancreatitis causes ARDS
A
The inflammatory process in acute pancreatitis leads to the release of pro-inflammatory cytokines such as TNF-alpha, IL-1, and IL-6 into the systemic circulation. These cytokines induce a systemic inflammatory response syndrome (SIRS), which increases vascular permeability and results in pulmonary oedema. Additionally, activated pancreatic enzymes can cause direct injury to alveolar-capillary membranes, exacerbating inflammation and leading to diffuse alveolar damage characteristic of ARDS. Management follows UK guidelines which include supportive care with mechanical ventilation using lung-protective strategies, fluid management to avoid volume overload, and addressing the underlying cause of pancreatitis.
10
Q
Investigations for pseudocyst of pancreas
A
Investigation is with CT, ERCP and MRI or endoscopic USS
11
Q
A
12
Q
What is acute pancreatitis?
A
Acute pancreatitis is an inflammatory condition of the pancreas that occurs suddenly and can be severe.
13
Q
What are the two most common causes of acute pancreatitis?
A
The two most common causes are gallstones and chronic and excessive alcohol consumption.
14
Q
True or False: Acute pancreatitis can be caused by medications.
A
True
15
Q
Fill in the blank: The classic presentation of acute pancreatitis includes severe ______ pain.
A
abdominal
16
Q
What laboratory test is most indicative of acute pancreatitis?
A
Elevated serum amylase and lipase levels.
17
Q
Which imaging study is preferred for diagnosing acute pancreatitis?
A
Abdominal ultrasound is preferred for detecting gallstones; CT scan is used for assessing complications.
18
Q
What is the Ranson criteria used for?
A
The Ranson criteria are used to assess the severity and prognosis of acute pancreatitis.
19
Q
True or False: Patients with acute pancreatitis should be given oral food intake immediately.
A
False
20
Q
What is the initial management step in acute pancreatitis?
A
The initial management step is supportive care, including fluid resuscitation and pain management.
21
Q
What is the role of antibiotics in the management of acute pancreatitis?
A
Antibiotics are not routinely used unless there is evidence of infected pancreatic necrosis.
22
Q
Which complication is associated with severe acute pancreatitis?
A
Pancreatic necrosis, abscess formation, and systemic inflammatory response syndrome (SIRS).
23
Q
What is the significance of a patient’s age in acute pancreatitis prognosis?
A
Older age is associated with a higher risk of complications and poorer prognosis.
24
Q
Fill in the blank: The presence of ______ in the blood can indicate a severe case of acute pancreatitis.
A
elevated CRP levels
25
What lifestyle change can help prevent recurrent acute pancreatitis?
Avoiding alcohol consumption.
26
True or False: Surgical intervention is often the first line of treatment in acute pancreatitis.
False
27
What is the 'pancreatic rest' approach in the management of acute pancreatitis?
The 'pancreatic rest' approach involves nil per os (NPO) status to minimize pancreatic stimulation.
28
Which scoring system is used to predict mortality in acute pancreatitis?
APACHE II scoring system.
29
Fill in the blank: Patients with acute pancreatitis should be monitored for ______ failure.
respiratory
30
What is the term for the collection of fluid surrounding the pancreas after acute pancreatitis?
Pancreatic pseudocyst.
31
What dietary changes are recommended after recovery from acute pancreatitis?
A low-fat diet and avoidance of alcohol.
32
True or False: Acute pancreatitis can resolve on its own without treatment.
True, in mild cases.
33
What is the role of ERCP in acute pancreatitis management?
ERCP is used to remove stones from the bile duct if they are causing pancreatitis.
34
What is a common symptom that may indicate a complication of acute pancreatitis?
Persistent fever or increasing abdominal pain.
35
What is the '3-day rule' in the context of acute pancreatitis management?
If a patient does not improve within 3 days, further investigation is warranted.
36
Fill in the blank: The ______ sign is a physical exam finding associated with acute pancreatitis.
Cullen's
37
What does GERD stand for?
Gastroesophageal reflux disease
38
True or False: GERD is characterized by the retrograde flow of gastric contents into the esophagus.
True
39
What is a common symptom of GERD?
Heartburn
40
Which diagnostic test is often used to confirm GERD?
24-hour pH monitoring
41
Name a lifestyle modification that can help manage GERD symptoms.
Avoiding large meals
42
What class of medication is typically used first-line for GERD treatment?
Proton pump inhibitors (PPIs)
43
What is the primary cause of peptic ulcers?
Helicobacter pylori infection
44
Fill in the blank: The most common complication of peptic ulcers is __________.
Hemorrhage
45
True or False: Nonsteroidal anti-inflammatory drugs (NSAIDs) can contribute to the development of peptic ulcers.
True
46
What is the hallmark symptom of a duodenal ulcer?
Epigastric pain that improves with food
47
What imaging study is typically used to evaluate peptic ulcers?
Upper gastrointestinal endoscopy
48
What is the treatment regimen for H. pylori eradication?
Triple therapy: PPI, amoxicillin, and clarithromycin
49
What condition is characterized by the presence of multiple gastric ulcers?
Zollinger-Ellison syndrome
50
Name one risk factor for developing gastric cancer.
Chronic gastritis
51
What is the primary symptom of gastric cancer?
Weight loss
52
True or False: Linitis plastica is a type of gastric cancer that presents with a thickened gastric wall.
True
53
What type of imaging is preferred for staging gastric cancer?
CT scan of the abdomen
54
What is the role of endoscopic ultrasound in gastric cancer?
To assess the depth of invasion and lymph node involvement
55
What is the most common type of esophageal cancer?
Adenocarcinoma
56
Fill in the blank: Achalasia is characterized by __________ of the lower esophageal sphincter.
Increased tone
57
What is a common symptom of achalasia?
Dysphagia for solids and liquids
58
What diagnostic test is used to confirm achalasia?
Esophageal manometry
59
True or False: Surgical myotomy is a treatment option for achalasia.
True
60
What is the most common cause of esophagitis?
Reflux disease
61
What is a potential complication of severe esophagitis?
Stricture formation
62
What is the mainstay treatment for esophagitis caused by reflux?
Proton pump inhibitors (PPIs)
63
Name one infectious cause of esophagitis.
Candida infection
64
True or False: Eosinophilic esophagitis is associated with food allergies.
True
65
What is the primary treatment for eosinophilic esophagitis?
Elimination diet or topical corticosteroids
66
What is the main symptom of a hiatal hernia?
Heartburn
67
What type of hiatal hernia is most common?
Sliding hiatal hernia
68
Fill in the blank: A __________ is a protrusion of the stomach through the diaphragm.
Hiatal hernia
69
What is the primary treatment for symptomatic hiatal hernia?
Lifestyle modifications and PPIs
70
What is the name of the procedure to correct a hiatal hernia?
Nissen fundoplication
71
True or False: Barrett's esophagus is a precancerous condition associated with chronic GERD.
True
72
What is the primary method for diagnosing Barrett's esophagus?
Endoscopy with biopsy
73
What is the risk associated with Barrett's esophagus?
Increased risk of esophageal adenocarcinoma
74
What is the initial management for Barrett's esophagus?
Regular surveillance endoscopies
75
What is the common name for the condition characterized by esophageal webs?
Plummer-Vinson syndrome
76
Fill in the blank: The classic triad of Plummer-Vinson syndrome includes dysphagia, iron deficiency anemia, and __________.
Esophageal webs
77
What is the treatment for Plummer-Vinson syndrome?
Iron supplementation and dilation of esophageal webs
78
What is the primary cause of esophageal varices?
Portal hypertension
79
True or False: Esophageal varices can lead to life-threatening hemorrhage.
True
80
What is the first-line treatment for acute variceal hemorrhage?
Endoscopic variceal band ligation
81
What medication is used to reduce portal pressure in variceal hemorrhage?
Vasopressin or octreotide
82
What is a common complication of untreated varices?
Rebleeding
83
Fill in the blank: The __________ is a muscular tube that connects the throat to the stomach.
Esophagus
84
Genetic causes of chronic pancreatitis
cystic fibrosis
hemochromatosis
85
can we rely on enzyme assay in chronic pancretitis?
No because cells producing those enzymes are destroyed and there is fibrosis that obstructs
86
Diagnostics for chronic pancreatitis
we use a combination of patient history (including symptoms like recurrent abdominal pain), imaging studies such as CT or MRI scans which can show structural changes in the pancreas, and sometimes more advanced tests like endoscopic ultrasound or ERCP. In some cases, functional testing using secretin stimulation test may also be used.
87
Chronic pancreatitis complications
Osteoporosis
PUD
Diabetes (type 3c)
Steatorrhea
88
Common location for pancreatic cancer
Head of pancreas
89
Investigation of choice for pancreatic cancer
HRCT
(double duct sign)
90
Association of pancreatic cancer
increasing age
smoking
diabetes
chronic pancreatitis (alcohol does not appear an independent risk factor though)
hereditary non-polyposis colorectal carcinoma
multiple endocrine neoplasia
BRCA2 gene
KRAS gene mutation
91
92
Complications of c.diff
Toxic megacolon
Bowel perfortaion
Sepsis
Pseudomembranous colitis
93
Amtibiotics causing c.diff infection
Clindamycin
Cephalosporin
Ceftriaxone
Mero
94
First line antibiotic for c.diff
Vanco
2nd: Febuxostat
(Supportive care, isolation for 48hr)
95
96
Colon cancer commonly metastasize to
Liver
97
Rectal cancer metastasize commonly to
Lungs
98
Apple core sign on barium enema
Colorectal cancer
99
Difference between FAP and HNPCC
FAP on left side and full of polyps
HNPCC on right side (proximal colon) and no polyps and remain asymptomatic until last stage bcs no polyps found and only occult bleeding
Colonoscopy doesnt really help with HNPCC
100
HbsAg positive
Anti- Hbc positive
Carrier
101
HbsAg positive
Acute hepatitis
102
Diagnosis of carcinoidd ssydrome
Octreotide scan
Urinary 5HIAA
Nicain levels
103
Gene involved in hemochromatosis
HFE gene on both copies of chromosome 6
104
Iron profile in hemochromatosis
transferrin saturation > 55% in men or > 50% in women
raised ferritin (e.g. > 500 ug/l) and iron
low TIBC
105
106
HbsAg negative
Anti-Hbs positive
Immunized
107
Anti-Hbc positive
HbsAg negative
Previous hep B positive and not a carrier
108
Bronze skin pigmentation
Hemochromatosis
109
110
HbsAg +
HbeAg +
Anti-HbC igG +
Chronic hepatitis
111
112
Causes of UC flares
Stress
NsAIDS
STEROIDS
Cessation of smoking
113
114
Watershed areas
Splenic flexure
Rectosigmoid junction
115
Griffith's point
Splenic flexure
116
Why watershed areas are prone to ischemia
Due to their location at furthest point from arterial supply
117
Thumbprinting is a sign of
Ischemic colitis
118
Ischemic colitiss affect what area
Watershed areas
119
Ischmic colitis leads to
Infoammation
Ulceration
Haemorrhage
120
Why thumbprinting is seen
Due to mucosal edema and haemorrhage
121
10-25 years
Neurological symptoms (basal gqmglia)
Sp3eeech disturbance
KF rings
RTA
Blue nails
Excessive salivation
Family hx of liver disease
Wilson's disease
122
123
Management for wilsons
Penicillamine
Trinetine hydrochloride
Tetrathiomolybdate
124
125
Wjich antiviral is contraindicated in pregnancy
Ribavarin
126
Antiviral that can be given in preg hepatitis
Lamivudine
Tenofovir
127
128
129
Glasgow-Blatchford score at first assessment
helps clinicians decide whether patients can be managed as outpatients or not
130
Rockall score is used after endoscopy
provides a percentage risk of rebleeding and mortality
includes age, features of shock, co-morbidities, aetiology of bleeding and endoscopic stigmata of recent haemorrhage
131
132
Painless bleeding
Old age
Do not cause pain on defecation
O/E reveal lesion on proctoscopy
Rectal polyp
133
A triad of abd pain, hepatomegaly and ascites
Budd chiari syndrome
134
Initial radiological investigation for budd chiari syndrome
U/S WITH DOPPLER
135
Causes of budd chiari syndrome
polycythaemia rubra vera
thrombophilia: activated protein C resistance, antithrombin III deficiency, protein C & S deficiencies
pregnancy
combined oral contraceptive pill: accounts for around 20% of cases
136
Differentiate between cholestatic and hepatic cuase on labs
proportionate rise in ALT > proportionate rise in ALP = hepatitic
proportionate rise in ALT < proportionate rise in ALP = obstructive/cholestatic
137
Whats a cholestatic picture on the LFTs
cholestatic: initially raised ALP and GGT, then raised serum direct bilirubin as it spills over into blood and urine.
138
biliary disease in patients with HIV is sclerosing cholangitis due to which infections
CMV, Cryptosporidium and Microsporidia
139
cholestasis
jaundice, pruritus
raised bilirubin + ALP
right upper quadrant pain
fatigue
ANA and pANCA positive
HIV related
PSC
140
Type of cells in gastric adenocarcinoma
Signet ring cells
141
Risk factors for gastric cancer
Helicobacer pylori
triggers inflammation of the mucosa → atrophy and intestinal metaplasia → dysplasia
pernicious anaemia, atrophic gastritis
diet
salt and salt-preserved foods
nitrates
ethnicity: Japan, China
smoking
blood group A
142
lymphatic spread of gastric cancer
left supraclavicular lymph node (Virchow's node)
periumbilical nodule (Sister Mary Joseph's node)
143
HFE on chromosome 6 autosomal recessive
Haemochromatosis
144
ATP7B on chromosome 13 -
Wilson's disease
autosomal recessive
145
HFE gene responsible for what
iron storage in body
146
why serum ferritin is unreliable in diagnosis of hemochromatosis
because it is an acute phase reactant and can be raised in any other inflammation in body
147
Typical iron study profile in patient with haemochromatosis
transferrin saturation > 55% in men or > 50% in women
raised ferritin (e.g. > 500 ug/l) and iron
low TIBC
148
to confirm diagnosis of hemochromatosis
molecular genetic testing for the C282Y and H63D mutations
MRI is generally used to quantify liver and/or cardiac iron
liver biopsy is now generally only used if suspected hepatic cirrhosis
149
Management for severe colitis
should be treated in hospital
IV steroids are usually given first-line
IV ciclosporin may be used if steroids are contraindicated
if after 72 hours there has been no improvement, consider adding IV ciclosporin to IV corticosteroids or consider surgery
150
if the patient has abdominal pain relieved by defecation or associated with altered bowel frequency stool form, in addition to 2 of the following 4 symptoms:
altered stool passage (straining, urgency, incomplete evacuation)
abdominal bloating (more common in women than men), distension, tension or hardness
symptoms made worse by eating
passage of mucus
IBS
151
Redflags for IBS
rectal bleeding
unexplained/unintentional weight loss
family history of bowel or ovarian cancer
onset after 60 years of age
152
investigations for IBS
CBC
ESR/CRP
coeliac disease screen (tissue transglutaminase antibodies)
153
Extra intestinal manifestaion of IBD
Arthritis
skin lesions
Gall stones
PSC (uc)
Oral ulcers
154
ASCA positive in
Crohns
155
pANCA positive in
UC
156
Riskfactor for barrets
gastro-oesophageal reflux disease (GORD) is the single strongest risk factor
male gender (7:1 ratio)
smoking
central obesity
157
Test to assess exocrine function of pancreas
fecal elastase
158
Risk factors for HCC
liver cirrhosis, for example secondary* to hepatitis B & C, alcohol, haemochromatosis and primary biliary cirrhosis
alpha-1 antitrypsin deficiency
hereditary tyrosinosis
glycogen storage disease
aflatoxin
drugs: oral contraceptive pill, anabolic steroids
porphyria cutanea tarda
male sex
diabetes mellitus, metabolic syndrome
159
wilson is not a risk factor for which cancer
HCC
160
symptomatic relief of pruritis
Cholestyramine
161
It may be considered in patients who do not adequately respond to ursodeoxycholic acid for PBC , or in those with advanced disease, but is not used as a first-line treatment option.
Prednisolone
162
Diarrhoea + hypokalaemia →
villous adenoma
163
Adenoma, metabolic acidosis and hypokalemia
Villous adenoma
164
On sigmoidoscopy or colonoscopy, villous adenomas appear as
cauliflower like growth
165
Metabolic ketoacidosis with normal or low glucose:
think alcohol
166
3 causes of raised ketones
Diabetes
starvation
Alcohol
167
glucose > 11mmol/L (or known diabetes), pH < 7.3, bicarbonate < 15mmol/L and ketones > 3mmol/L. This patient does not have a history of diabetes and is not taking drugs that could cause euglycaemic diabetic ketoacidosis
DKA
168
Metabolic acidosis
Elevated anion gap
Elevated serum ketone levels
Normal or low glucose concentration
Alcoholic diabetic ketoacidosis
169
treatment for alcoholic ketoacidosis
infusion of saline & thiamine. Thiamine is required to avoid Wernicke encephalopathy or Korsakoff psychosis.
170
Charcots triad
RUQ pain
Jaundice
Fever high hrade with rigor and chills
171
Reynold Pentad
RUQ pain
hypotension
Jaundice
Confusion
Fever
172
complication of ileocecal resection
bile acid malabsorption
173
diagnosis for bacterial gastroenteritis
stool culture positive
174
confirmed NAFLD and an ELF score >10.51 diagnosis
liver fibrosis.
175
metabolic syndrome
HTN
DM
Obesity
176
Hepatic steatosis on u/s seen as
Echogenicity
177
normal AST:ALT
less than 1 if elevated indicate liver fibrosis
178
diagnosis and monitoring of NAFLD. It made the following suggestions if the ELF blood test was not available:
FIB4 score or NALFD fibrosis score
these scores may be used in combination with a FibroScan (liver stiffness measurement assessed with transient elastography)
179
effect of vipoma
WDHA (Watery diarrhea, Hypokalemia, Achlorhydria) also called Verner-Morrison
180
triad of ovarian fibroma, ascites, and pleural effusions.
Meigs syndrome
181
Ascitic fluid analysis in a patient with spontaneous bacterial peritonitis would reveal
a raised white cell count with predominantly neutrophils.
182
Diarrhoea - biospy shows pigment laden macrophages =
laxative abuse
183
Treatment for eosinophilic esophagitis
Diet (elemental diet)
Drugs (PPI+ steroids i.e fluticasone or budesonide)
Dilatation
184
somatostatin secreted from
D cells
185
CCK secreted from
I cells of upeer small intestine
186
S cells
These cells secrete secretin a bicarbonate-rich fluid from the pancreas and hepatic cells and are stimulated by fatty acids.
187
Internal hemorrhoids are located above dentate line and are supplied by
splanchnic nerves
188
external hemorrhoids by
pudendal nerve (s2-s4) hence are painful.
189
CXR findings of achalasia
widened mediastinum or an air-fluid level in the oesophagus
190
squamous cell carcinoma of esophagus
sensitive to radiotherapy
191
Raised IgG
Raised transaminases
With mild change in ALP
Autoimmune hepatitis
192
193
Drugs that should not be given in pt with IBS
Lactulose
194
195
First line treatment for hepatorenal syndrome
Terlipressin
196
Lab findings for AIH
Raised AsT AlT but ALP almost normal
Raised IgG
Antibodies positive
Hypergammaglobulinemia
197
198
: Histopathological findings in autoimmune hepatitis include
interface hepatitis with lymphoplasmacytic infiltrate and rosette formation of hepatocytes
199
Causes of SCC of esophagus (ASAP)
Alcohol
Smoking
Achalasia
Plummer winson
200
Drugs causing liver cirrhosis (MMA)
Methotrexate
Methyldopa
Amiadrone
201
Nitrofurantoin
can work against gram-positive and gram-negative antibiotics and is often the first-line treatment for uncomplicated urinary tract infections. Unfortunately, a potential side effect is an acute hepatitis and hepatic failure, rather than cholestasis.
202
imaging modality of choice for chronic pancreatitis.
CT pancreas. will show calcification in pancreas
203
is a rare systemic auto-inflammatory disease characterised by the classic triad of fevers, joint pain, and a distinctive salmon-coloured bumpy rash.
Adult-onset Still's disease
204
best investigation to differentiate hydatid cysts from amoebic and pyogenic cysts
CT Scan
205
classical triad of; biliary colic, jaundice, and urticaria
Biliary rupture of hydatid cyst
206
Serology test for hydatid cyst
ELISA
(combined with imaging studies such as ultrasound, CT or MRI scans for a more accurate diagnosis according to UK management guidelines.)
207
pre- and post-operatively for hydatid disease
Albendazole and definitive is surgery
208
drug of choice for amoebic abscesses.
Metronidazole
209
Pyogenic liver abscesses treatment
require drainage and antibiotics, often a combination of metronidazole with a cephalosporin or quinolone
210
hallmark symptom of refeeding syndrome
Refeeding syndrome
211
Wernicke enceph triad
Ataxia
"Mental confusion
Ophthalmoplegia
212
Korsakoff syndrome
Ante and retrograde amnesia
Confabulations
Amnesia
213
ECG changes for refeeding syndrome
Torsades-des-pointes secondary to hypomagnesaemia can result as a consequence of refeeding syndrome
Uwaves and flattening of T waves as a result of hypokalemia
214
common complication
of TIPSS
exacerbation of hepatic encephalopathy
215
Drug used in exacerbation of UC
Oral azathioprine
Oral mercaptopurine
216
During Endoscopy for H pylori.
CLO test
217
only test recommended for H. pylori post-eradication therapy
Urea breath test
218
STK11/LKB1 mutation
PJS
219
Risk factors for SBP
Varices
Advanced cirrhosis
Use of PPI
Previous episode of SBP
Malnutrition
220
Organism causing SBP
E.coli
Gram negative ones commonly
221
________ is more common than vitamin B12 deficiency in coeliac disease)
Folate def:
222
Serology of coeliac
tissue transglutaminase (TTG) antibodies (IgA) are first-choice according to NICE
endomyseal antibody (IgA)
needed to look for selective IgA deficiency, which would give a false negative coeliac result
223
Gold standard for diagnosis of coeliac
Endoscopic intestinal biopsy that shows
villous atrophy
crypt hyperplasia
increase in intraepithelial lymphocytes
lamina propria infiltration with lymphocytes
224
is the investigation of choice for suspected carcinoid tumours
Urinary 5-HIAA
225
Gilberts syndrome
Mutation of UDGT1A1
226
Raised level of unconjugated bilirubin(17- 100) with normal LFTs
Gilberts syndrome
227
s jaundice, which can be intermittent and often precipitated by factors such as fasting, dehydration, stress, physical exertion or illness. Associated symptoms can include mild abdominal discomfort and fatigue but many individuals are asymptomatic.
Gilbert syndrome
(Autosomal recessive)
228
Test to evaluate RTA
Ammonium chloride acidification test
229
Flushing, diarrhoea, bronchospasm, tricuspid stenosis, pellagra →
carcinoid with liver mets - diagnosis: urinary 5-HIAA
230
secondary prophylaxis of hepatic encephalopathy
Lactulose
Rifaximin
231
melanosis coli which is characterised by a brown-black discolouration of the colon due to lipofuscin deposition in macrophages within the lamina propria.
Laxative abuse
232
Diagnostic test small bowel bacterial overgrowth syndrome
Hydrogen breathe test
233
Management for SBBOS
Rifaximin
Coamoxiclav
Metronidazole
234
neonates with congenital gastrointestinal abnormalities
scleroderma
diabetes mellitus
Risk factors for SBBOS
235
Infertility is sulphasalazine or mesalazine
Sulphasalazine
(S for Sperm and S for Sulphasalazine)
236
Neurological causes of dysphagia
CVA
Parkinson's disease
Multiple Sclerosis
Brainstem pathology
Myasthenia Gravis
237
Dysphagia for both solids and liquids
Ptosis
Extraocular m/s weakness
Myasthenia Gravis
238
biomarker for neutrophilic infiltration and inflammation within the colon. Elevated levels are often seen in inflammatory bowel disease;
Fecal calprotectin
239
Organisms which may colonise CF patients
Staphylococcus aureus
Pseudomonas aeruginosa
Burkholderia cepacia*
Aspergillus
240
Diarrhoea, weight, arthralgia, lymphadenopathy, ophthalmoplegia ?
Whipple's disease
241
Previous hepatitis B infection, not a carrier, would be indicated by a
positive Anti-HBs and Anti-HBc, and negative HBs antigen
242
243
HNPCC screening started when
At 25years of age
Or 5 years prior the last member was diagnosed
244
increases secretion of bicarbonate-rich fluid from pancreas and hepatic duct cells
Secretin
245
inhibits gastric acid secretion and absorption from the intestine while promoting smooth muscle relaxation and blood flow
VIP
246
Causes of hypoalbuminemia
Liver disease
Renal disease
Malnutrition
Sepsis
Burns
247
For assessing mural invasion what test to be done
Endoscopic ultrasound
248
249
Complication of patients on clindamycin for cellulitis that they must be warned about
Diarrhea
250
251
252
Chief cells secrete what
pepsin, a proteolytic enzyme
253
Red flag features in IBS
FOUR
F - Family history of bowel or ovarian cancer
O - Onset after 60 years of age
U - Unintentional/unexplained weight loss
R - Rectal bleeding
254
Angiodyssplasia associated with what heart condition
Aortic stenosis
255
Heydes syndrome
Angiodysplasia
Aortic stenosis
256
257
Cause of heyde syndrome
Aquifer vwF def
258
Management of angiodysplasia
endoscopic cautery or argon plasma coagulation
antifibrinolytics e.g. Tranexamic acid
oestrogens may also be used
259
Diagnosis of angiodysplasia by
Colonoscopy
Mesenteric angiography if acute bleeding
260
Microscopic colitis presents with what on histology
Intraepithelial lymphocytes >20 per 100 epithelial cells
261
261
Adverse effects of PPI
Hypomagnesemia
Hyponatremia
Osteoporosis
Microscopic colitis
Increased risk of c.diff infection
262
_______ are used to monitor treatment in haemochromatosis
Ferritin and transferrin saturation
263
264
266
Antibiotics having known interaction wwith alcohol
Metronidazole
Tinidazole
267
In suspected SBP- diagnosis is by paracentesis.
Confirmed by neutrophil count >250 cells/ul
268
used in the management of Crohn's disease and ulcerative colitis by mitigating the inflammation process.
5- aminosalicylic acid
269
Recurrent episode of c.diff toxin
With 12wks: oral fidaxomicin
After 12 wks: oral vanco or fidaxo
270
271
272
perianal itching, particularly at night
girls may have vulval symptoms
Threadworms
273
Threadworm management
CKS recommend a combination of anthelmintic with hygiene measures for all members of the household
mebendazole is used first-line for children > 6 months old. A single dose is given unless infestation persists
274
Palpable gall bladder with painless jaundice
Courvosiers sign
Positive in cholangiocarcinoma
275
Other than antibiotics what is the risk factor for CDI
PPI
276
Chronic anal fissure - treatment
topical glyceryl trinitrate
277
How does topical glyceryl trinitrate work
It works by relaxing the internal anal sphincter, which reduces pressure and increases blood flow to promote healing of the fissure. Its side effects can include headaches or dizziness due to systemic absorption.
278
it is essential for these patients to receive regular immunisations for coeliac patient
because they develop hyposplenism which increases their risk to develop infections
279
What clotting factors produced from liver
Liver produces clotting factors II, V, VII, IX and X and they are vit K dependent
280
Diarrhoea - biospy shows pigment laden macrophages =
laxative abuse
281
Amylase:
breaks starch down to sugars
282
NAAT testing for
Chlamydia
Herpes
283
type of pneumonia involved in reactivation of type 1 HSV
s. pneumonia
284
Investigation of choice for herpes
NAAT
285
treatment for acyclovir
suppressive therapy and oral acyclovir
started after 36wks of gestation
delivery via c section
286
N.gonorrhea is a gram ____
negative diplococci
287
Treatment for influenza
only in immunocompromised individual
first ine : Oseltamivir
2nd line: Zanamivir
288
Organism involved in hand foot and mouth disease
enterovirus
coxsackie A16 virus
highly contagious
289
Helminthic conditions treatment of choice
Bendezoles
Ivermectin
290
Treatment for Hep B
Interferon alpha 2a
second line: tenofovir, entecavir or telbivudine
291
292
292
294
Hypophosphatemia
Hypokalemia
Hypomagnesemia
Refeeding syndrome
295
