Gastro Flashcards
(175 cards)
1
Q
A
2
Q
What is the most likely site for ischaemic colitis?
A
Splenic flexure
3
Q
What are the two main interventions for a bleeding ulcer?
A
1- endoscopy, 2- surgery
4
Q
What condition is associated with painless jaundice?
A
Pancreatic cancer
5
Q
What symptoms are associated with a pharyngeal pouch?
A
Halitosis, nocturnal coughing, and dysphagia
6
Q
What is a benign condition affecting the esophagus?
A
Benign oesophageal stricture
7
Q
What is amylase primarily helpful for diagnosing?
A
Pancreatitis
8
Q
What lab results are raised due to alcohol consumption?
A
Raised ferritin and raised GGT
9
Q
What syndrome is caused by a gastrin-secreting tumor?
A
Zollinger Ellison syndrome
10
Q
How is Zollinger Ellison syndrome diagnosed?
A
Secretin stimulation test
ZESSSST - Zollinger Ellison Syndrome Secretin Stimulation Testing
11
Q
What is often involved in non-inherited colon cancer?
A
12
Q
What is the treatment for severe ulcerative colitis with systemic upset?
A
IV Hydrocortisone
13
Q
What is the management for tense ascites?
A
Draining
14
Q
What is the treatment for liver cirrhosis with non-tense ascites?
A
Spironolactone
15
Q
What can gastrinomas cause?
A
Ulcers
16
Q
What do pigment-laden macrophages suggest?
A
Laxative abuse
17
Q
What are the characteristics of Peutz Jeghers syndrome?
A
Melaninisation of bowel and skin, polyps
18
Q
What causes liver enzymes to be in the 1000s?
A
Paracetamol overdose, ischaemia, or viral hepatitis
19
Q
What medications can cause dyspepsia?
A
NSAIDs, Bisphosphonates, Steroids
20
Q
Where are gastrinomas mainly located?
A
First part of the duodenum
21
Q
What is the treatment for life-threatening C. difficile infection?
A
Oral vancomycin and IV metronidazole
22
Q
What does TIPS often exacerbate?
A
Hepatic encephalopathy
23
Q
What is the treatment for primary biliary cholangitis (PBC)?
A
Ursodeoxycholic acid
24
Q
What is gallstone pancreatitis more likely to occur during?
A
Pregnancy
25
What does HELLP syndrome in pregnancy stand for?
Haemolysis, elevated liver enzymes, low platelets
26
What is VIPoma associated with?
Watery diarrhoea, hypokalaemia, and achlorhydria
27
What clotting factor is characteristically raised in alcohol-related liver disease?
Factor 8
28
What is the strongest risk factor for anal cancer?
HPV infection
29
What do granulomas suggest?
Crohn's disease
30
What test is used for carcinoid tumours?
Urinary 5-hydroxyindoleacetic acid
31
What can Didanosine, an NRTI, cause?
Pancreatitis
32
What does cholestatic liver function tests indicate?
High ALP
33
What does biliary obstruction affect?
Liver enzymes
34
What is measured to assess progress in haemochromatosis?
Ferritin and transferrin levels
35
What is the risk of hepatocellular carcinoma (HCC) in PBC?
20 fold increase
36
What is the most common cause of HCC worldwide?
Hepatitis B
37
What is the best imaging for oesophageal/gastric cancer?
Endoscopic ultrasound
38
What is suspected if there is difficulty getting through the sphincter?
Motility disorder
39
Where is ulcerative colitis most commonly located?
Rectum
40
What is the refeeding protocol after starvation?
Reintroduce diet as half diet for 2 days
41
What is Gilbert's syndrome characterized by?
Isolated jaundice when stressed; no treatment needed
42
What is pseudomembranous colitis characterized by?
Multiple white plaques in colon
43
What does Dubin Johnson syndrome cause?
Conjugated hyperbilirubinaemia, sometimes jaundice
44
What is the first line treatment for variceal bleeding?
Endoscopic variceal band ligation
45
What is the treatment if endoscopic variceal band ligation fails?
TIPS, connects hepatic vein to portal vein
46
What is the prophylaxis for varices?
Propranolol and endoscopic band ligation every 2 weeks for medium to large varices
47
What can low magnesium, potassium, and phosphate indicate?
Refeeding syndrome
48
What characterizes tumor lysis syndrome?
High potassium, high phosphate, low calcium
49
What is angiodysplasia associated with?
Aortic stenosis
50
What are the characteristics of primary biliary cholangitis?
IgM, AMA, M2 subtype, middle-aged females
51
What must be done before coeliac testing?
Eat gluten for 6 weeks before testing
52
What are the symptoms of Budd-Chiari syndrome?
Abdominal pain (sudden onset severe), hepatomegaly, and ascites
53
What antibodies suggest autoimmune hepatitis?
Smooth muscle antibodies
54
What is the treatment for eosinophilic oesophagitis?
Dietary modification and topical steroids
55
What is acute fatty liver of pregnancy characterized by?
Liver symptoms with equally raised LFTs
56
What is cholestasis of pregnancy characterized by?
Liver symptoms with most raised ALP
57
What genetic abnormality is associated with familial adenomatous polyposis (FAP)?
APC gene abnormality
58
What test is used for bile acid malabsorption?
SeHCAT test
59
What is the post-eradication test for H. pylori?
Urea breath test
60
What are the symptoms of Whipple's disease?
Diarrhoea, weight loss, arthralgia, ophthalmoplegia
61
What antibiotics can cause cholestasis?
Co-amoxiclav and Flucloxacillin
62
What imaging is used for Budd-Chiari syndrome?
Abdominal ultrasound with Doppler
63
What is the first line investigation for lactose intolerance?
Hydrogen breath test
64
What indicates adequate response to Hep B immunisation?
Anti-HBs check at 6 months
65
What is a complication of pancreatitis?
ARDS
66
What is the first line treatment for non-alcoholic fatty liver disease (NAFLD)?
Weight loss
67
What score can be used for acute appendicitis?
Alvarado score
68
What is the treatment for a liver abscess?
Drainage and antibiotics
69
What test is needed for NAFLD?
Enhanced Liver Fibrosis (ELF) test
70
What should be assessed before offering azathioprine or mercaptopurine therapy in Crohn's disease?
TPMT activity
71
What is the recommended procedure for patients identified with FAP?
Total proctocolectomy due to high risk of cancer
72
What is the screening test for haemochromatosis in the general population?
Transferrin saturation
73
What is the risk associated with FAP?
Younger age and more deadly
74
What is more common, HNPCC or FAP?
HNPCC is more common and occurs at an older age
75
What does a high albumin gradient suggest?
Portal hypertension
76
How is C. difficile transmitted?
Faeco-oral through ingestion of spores
77
What is the topical steroid used for oesophagitis?
Oral fluticasone which is then swallowed
78
What is the carcinogenic medication that should only be prescribed to palliative patients?
Codanthramer
79
What is primary sclerosing cholangitis (PSC) linked with?
Ulcerative colitis; MRCP is used for diagnosis
80
What can omeprazole increase the risk of?
Severe diarrhoea in C. difficile infection
81
What cancers are associated with HNPCC?
Colon cancer and endometrial cancer
82
What does TTG testing not work for?
IgA deficient patients
83
What symptoms are associated with a pharyngeal pouch?
Dysphagia, aspiration pneumonia, halitosis
84
What is bezlotoxumab used for?
C. difficile toxin
85
What can carcinoid syndrome affect?
The right side of the heart
86
What are crypt abscesses indicative of?
Ulcerative colitis
87
What is the protocol for the urea breath test?
No PPI for 2 weeks, no antibiotics for 4 weeks
88
What can cause villous atrophy?
Coeliac disease, tropical sprue, hypogammaglobulinaemia, Whipple's disease
89
What is the treatment for mild-moderate distal UC flare?
Topical/rectal aminosalicylate
90
What is the next step if UC affects more of the bowel?
Topical steroid, then oral steroid
91
What does a palpable bladder and painless jaundice suggest?
Cholangiocarcinoma
92
What indicates recurrent C. difficile infection?
93
What is the treatment for more than 2 flares of UC in 12 months?
Azathioprine
94
What causes secondary haemochromatosis?
Blood transfusions
95
What does H. pylori cause?
Severe gastroesophageal reflux disease (GORD) without diarrhoea
96
What is the second line treatment for IBS?
Low dose TCA
97
What is the management for Child Pugh A with tumors <2cm?
Resection
98
What is the management for Child Pugh B with multiple tumors <5cm?
Transplant, TACE, or RFA in the meantime
99
What is the management for Child Pugh C?
Best supportive care
100
What is the first line treatment for C. difficile?
Oral vancomycin
101
What should be added if C. difficile is severe?
IV metronidazole
102
What is the treatment for gastric malt lymphoma?
Eradicate H. pylori
103
What does paracetamol overdose cause?
Necrosis; viral hepatitis also causes necrosis
104
What should be done if a hydatid cyst has daughter cysts?
Surgery instead of PAIR (puncture, aspiration, injection, reaspiration)
105
What is the HLA associated with coeliac disease?
HLA DQ2
106
What imaging is used for chronic pancreatitis?
CT pancreas to look for pancreatic calcification
107
What causes perianal itching in children and family members?
Enterobius vermicularis (threadworms)
108
What does Wilson's disease not cause?
HCC; haemochromatosis does
109
What gene is associated with familial adenomatous polyposis (FAP)?
Adenomatous polyposis coli tumor suppressor gene
110
What does retrocardiac air fluid level indicate?
Achalasia
111
What is cirrhosis characterized by?
Excess collagen and extracellular matrix deposition in periportal and pericentral zones
112
What is the management for oesophageal biopsy with non-dysplasia?
High dose PPI
113
What is the management for oesophageal biopsy with metaplasia?
Endoscopy
114
What is the management for oesophageal biopsy with dysplasia?
Radiofrequency ablation
115
What is the characteristic effect of oesophageal cancer?
Oesophageal stricture with apple core effect
116
What imaging is needed in PBC prior to diagnosis?
Ultrasound to exclude extrahepatic dilatation
117
What is the inheritance pattern of FAP?
Autosomal dominant on chromosome 5
118
What can diarrhea and hypokalaemia indicate?
Villous adenoma
119
What is autoimmune hepatitis characterized by?
Hepatitis and amenorrhoea
120
What is the treatment regimen for H. pylori?
Lansoprazole, amoxicillin, and clarithromycin or PPI, metronidazole, and clarithromycin
121
What gene is associated with HNPCC?
MSH2 gene for DNA mismatch repair
122
What stimulates gastrin release?
Luminal peptides
123
What is the best marker of severity in pancreatitis?
CRP over 150, WBC over 16, LDH greater than 350, hypocalcaemia
124
What is the risk of colon cancer with severe UC?
Increased risk
125
What causes hepatorenal syndrome?
Splanchnic vasodilation
126
What is goblet cell depletion indicative of?
Ulcerative colitis
127
What is the treatment for a liver abscess?
Amoxicillin, ciprofloxacin, and metronidazole
128
What are the criteria for bariatric surgery?
BMI 35 with risk factors, BMI >40 without risk factors
129
What is the treatment for diarrhea and hypokalaemia?
Villous adenoma
130
What is the treatment for post-resection diarrhea in Crohn's?
Cholestyramine
131
What immunoglobulin is associated with alcoholic liver disease?
IgA
132
What immunoglobulin is associated with primary biliary cirrhosis?
IgM
133
What immunoglobulin is associated with autoimmune hepatitis?
IgG
134
What is the secondary prophylaxis for hepatic encephalopathy?
Lactulose and rifaximin
135
What is the treatment for spontaneous bacterial peritonitis (SBP)?
IV Cefotaxime
136
What can alcohol cause besides liver disease?
Ketoacidosis when glucose is normal
137
What is the treatment for small bowel overgrowth?
Rifaximin
138
What condition is Sjögren's syndrome associated with?
Primary biliary cholangitis (PBC)
139
What imaging is used for Budd-Chiari syndrome?
Doppler ultrasound of the liver
140
What is the most common organism causing SBP?
E. coli
141
What imaging is used for pancreatic cancer?
High-resolution CT pancreas
142
What is the link between H. pylori and cancer?
No link established
143
What is the treatment for alcohol hepatitis?
Prednisolone
144
What is the positive predictive value (PPV) of FOB?
5-15%
145
What does maize not include?
Gluten
146
What is the diagnostic procedure for microscopic colitis?
Colonoscopy and biopsy
147
What is not recommended for patients with dementia?
PEG
148
What can transient elastography assess?
Fibrosis
149
What is the treatment for severe ulcerative colitis?
Admit and IV hydrocortisone
150
What is the prophylaxis for variceal bleeds?
Antibiotic prophylaxis
151
What tests are used for haemochromatosis?
Transferrin and ferritin
152
What is the inheritance pattern of Peutz-Jeghers syndrome?
Autosomal dominant
153
What is gastric adenocarcinoma characterized by?
Signet ring cells
154
What neutrophil count indicates SBP?
>250 in paracentesis
155
What symptoms in haemochromatosis are reversible?
Skin pigmentation and cardiomyopathy
156
What is the gold standard for GORD?
24-hour oesophageal pH monitoring
157
What test is used for Gilbert's syndrome?
Nicotinic acid test
158
What does NICE suggest regarding lactulose in IBS?
Avoid lactulose
159
What can pancreatitis cause in the eyes?
Cotton wool spots
160
What is hepatic vein thrombosis associated with?
More rapid ascites than hepatic portal vein thrombosis
161
What immunoglobulin is associated with coeliac disease?
IgA
162
What is the treatment for Wilson's disease?
Penicillamine
163
What is H. pylori associated with?
Duodenal ulceration and gastric adenocarcinoma
164
What should be avoided in IBS?
Insoluble fibre
165
What characterizes type 1 hepatorenal syndrome?
Occurs within 2 weeks; type 2 is more gradual
166
What causes biliary colic after fatty foods?
CCK
167
What is the treatment for chronic anal fissure?
Topical GTN
168
What is the management for hepatorenal syndrome?
Albumin and terlipressin
169
What causes pain on defecation?
Anal fissure over internal hemorrhoids
170
What is the treatment for more than 2 flares in 12 months?
Oral azathioprine
171
What is the management for newborns exposed to Hep B?
Newborn Hep B vaccine + Hep B immunoglobulin
172
What is the prophylaxis for SBP?
Ciprofloxacin
173
What test is useful for exocrine function in chronic pancreatitis?
Faecal elastase
174
What is the route of administration for Fidaxomicin?
Oral
175
What is the most common cause of HCC in Europe?
Hepatitis C
