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Pete FFICM SOE/OSCE > Gastro - Liver > Flashcards

Gastro - Liver Flashcards

1
Q

Defining feature of acute liver failure

A

Coagulopathy
Encephalopathy with raised icp
Jaundice

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2
Q

Defining features of chronic liver failure

A 
Jaundice
Ascites and SBP
Varices
Encephalopathy without raised ICP
hepatorenal syndrome
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3
Q

Timing of acute liver failure

A

Hyperacute less than 7 days
Acute 7 to 28 days
Sub acute 5 to 12 weeks

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4
Q

Grade 1 encephalopathy

A

Trivial lack of awareness
Euphoric, anxiety
Short attention span
Impaired addition

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5
Q

Grade 2 encephalopathy

A

Lethargy or apathy
Minimal disorientation to time and place
Subtle personality change
Impaired subtraction

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6
Q

Grade 3 encephalopathy

A

Somnolence, semi stupour
Responds to verbal
Confusion
Grossly disorientated

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7
Q

Grade 4 encephalopathy

A

Coma, unresponsive to verbal or pain

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8
Q

Kings criteria for paracetamol overdose

A

pH less than 7.3 after fluid resus

OR

Encephalopathy grade 3/4
PT > 100 (INR 6.5)
Creatinine > 300

OR

lactate greater than 3 at 12 hours
Lactate grater than 3.5 4 hours
After fluid resus

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9
Q

Kings criteria non paracetamol

A

PT>100
(INR 6.5)

Or any three of 
PT>50 INR 3.5
Non hep A/B aetiology
Age less than 10 or greater than 40
Bilirubin greater than 300
Jaundice prior to encephalopathy for more than 7 days
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10
Q

Components of the Child Pugh score

A 
Bilirubin
Albumin
INR
Ascites
Encephalopathy
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11
Q

Types of hepatic encephalopathy as said by international society for hepatic encephalopathy and nitrogen metabolism

A

Type A relates to acute liver failure
Type B relates to Porto-systemic bypass
Type C relates to cirrhosis

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12
Q

Is it variceal or non variceal bleeding that is most common

A

Non-variceal

80%

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13
Q

Components of Glasgow Blatchford score

A 
Urea
Hb
Systolic bp 
Presence of: pulse more than 100
Malaena 
Syncope 
Hepatic failure
Cardiac failure
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14
Q

Components of rockall score

A 
Age
Shock
Co morbidity
Diagnosis
Evidence of bleeding
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15
Q

Grading of varices

A

1 small epitheliasied and disappear on insufflation
2 everything in between
3 large varices occluding the lumen

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16
Q

Which balloon is inflated first in sengstaken

A

Gastric

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17
Q

Does the oesophageal balloon always need inflating

A

No

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18
Q

Volume of air into gastric balloon of sengstaken

A

250ml

19
Q

Length of insertion of sengstaken

A

50 to 55cm

20
Q

Weight of traction on sengstaken

A

500g

21
Q

Maximum time for sengstaken

A

12 hours

If using oesophageal balloon deflate for five minutes every hour

22
Q

Criteria for ranson score

A 
Admission
Age over 55
AST greater than 250
Glucose more than 11.2
LDH Greater than 350
24 hours
Fall in Hct more than 10%
PaO2 less than 8
BE 4
Fluid sequestration of more than 6 litres
Rise in urea more than 1.8
23
Q

Glascow Imrie score for pancreatitis

A 
Oxygenation
Age
Wcc 
Calcium
Urea
LDH 
Albumin
Glucose
24
Q

Normal intra abdominal pressure

A

5-7mmHg

25
Q

Grades of intra abdominal hypertension

A

1- 12-15
2 16-20
3 21-25
4 more than 25

26
Q

Grade 1 intra ab hypertension

A

12-15 mmHg

27
Q

Grade 2 intra ab hypertension

A

16-20

28
Q

Grade 3 intra ab hypertension

A

21-25

29
Q

Grade 4 intra ab hypertension

A

Greater than 25

30
Q

Equation of abdominal perfusion pressure

A

APP = MAP - IAP

31
Q

Definition of abdominal compartment syndrome

A

intra abdominal hypertension greater than 20 plus associated organ failure

32
Q

At what intra abdominal pressure does renal perfusion reduce

A

15 mmHg

33
Q

At what intra abdominal pressure does anuria occur

A

Greater than 30mmHg

34
Q

Calorie requirements by schofield formula

A

25 kcal/kg/day if under 65
20 if over 65

More in burns

35
Q

Carbohydrate needs in Itu

A

3-4g/kg per day

Should by 60% of the non protein carbs

36
Q

Fat needs on Itu

A

0.7 to 1.5g/kg

Should be 40 percent of non protein calories

37
Q

Protein needs

A

1-1.5g/kg

1.5-2 In burns

38
Q

Protein needs In burns

A

1.5 to 2 g/kg

39
Q

Water needs

A

30mls per kg

40
Q

Sodium needs

A

1-2 mmol per kg

41
Q

Potassium needs

A

0.7 to 1 mmol/kg

42
Q

Calcium needs

A

0.1 mmol/kg

43
Q

Magnesium needs

A

0.1mmol/kg

44
Q

Phosphate needs

A

0.4mmol/kg

Pete FFICM SOE/OSCE (199 decks)

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