Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Medicine for Finals > Gastroenterology > Flashcards

Gastroenterology Flashcards

(74 cards)

Start Studying
1
Q

liver cirrhosis: causes

A

alcohol
NAFLD
Hepatitis B or C
Metabolic liver disease (Wilson’s, haemochromatosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

liver cirrhosis: most sensitive investigation

A

FBC - thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

liver cirrhosis: complications

A
  • UGIB
  • sepsis
  • spontaneous bacterial peritonitis
  • hypoglycaemia
  • hepatocellular carcinoma
  • hepatorenal syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

liver cirrhosis: monitoring for hepatocellular carcinoma

A

6 monthly USS
Alpha fetoprotein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

decompensated liver disease: triggers

A
  • alcohol
  • Hepatitis A or E
  • infection
  • dehydration
  • constipation
  • UGIB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

acute hepatitis: causes

A
  • Alcohol
  • Hepatitis A or E
  • Autoimmmune
  • Toxicity (e.g. paracetamol)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

autoimmune hepatitis: types and serology

A

Type 1 - ANA, anti-SMA
Type 2 - anti-LMK1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

primary sclerosing cholangitis: distribution

A

intra- and extra-hepatic bile ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

primary biliary sclerosis: distribution

A

intra-hepatic bile ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

primary sclerosing cholangitis: associations

A

ulcerative colitis (in 70% cases)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

primary sclerosing cholangitis: presentation

A

intermittent jaundice and pruritis, classically younger people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

primary biliary sclerosis: associations

A
  • Sjogren’s syndrome
  • Raynaud’s phenomenon
  • arthritis
  • autoimmune thyroid disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

primary biliary sclerosis: presentation

A

insidious onset of fatigue, weight loss, pruritis, classically in middle aged women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

primary sclerosing cholangitis: investigations

A

pANCA in 70% cases (also: ASM, ANA)
ERCP shows stricturing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

primary biliary sclerosis: investigations

A

AMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

primary sclerosing cholangitis: management

A

No curative treatment

Consider cholestyramine (pruritis), ERCP stenting or balloon dilation, liver transplant for end-stage disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

primary biliary sclerosis: management

A

Ursodeoxycholic acid

Consider cholestyramine (pruritis), liver transplant for end-stage disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

primary sclerosing cholangitis: complications

A
  • recurrence
  • biliary cirrhosis
  • Cholangiocarcinoma
  • colorectal cancer
  • portal hypertension
  • malabsorption (metabolic bone disease)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

primary biliary sclerosis: complications

A
  • cirrhosis
  • Hepatocellular carcinoma
  • malabsorption (metabolic bone disease)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

ulcerative colitis: distribution

A

large bowel +/- ‘backwash ileitis’, continuous distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

ulcerative colitis: associations

A

pANCA
Primary Sclerosing Cholangitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

ulcerative colitis: presentation

A

Violent, bloody, mucousy diarrhoea and abdominal pain, systemic malaise.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

ulcerative colitis: extra-intestinal manifestations

A

eyes - uveitis
joints - AS, arthropathy, sacroilitis
skin - erythema nodosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

ulcerative colitis: management of acute flairs

A
  1. topical aminosalicylate (sulfasalazine, mesalazine)
  2. oral aminosalicylate
  3. topical or oral steroid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
ulcerative colitis: maintenance therapy
1. topical or oral aminosalicylate 2. add azathioprine or cyclosporine 3. trial anti-TNF (infliximab, adalibumab)
26
ulcerative colitis: complications
- toxic megacolon - primary sclerosing cholangitis - colonic cancer
27
Crohn's disease: distribution
can affect any part of the GIT, commonly affects the terminal ileum, see skip lesions
28
Crohn's disease: risk factors
smoking
29
Crohn's disease: presentation
diarrhoea which may be bloody, steatorrhoea, crampy abdominal pain and systemic malaise see mouth ulcers and perianal disease (skin tags, fistulae, abscesses)
30
Crohn's disease: extra-intestinal manifestations
eyes - uveitis, episcleritis joints - AS, arthropathy skin - erythema nodosum
31
ulcerative colitis: investigations
- stool culture - fecal calprotectin - barium contrast studies - flexible sigmoidoscopy Avoid barium studies and endoscopy during acute flair due to risk of perforation
32
Crohn's disease: investigations
- stool culture - fecal calprotectin - barium contrast studies - colonoscopy +/- OGD - haematinics
33
Crohn's disease: management of acute flair
1. Oral corticosteroid 2. Azathioprine or mercaptopurine 3. Anti-TNF (infliximab, adalimumab)
34
Crohn's disease: maintenance therapy
Azathioprine or mercaptopurine
35
Crohn's disease: complications
- strictures - perforation - fistulae - abscesses - malabsorption - carcinoma - bile duct stones
36
splenomegaly: causes
- malaria - visceral leishmaniasis - CML - myelofibrosis
37
hyposplenism: causes
- iatrogenic - trauma - Sickle Cell Disease - Coeliac Disease - Hepatic Disease - Grave's Disease - SLE - Amyloid - Thrombosis
38
Hepatitis A: course
Acute hepatitis, typically following 3-6wk prodrome of malaise, anorexia, fever, N&V
39
Hepatitis E: course
Acute hepatitis, typically following 3-6wk prodrome of malaise, anorexia, fever, N&V
40
Acute viral hepatitis: serology
IgM = acute illness IgG = past infection
41
Hepatitis A: spread
faeco-oral
42
Hepatitis E: spread
faeco-oral (Pork and Shellfish)
43
Hepatitis C: course
Chronic infection, typically without acute illness. Usually found incidentally.
44
Hepatitis B: course
Chronic infection, usually heralded by acute illness and hepatitis which follows 3-6mo incubation period
45
Hepatitis C: serology
IgM = acute infection IgG = chronic infection
46
Hepatitis C: management
(IFN-alpha and ribavirin) Sofosbuvir
47
Hepatitis B: serology
HbsAg = any exposure HbcAg = chronic exposure Anti-HbcAg IgM = acute infection Anti-HbcAg IgG = chronic or cleared infection Anti-HbsAg = in isolation indicates vaccination
48
Hepatitis B: management
Acutely, supportive care Chronic carriage, tenofovir or IFN-alpha
49
Hepatitis D: course
Chronic, superinfects Hep B carriers and causes more rapid progression to liver failure
50
Hepatitis B: vaccination criteria
- MSM - IVDU - occupational risk
51
Hepatitis A: vaccination cirteria
- travellers - people with chronic liver disease - haemophiliacs - MSM - IVDU - occupational risk
52
acute viral hepatitis: management
supportive
53
hepatorenal syndrome: presentation
- cirrhosis - ascites - renal failure
54
hepatorenal syndrome: management
terlipressin
55
ascitic tap
- MC&S - Cytology - neutrophils >250 in SBP - SAG ratio: >11 = transudate; <11 = exudate
56
causes of transudative ascites
- liver disease - heart failure
57
causes of exudative ascites
- pancreatitis - malignancy - nephrotic syndrome - TB
58
spontaneous bacterial peritonitis: diagnostic criteria
Ascitic tap neutrophils > 250
59
variceal bleed: management
terlipressin broad spectrum antibiotics endocscopy (banding or sclerotherapy) In an emergency, consider Sengstaken-Blakemore tube. If resistance, consider TIPS
60
peptic ulcer: first-line management
oral PPI H pylori stool antigen (breath test if known previous infection)
61
peptic ulcer: management in H pylori infection
eradication therapy: PPI + amoxicillin + clarithromycin
62
peptic ulcer: management of associated UGIB
endoscopic haemostasis (adrenaline injection) clipping or ablation
63
UGIB: scoring systems pre- and post-endoscopy
Pre: Glasgow Blatchford Score Post: Rockall Score
64
peptic ulcer: risk factors
- H pylori infection - Drugs (NSAIDs, SSRIs, steroids, bisphosphonates) - smoking - alcohol - Zollinger-Ellison syndrome
65
peptic ulcer: complications
- UGIB - perforation - malignancy
66
acute pancreatitis: causes
*I GET SMASHED* - idiopathic - gallstones - ethanol - trauma - steroids - mumps (or other viruses) - autoimmune - scorpion stings - hypercalcaemia or hypertriglyceridaemia - ERCP - drugs (azathioprine, mesalazine, bendroflumethiazide, furosemide, valproate) also: smoking
67
acute pancreatitis: most sensitive and specific investigation
serum lipase
68
acute pancreatitis: differentials for a raised amylase
- acute pancreatitis - pseudocyst - mesenteric infarct - perforated viscus - acute cholecystitis - DKA
69
acute pancreatitis: diagnostic criteria
1. Typical history 2. Amylase or lipase elevated above 3x ULN 3. Imaging to rule-out gallstones (USS) or perforation (CTAP) *2/3 is diagnostic*
70
acute pancreatitis: assessment for severe pancreatitis
*Glasgow Criteria* - PaO2 < 7.9kPa - Age > 55 - Neutrophils (WCC > 15) - Calcium < 2 - Renal dysfunction (urea >16) - Enzymes (LDH > 600) - Albumin < 32 - Sugar (Glucose > 10) *3+ = high risk*
71
acute pancreatitis: management
supportive (fluids, analgesia, managed nutrition)
72
acute pancreatitis: complications
- peripancreatic fluid collection - pseudocyst (4wks post-attack, raised amylase, if asymptomatic monitor 12wks) - pancreatic necrosis (+/- infection) - pancreatic abscess (secondary to infected pseudocyst) - haemorrhage - sepsis - ARDS
73
chronic pancreatitis: causes
- alcohol [common] - recurrent acute pancreatitis - haemochromatosis - CF - hypercalcaemia - smoking - CKD - ductal obstruction (e.g. tumour, stones, annular pancreas)
74
chronic pancreatitis: management
- enzyme supplements - analgesia

Medicine for Finals (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions