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Year 6 > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

what are the organisms of gastroenteritis in the following?

  1. watery non bloody diarrhoea started a few hours after food
  2. watery non bloody diarrhoea after reheated rice
  3. canned foods/packed honey
  4. reheating meats - 24 hrs watery diarrhoea
  5. travellers diarrhoea - last 3-4 days
  6. fever, roth spots, constipation
  7. bloody diarrhoea, pain, fever
  8. farming or contact with animal faeces
  9. rice water stool/ shellfish
  10. bloddy diarrhoea lasting 20 days BBQ
A
  1. staph aureus
  2. bacilius cerues
  3. clostridium botulinum
  4. clostridium perfringes
  5. E coli
  6. salmonella typhi
  7. shigella
  8. yersinia
  9. vibrio cholera
  10. campylobacter jejuni
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2
Q

which antibiotics treat salmonella typhi?

A

ceftriaxone then switch to ciprofoxacin

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3
Q

which abx treat campylobacter jejuni?

A

clarithromycin or cipoifloxacin

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4
Q

which HLA are associated with coeliac?

A

HLA DQ2 and 8

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5
Q

what is seen on biopsy in coeliac?

A

villous atrophy, crypt hyperplasia

(shorter microvilli and flat mucosa)

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6
Q

which dermatological condition is associated with coeliac?

A

dermatitis herpetiformis (on the elbows and knees)

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7
Q

what investigations should you do in someone who you suspect has coeliac?

in which pts should you test?

A

iron, folate, b12
blood smear - target cells, howell jolly bodies
IgA anti-tissue transglutaminase TTG
IgA anti-endomysial cell
OGD and duodenal biopsy

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8
Q

what is the investigation of choice for appendicitis?

A

CT abdomen

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9
Q

what are some signs of appendicitis?

A

rovsings - pain in RIF upon palpation of LIF
copes - pain on flexion and internal rotation of hip
psoas - pain on hip extension

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10
Q

what is the management for appendicitis?

A

prophylactic abx
appendectomy

lavage if perforation

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11
Q

how do you differentiate between biliary disease?

A

pain - biliary colic
pain and fever - cholecystitis
pain, fever, jaundice - cholangitis

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12
Q

what do LFTs in cholecystitis show?

A

normal billirubin, ALT/AST
raised amylase
raised ALP

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13
Q

what is reynolds pentad?

A

acute cholangitis
pain, fever, jaundice, hypotension, confusion

DO ERCP

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14
Q

what is the 1st line investigation for cholangiocarcinoma?

A

CT abdomen

  • ERCP
  • abnormal LFT
  • ca19-9 and CAE -not specific
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15
Q

what are some signs of primary billiary cirrhosis?

A

itching in middle ages woman
obstructive jaundice - pale stool dark urine
hypercholestrolaemia

raised ALP/GGT
anti mitochondrial antibody
raised IgM

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16
Q

what is the management of PBC?

A

ursodeoxycholic acid
cholestyramine (for puritis)

17
Q

what are some symptoms of primary sclerosing cholangitis

A

puritis
obstructive jaundice
steatorrhea
splenomegaly

18
Q

what is the diagnostic test of primary sclerosis cholangitis?

A

MRCP - beaded appearance
pANCA
biopsy of bile duct “onion skin”

19
Q

what investigation findings are seen in autoimmune hepatitis?

A

anti-nuclear antibody ANA
riased IgG
biopsy - piecemeal necrosis = inflammation beyond the limiting plate

20
Q

what are the symptoms of portal hypertension?

A

splenomegaly
ascites
varices
encephalopathy

21
Q

what is the management of chronic live disease?

A

diet - restrict alcohol, fluids, low sodium
diuretics - spironolactone
prophylaxis - ciprofloxacin + propranolol
refractory - TIPSS

22
Q

what do blood tests show in haemochromatosis?

A

TRANSFERRITIN SATURATION raised
ferritin raised
iron raised
TIBC reduced

23
Q

what investigations should be done in impaired LFTs?

A

USS - increased echogenicity in NAFLD
enhanced liver fibrosis panel
Fibroscan - offered to alcoholics and HCV infection
lier biopsy

24
Q

which investigations should be done for pancreatitits?

A

serum amaylse > 3 times normal
serum lipase - more sensitive
USS
CT abdo

25
Q

how is pancreatitis classified?

A

mild - no organ failure
moderate - transient organ failure <48 hrs
severe - persistent >48hrs

26
Q

what are some complications of pancreatitis?

A

haemorrhage, SIRS, ARDS, hyperglyceamia, hypocalcaemia

pancreatic abscess, necrosis

27
Q

wat is courvoisiers law?

A

painless jaundice = head of pancreatic cancer

28
Q

what investigations are done for diverticulitis?

A

acute - CT abdomen
Chronic (diverticular disease) - barium enema

29
Q

how do you manage diverticulitis?

A

acute
- abx, drip and suck

chronic
- soluble high fibre diet

30
Q

when do you do an urgent OGD?

A

dysphagia
upper abdo mass
>55y/o AND weight loss AND
- dyspepsia
- reflux
- upper abdo pain

31
Q

what do you do if an OGD is -ve but pt is experiencing symptoms?

A

24 hr oesophageal pH monitoring

32
Q

how do you treat dyspepsia?

A

review meds
trial ppi
- C13 urea breath test OR stool antigen test for H pylori - treat with triple therapy clarith, amox, PPI

treatment resistant - urgent ogd

Year 6 (10 decks)

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