Gastroenterology Flashcards by Clara Sattentau

Q

Wilson’s disease lab findings

A

Low caeruloplasmin concentration
Hepatic, serum and urinary copper all raised

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Q

Sweating
Hunger
Weight gain
Low glucose

?cause

A

Insulinoma

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Q

Insulinoma (diagnostic test)

A

Prolonged (72h) fasting glucose levels

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Q

Loose stool/diarrhoea following resection of bowel (terminal ileum) for Crohn’s disease. Normal CRP/calprotectin

Cause?

A

Bile salt-induced diarrhoea

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Q

Bile salt-induced diarrhoea

Treatment?

A

Bile acid binders e.g. cholestyramine

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Q

Primary sclerosing cholangitis
linked to…

A

Linked to UC

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Q

Primary biliary cholangitis

A

Autoimmune condition
Middle-aged women
Pruritus
Fatigue

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Q

Artery supplying stomach -> where bile duct enters duodenum

A

Celiac trunk

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Q

Artery supplying duodenum (where bile duct enters) -> 2/3 across transverse colon

A

Superior mesenteric

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Q

Hypogonadotropic hypogonadism
Peri-anal dermatitis
Cognitive impairment
Alopecia
Hepatosplenomegaly

A

Zinc deficiency

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Q

Niacin deficiency symptoms

A

Pellagra
Diarrhoea, dermatitis, dementia
Mucosal, anogenital lesions

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Q

Carcinoid syndrome

Features

A

Flushing
Diarrhoea
Bronchospasm
Tricuspid stenosis
Pellagra

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Q

Carcinoid syndrome

Cause

A

Release of serotonin into systemic circulation from liver

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Q

Gastrin

Secreted by…
Secreted in…
Effects…

A

G cells
Antrum and duodenum
Increases gastric acid and intrinsic factor production production from parietal cells
Increases pepsinogen release from chief cells
Increases gastric motility

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Q

Cholecystokinin (CCK)

Secreted by…
Secreted in…
Effects…

A

I cells
Duodenum, ileum
Stimulates gallbladder contraction
Stimulates release of pancreatic enzymes
Relaxes sphincter of Oddi

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Q

Secretin

Secreted by…
Secreted in…
Effects…

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A

S cells
Duodenum, jejenum
Stimulates secretion of bicarb from pancreas
Inhibits gastrin and gastric acid secretion

Q

Vasoactive int

Secreted by…
Secreted in…
Effects…

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A

Q

Gastric inhibitory polypeptide (GIP)

Secreted by…
Secreted in…
Effects…

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A

K cells
Reduces gastric acid secretion and motility
Stimulates insulin release

Q

Motilin

Secreted by…
Secreted in…
Effects…

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A

Mo cells/ECL cells
Increases small bowel motility and gastric emptying

Q

Somatostatin

Secreted by…
Secreted in…
Effects…

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A

D cells (stomach, small intestine, pancreas)
Inhibits secretion and action of all other GI hormones

Q

Young person, deranged LFTs, ascites, abdominal pain

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A

Budd-Chiari syndrome = thombosis of hepatic vein

Q

Budd-Chiari risk factors

Study These Flashcards

A

Pregnancy/post-partum
COCP

Q

Budd Chiari investigation of choice

Study These Flashcards

A

USS abdomen with flow studies

Q

Small bowel overgrowth syndrome test

Study These Flashcards

A

Hydrogen breath test

Refractory dyspepsia Multiple duodenal ulcerations Imaging = ?GI malignancy Condition associations

Zollinger Ellison syndrome = gastrinoma Sometimes associated with MEN1

Bezlotoxumab

Monoclonal for C diff - binds to C diff toxin B

Vitamin C (ascorbic acid) -> effect on iron absorption

Conversion of Fe3+ to Fe2+

Diarrhoea Pigment laden macrophages on colonoscopy biopsy

Laxative abuse

Chronic pancreatitis test

Faecal elastase

ataxia, ophthalmoplegia and confusion b/g alcohol excess

Wernicke's encephalopathy

anterograde amnesia (unable to form new memories), retrograde amnesia (unable to recall past memories) and confabulation (making up new memories) b/g alcohol excess

Korsakoff's syndrome

anal fissure treatment

1. Lidocaine ointment +/- laxatives 2. Topical GTN (6-8 weeks) 3. Referral to surgeons

Pancreatitis scoring system

PANCREAS PaO2 <8kPa Age >55 Neutrophilia; WCC >15 Calcium <2 Renal function; urea >16mmol/L Enzymes: LDH >600; AST >200 Albumin <32 Sugar (glucose) >10mmol/L

Middle aged man Diarrhoea weight loss arthralgia Lymphadenopathy Ophthalmoplegia diagnosis?

Whipple's disease (can be HLA-B27 positive!)

Budd Chiari Investigation of choice

USS with doppler flow

Most common area to have ischaemic colitis

Splenic flexure

Screening for haemochromatosis

general population: transferrin saturation and ferritin family members: HFE gene

Double duct sign Sign of..?

Pancreatic cancer

King's college liver transplant guidelines (paracetamol toxicity)

Arterial pH < 7.3, 24 hours after ingestion or all of the following: prothrombin time > 100 seconds creatinine > 300 µmol/l grade III or IV encephalopathy