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gastroenterology Flashcards

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1
Q

what are MEN-I neoplasms

A

parathyroid - hyperparathyroid
pituitary
pancreas - insulinoma, zolinger-ellinson

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2
Q

what is Zollinger-Ellinson syndrome

A

gastrin secreting adenoma
most commonly found in the pancreas

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3
Q

dysphasia, regurgitation and halitosis
suggestive of

A

pharyngeal pouch

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4
Q

management of pharyngeal pouch

A

surgery

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5
Q

what drug other than antibiotic is a risk for C.diff

A

omeprazole

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6
Q

how does hepatic encephalopathy present

A

confusion and altered consciousness

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7
Q

pathophysiology of hepatic encephalopathy

A

excess absorption of ammonia from bacterial breakdown of proteins

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8
Q

management of hepatic encephalopathy

A

lactulose - promotes excretion of ammonia (1st line)

rifaximin - modulates gut flora, decreasing ammonia production

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9
Q

does high urea indicate upper of lower GI bleed

A

upper

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10
Q

what test is most useful to distinguish between IBS and IBD

A

faecal calprotectin

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11
Q

can PPI cause hyponatraemia

A

yes

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12
Q

what must be given before large volume paracentesis

A

IV human albumin solution

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13
Q

1st line investigation for mesenteric ischaemia

A

serum lactate

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14
Q

what enzymes are good for comparing end stage liver disease

A

albumin
coagulation enzymes

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15
Q

management of c.diff

A
  1. oral vancomycin
  2. oral fidaxomicin
  3. oral vancomycin + IV metronidazole
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16
Q

spontaneous bacterial peritonitis most common organism

A

e.coli

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17
Q

what needs to be stopped before urea breath test

A

antibiotics 4 weeks before
PPI 2 weeks before

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18
Q

why do patients with coeliac disease require more immunisation

A

due to hyposplenism

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19
Q

what should be given for prophylaxis against spontaneous bacterial peritonitis

A

oral ciprofloxacin

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20
Q

SAAG >11 means ascites is caused by what

A

portal hypertension

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21
Q

1st line for flare of UC

A

rectal mesalazine

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22
Q

investigation of choice for patient with perianal fistula who has crohns

A

MRI

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23
Q

how should a severe flare of UC be managed

A

IV corticosteroids in hospital

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24
Q

Budd-Chiari triad

A

sudden onset abdominal pain
ascites
tender hepatomegaly

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25
metabolic ketoacidosis with normal or low glucose think...
alcohol
26
what is AST/ALT ratio in alcoholic hepatitis
2:1
27
triad of acute cholangitits
fever jaundice RUQ pain
28
what levels are raised in autoimmune hepatitis
IgG anti nuclear antibodies anti smooth muscle antibodies
29
what bug can you get from swimming pool
giardia - resistant to chlorine
30
isolated rise in bilirubin associated with stress is likely to be
Gilberts syndrome
31
can PPI cause hyponatraemia true or false
true
32
side effect of aminosalicylates
agranulocytosis - FBC !!!!
33
how does agranulocytosis present
fever, rigors
34
what vitamin is absorbed the ileum
B12
35
gene mutation in Gilberts
UGT1A1
36
inheritance of Gilberts
autosomal recessive
37
gene mutation in Wilsons
ATP7B
38
1st line investigation for coeliac disease
anti-TTG IgA antibody
39
what immunoglobulin in PBC
IgM
40
abdominal pain rose coloured spots on chest and abdomen
salmonella typhi
41
serum copper levels in Wilsons disease
low
42
hairy white patch on tongue is suggestive of
epstein barr virus
43
cancer associated with UC
cholangiocarcinoma
44
what tumour marker in cholangiocarcinoma
CA19-9
45
what juice can you not drink whilst taking warfarin
grapefruit juice
46
blood gas in person vomiting
metabolic alkalosis with hypokalaemia
47
liver failure following cardiac arrest is due to
Ischaemia hepatitis
48
SAAG > 11 is it transudate or exudate
transudate
49
SAAG <11g is transudate or exudate
exudate
50
management of alcoholic ketoacidosis
IV thiamine and 0.9% saline
51
what is given prior to appendectomy
IV antibiotics (prophylaxis)
52
abdominal pain + blood and leukocytes look for
stones
53
nitrates on urine dip suggests
urinary infection
54
management of PBC
antipruritics ursodeoxycholic acid
55
investigation of choice in patient with severe flare of UC
sigmoidoscopy
56
crypt abscess is seen in
UC
57
what is co administered with isoniazid to precent peripheral neuropathy
pridoxine (vitamin B6)
58
watery green diarrhoea post cholecystectomy is
bile acid malabsorption
59
how to treat bile acid malabsorption
cholestyramine
60
HNPCC causes
colorectal cacner endometrial cancer
61
seagull shape appearance on microscopy is
campylobacter
62
management of campylobacter
azithromycin
63
easy bruising and gum bleeding is
vitamin C deficiency
64
management of severe alcoholic hepatitis
corticosteroids
65
management of patient with ascites secondary to liver cirrhosis
spironolactone
66
double duct sign is seen in what
pancreatic cancer
67
periodic acid-stiff (PAS) positive macrophages is seen in
whipples disease
68
Liver failure triad
Encephalopathy Jaundice Coagulopathy
69
Type 2 diabetes with abnormal liver function is likely to be
non alcoholic fatty liver disease
70
Gene in HNPCC
MSH2 MLH1
71
Metabolic alkalosis + hypokalaemia is
prolonged vomiting
72
Surgical management of achalasia
Heller cardiomyotomy
73
what drug can worsen symptoms in Parkinsonism
metoclopramide - dopamine antagonist
74
management of patient who has crohns who develops perianal fistula
metronidazole
75
what does TIPS procedure connect
portal vien to hepatic vein
76
where does Crohn mostly affect
ileum
77
management of autoimmune hepatitis
steroids
78
medication to maintain remission in crohns
azathoprine
79
anti emetic contraindicated in bowel obstruction
metoclopramide
80
medication to induce remission in crohns
prednisolone
81
what drug can cause cholestasis
co-amoxiclav
82
gold diagnosis for NAFLD
transient elastography
83
what does Zollinger Ellinson syndrome cause
several ulcerations in stomach and duodenum due to uncontrolled release of gastrin
84
definitive management of ascending cholangitis
ERCP
85
features of ascending cholangitis
Charcot triad - RUQ pain - fever - jaundice
86
what hepatitis can be spread through shellfish
hepatitis A
87
what shape is campylobacter
spiral shape
88
MRCP beaded appearance
PSC

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