Gastroenterology Flashcards by serena patel

Coeliac

what kind of disease
where is affected
who is affected

T cell autoimmune
Small bowel - terminal illeum
villi atrophy
infancy and 50-60

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Coeliac symptoms

steatorrhea 
diarrhoea
fatigue
abdo pain
bloating
nausea/vomiting
weight decrease

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Coealic test results

what antibody to show if auto immune
where to biopsy and what to look for

decrease Hb, B12, ferritin
Look for IgG to see if autoimmune 
--> antibodies against glyteine
-->serology sensitive and specific 
Duodenal biopsy to see vili and lymphocytes

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Coealic can be from what anemias

Macrocytic MCV
Microcytic MCV
Normocytic

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what breaks down carbs?

if it’s lacking, what does it suggest?

Amylase - breaks down into small sugars

If no amylase -> pancreatic insufficiency

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Amylase is? and breaks down?

enzyme that helps digest carbohydrates

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Chronic pancreatitis markers - 3

Increased amylase
Increase lipase
Fecal elastase

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Chronic pancreatitis causes - 5

Increase levels of fat
family history - auto immune
Alcohol
CF
pancreatic duct obstruction

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check for proteins to check for…?

how to check for albumin?

check for protein of malabsorption

Do: bloods for albumin

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Lipase

where is it made
if lacking then what happens to stool?
vit k deficiency sign
what vitamins are fat soluble

Made in pancreas
If lacking = diarrohea  and floating stool
Vitamin malabsorption
 - Vit K: bruising
- ADEK = fat soluble vitamins

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lactose intolerance

- how does it cause diarrhoea

increases osmolarity, therefore causes diarrhoea

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pancreatitis treatment and what is in it

creaon (enzymes) - amylase, lipase and proteins

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pancreatitis investigations - and results - 3

CT shows calcification
bloods - enzyme level
breath test

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pancreatitis symptoms

epigastric pain
bloating
steatorrhea
weight loss

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Crohns symptoms

leisons
characteristic features
symptoms

skip leisons - 3 layers
bloody diarrhea, malaise, fever, malabsorption, abdo pain, weight loss, anemia
granulomas
fistulas

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crohns investigations

FBC, ESR, CRP, U&amp;E, INR, Fe, B12, Folate
stool 
colonoscopy, rectal biopsy
barium enema
MRI

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crohns management

mild
severe

mild: prednisolone
severe: hydrocortisone, metronidazole, infliximab

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ulcerative colitis symptoms

- characteristic features

1 layer
pseudopolyps 
less weight loss than crohns
colonic
smoking helps
crypt abcess
superficial

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ulcerative colitis investigations (2) and results

stool
blood: anemia, leukyocytes
increased ESR
low albumin

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blood tests with inflammation results

increased WBC
increased CRP
increased platelets - thrombocythemia

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ulcerative colitis management - 3

- additional 1 for inflammation that is not steriodal

steriods
anti-tnfa
surgery
5 aza - methalazine (for inflam, non steriodal)

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portal hypertension - how it happens

THINK: platelets

congestion in the spleen causes processing of platelets to increase therefore circulating platelets to decrease

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2 kinds of GI bleed

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hematasis

malena

GI bleed manage - 3 steps

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venous access - cannula
IV fluids
blood transfusions
rubber band ligation 
Give AB to decrease infection (quinolones)

resusitate - bloods and fluids
stop bleeding - terlipressin , rubber band ligation,
prevent re-bleeding - b blocker. Elective variceal band ligation (2 weekly endoscopies)

GI bleed cause

``` cancer NSAID GORD AAA TCAs peptic ulcer - h pylori Variceal bleed Mallory-weiss tear Boerhaeve's Rupture ```

H pylori treatment - triple therapy - if pen allergy then what?

PPI 2 AB - clarithromycin or amox if allergic to pens, give metrinidazole and doxycyclin

H pylori diagnosing - 3 ways

Biopsy - Clo test can be -ve if on AB or PPI, Bloods - check h pylori antibodies Stool sample

2 ways Esophageal varicies occur

progessive liver failure | portal hypertension - Na and H2o retained, varices from increased pressure

GI bleed signs - 3

haematemis (coffee ground or malena) chronic liver disease oesophageal varices

GI bleed investigation

Endo Colo duodenal biopsy

liver failure causes - 4

infection: viral hep drugs: paracetemol overdose toxins other: alcohol, cirrhosis, fatty liver

liver failure signs - 3

jaundice hepatic encephalopathy liver flap

liver failure - what tests to do

bloods: fbc, u&e, lft, clotting, glucose, paracetemol levels micro: blood, urine radio: cxr, abdo, ultrasound

cirrhosis signs

``` LFT increases dupentrens clubbing palmar erythema gynecomastia ```

cirrhosis tests results

blood: increase BR, increase AST, increase ALT, increase PR/INR, decrease platelet ultrasound: hepatomegaly, splenomegaly, ascites MRI: size increase

jaundice conjugated test results - hepatocellular - alcoholic - obstructive

hepatocellular - ALT more than AST Alcoholic - Increase AST and gamma T more than ALT Obstructive Increased ALP

autoimmune hepatitis - 2 features What antibody?

inflammation t suppressor cells defected anti-smooth muscle antibody positive

autoimmune hepatitis test results What antibody?

BR, AST, ALT increase Anemia hypergammaglobuinaemia Liver biopsy anti-smooth muscle antibody positive

primary biliary cirrhosis What antibody?

bilary duct damaged by auto immune granulomas fatigue, jaundice, hepatosplenomegaly Anti-mitochondrial antibodies

primary biliary cirrhosis test results What antibody?

Bloods: all increased, except albumin decreased Anti-mitochondrial antibodies

A1 antitrypsin deficiency - how is it caused - what is it - what does it cause

inherited inflammation is inhibited causes liver disease in children prevents elastase from damaging tissue

A1 antitrypsin symptoms

dysponea from emphysema cirrhosis jaundice pancreatitis

A1 antitrypsin tests

a1 antitrypsin decreases | liver biopsy

dyspepsia symtpoms

``` epigastric pain from hunger specific foods time of day fullness after meals heartburn ALARM: anemia, loss of weight, anorexia, recent, melena ```

duodenal ulcer symtpoms

epigastric pain before meals or at night | relieved by food and milk

do you need to stop PPI 2 weeks before endo?

yes

can reflux lead to barretts?

yes

symptoms of gord

heartburn - relived by antacids retrosternal pain painful swallowing increased salivation

gord investigations

endo if more than 4 weeks and vomiting or over 55

gord treatment

``` weight loss raise head in bed stop smoking small regular meals avoid certain food and drink ```

what is frank pus a sign of?

IBD diverticulitis fistula/abscess

what is the gold standard of diagnosing coeliacs?

duodenal biopsy

what is hereditary haemochromtosis?

iron deposit in joints and organs | -->hereditary

in viral hep, what is IgM and IgG? think: moms are active grandmothers are protective

``` m = active g= protective ```

is inr and pt increased in liver failure?

yes

Gastroenterology Flashcards

(55 cards)