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Flashcards in Gastroenterology Deck (55):
1

Coeliac
- what kind of disease
- where is affected
- who is affected

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

2

Coeliac symptoms

steatorrhea
diarrhoea
fatigue
abdo pain
bloating
nausea/vomiting
weight decrease

3

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

4

Coealic can be from what anemias

Macrocytic MCV
Microcytic MCV
Normocytic

5

what breaks down carbs?
if it's lacking, what does it suggest?

Amylase - breaks down into small sugars

If no amylase -> pancreatic insufficiency

6

Amylase is? and breaks down?

enzyme that helps digest carbohydrates

7

Chronic pancreatitis markers - 3

Increased amylase
Increase lipase
Fecal elastase

8

Chronic pancreatitis causes - 5

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

9

check for proteins to check for...?
how to check for albumin?

check for protein of malabsorption

Do: bloods for albumin

10

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

11

lactose intolerance
- how does it cause diarrhoea

increases osmolarity, therefore causes diarrhoea

12

pancreatitis treatment and what is in it

creaon (enzymes) - amylase, lipase and proteins

13

pancreatitis investigations - and results - 3

CT shows calcification
bloods - enzyme level
breath test

14

pancreatitis symptoms

epigastric pain
bloating
steatorrhea
weight loss

15

Crohns symptoms
- leisons
- characteristic features
- symptoms

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

16

crohns investigations

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

17

crohns management
- mild
- severe

mild: prednisolone
severe: hydrocortisone, metronidazole, infliximab

18

ulcerative colitis symptoms
- characteristic features

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

19

ulcerative colitis investigations (2) and results

stool
blood: anemia, leukyocytes
increased ESR
low albumin

20

blood tests with inflammation results

increased WBC
increased CRP
increased platelets - thrombocythemia

21

ulcerative colitis management - 3
- additional 1 for inflammation that is not steriodal

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

22

portal hypertension - how it happens
THINK: platelets

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

23

2 kinds of GI bleed

hematasis
malena

24

GI bleed manage - 3 steps

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

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

25

GI bleed cause

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

26

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

PPI
2 AB - clarithromycin or amox

if allergic to pens, give metrinidazole and doxycyclin

27

H pylori diagnosing - 3 ways

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

28

2 ways Esophageal varicies occur

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

29

GI bleed signs - 3

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

30

GI bleed investigation

Endo
Colo
duodenal biopsy

31

liver failure causes - 4

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

32

liver failure signs - 3

jaundice
hepatic encephalopathy
liver flap

33

liver failure - what tests to do

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

34

cirrhosis signs

LFT increases
dupentrens
clubbing
palmar erythema
gynecomastia

35

cirrhosis tests results

blood: increase BR, increase AST, increase ALT, increase PR/INR, decrease platelet

ultrasound: hepatomegaly, splenomegaly, ascites
MRI: size increase

36

jaundice conjugated test results

- hepatocellular
-alcoholic
-obstructive

hepatocellular - ALT more than AST
Alcoholic - Increase AST and gamma T more than ALT


Obstructive
Increased ALP

37

autoimmune hepatitis - 2 features

What antibody?

inflammation
t suppressor cells defected


anti-smooth muscle antibody positive

38

autoimmune hepatitis test results

What antibody?

BR, AST, ALT increase
Anemia
hypergammaglobuinaemia
Liver biopsy

anti-smooth muscle antibody positive

39

primary biliary cirrhosis

What antibody?

bilary duct damaged by auto immune granulomas

fatigue, jaundice, hepatosplenomegaly

Anti-mitochondrial antibodies

40

primary biliary cirrhosis test results

What antibody?

Bloods: all increased, except albumin decreased

Anti-mitochondrial antibodies

41

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

42

A1 antitrypsin symptoms

dysponea from emphysema
cirrhosis
jaundice
pancreatitis

43

A1 antitrypsin tests

a1 antitrypsin decreases
liver biopsy

44

dyspepsia symtpoms

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

45

duodenal ulcer symtpoms

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

46

do you need to stop PPI 2 weeks before endo?

yes

47

can reflux lead to barretts?

yes

48

symptoms of gord

heartburn - relived by antacids
retrosternal pain
painful swallowing
increased salivation

49

gord investigations

endo if more than 4 weeks and vomiting or over 55

50

gord treatment

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

51

what is frank pus a sign of?

IBD
diverticulitis
fistula/abscess

52

what is the gold standard of diagnosing coeliacs?

duodenal biopsy

53

what is hereditary haemochromtosis?

iron deposit in joints and organs
-->hereditary

54

in viral hep, what is IgM and IgG?

think: moms are active
grandmothers are protective

m = active
g= protective


55

is inr and pt increased in liver failure?

yes