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Flashcards in Gastroenterology and Hepatology Deck (24)
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1

First line Tx in MALToma

H pylori eradication (induces remission in up to 70% of patients) and then biopsy every three months. If not works, can use imatinib and rituximab in combination

2

Antibiotics and presentation Entamoeba histolytica

Metronidazole. Up to 1 - 3 week of bloody diarrhoea

3

Antibiotics in campylobacter and salmonella

Quinolones or cephalosporins

4

Treatment of anal fissure

1. Soften stool through fibre diet 2. GTN ointment 3. Lidocaine ointment 4. Oral amlodipine / Botox injections

5

Hep A effect on hepatocytes

Necrosis

6

How does alcohol cause a hypo?

Alcohol impacts pancreatic microcirculation and leads to release of insulin and over shoot of first phase insulin release

7

Pharmacological tx of varices

8

Interventional tx for varices

9

Interventions for consequences of portal hypertension

10

11

Whipple's disease 

Triad: chronic cough, weight loss with steatorrhoea and arthritis

Biopsy will show infiltration of lamina propria with PAS macrophages

Up to two years of antibiotics such as co-trimoxazole required

Infection with tropheryma whipplei

12

Tropical sprue presentation

diarrhoea, abdominal pain and weight loss but no chronic cough

13

Treatment UC vs CD

14

Ix and Tx for PSC

Progressive bile duct inflammation, stricutring and cholestasis, best visualised using MRCP

"rosebead appearance"

also antibodies: p-ANCA (but AMA in PBC is much more diagnostic)

60-70% in those with UC

Presentes with fatigue and pruritus, obstructive jaundice and cirrhosis. but can be asx.

tx: cholestyramine relieves pruritus, ursodeoxycholic acid, antibiotics for bacterial cholangitis

15

Difference creon and cholestyramine

Creon: Pancreatic insufficeincy diarrhoea

Cholestyramine: bile acid diarrhoea, which is seen due to malabsorption related to Crohn's or small bowel resection

16

Modern Hep B and Hep C treatment

Hep B: nucleotide analogue e.g. tenofovir

 

17

Bacterial overgrowth sx, side effects and tx

Early satiety, bloating and intermittent diarrhoea, increase in flatulence. 

Positive lactulose hydrogen breath test

B12 deficiency (and macroblastic anaemia) can be due to bacteria using B12 for their metabolism. 

Tx: rifaximin - alternatives metronidazole and tetracyclines

18

Flare up of UC steroids fail within 72 hours

If not dialted to more than 6cm, then may attempt cyclosporin to induce remission

19

What are contraindications to trnascutaneous liver biopsy?

ascites, INR > 1.6, platelets <60, 

20

well recognised complication of coeliac disease

splenic atrophy

21

Mechanism that prevents reflux

22

How do you recognise and manage serious paracetamol overdose?

INR

Bilirubin

Hepatic encepahlopathy

worsenins acidosis

worsening kidney disease

23

Kings college criteria

24

Carcinoid syndrome dx

24 hr HIAA urine