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Finals - Systems Paper > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

(147 cards)

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1
Q

Coeliac gene

A

HLA-DQ2

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2
Q

Coeliac diagnose

A 
Tissue transglutaminase (TTG) antibody and IgA
Endoscopic biopsy
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3
Q

Coeliac biopsy

A

Crypt hypertrophy

Villous atrophy

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4
Q

Treatment constipation

A

1) Lifestyle
2) Bulk forming - ispaghula
3) Osmotic - macrogol or lactulose
4) Stimulant - senna

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5
Q

Diagnose GORD

A

Clinical, endoscopy if red flag or failure treatment

If endoscopy -ve then 24h pH monitoring

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6
Q

Treatment GORD

A

1) Lifestyle
2) PPI one month
3) Lower dose if response, double if not
4) Surgery

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7
Q

Diagnose H Pylori

A

Urea breath test - 4w after antibiotic and 2w after PPI

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8
Q

Treatment H Pylori

A

7 days triple therapy:

- PPI + amoxicillin + (metronidazole or clarithromycin)

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9
Q

Upper GI bleeding scoring systems

A

Glasgow Blatchford - risk of having

Rochall - risk after endoscopy

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10
Q

Treatment oesophageal varices

A

1) Terlipressin and broad antibiotics

2) Vessel ligation

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11
Q

Identify IBS

A

6m:

  • Abdominal pain
  • Bloating
  • Change bowel habit
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12
Q

Treatment IBS

A

Pain - hyoscine butylbromide
Constipation - laxative but avoid lactulose
Diarrhoea - lopameride

CBT if failure

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13
Q

Identify crohns

A

No blood
Entire tract
Skip lesions
Full thickness

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14
Q

Identify UC

A

Blood
Continues inflammation
Superficial mucosa

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15
Q

Crohns histology

A

Goblet cells

Granuloma

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16
Q

Crohns induce remission

A

1) Glucocorticoid

2) Consider adding immunosuppresant

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17
Q

Crohns maintain remission

A

1) Azithrioprine or mercaptopurine

2) Methotrexate

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18
Q

Diagnose crohns fistula

A

MRI

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19
Q

Treat crohns fistula

A

Metronodazole

Draining seaton if complex

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20
Q

UC flares classification

A

Mild - <4 stools
Moderate - 4 to 6 stools or mimimal systemic
Severe - >6 or systemic disturbance

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21
Q

Diagnosis UC

A

Colonoscopy and biopsy

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22
Q

IC endoscopy findings

A

Pseudopolyps

Crypt abscesses

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23
Q

UC induce remission in proctatitis

A

1) Topical aminosalicylate (eg mesalazine)

2) Oral mesolazine

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24
Q

UC induce remission in left sided

A

1) Topical mesalazine

2) Oral mesolazine or corticosteroid

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25
UC induce remission in extensive disease
1) Topical mesalazine and oral | 2) Stop topical and add oral corticosteroid
26
Induce remission in severe UC
1) IV steroids | 2) IV ciclosporin
27
Maintain remission up to moderate UC
Proctatitis - topical mesalazine or oral | Left sided and extensive - oral mesalazine
28
Maintain remission in severe or 2 exacerbations a year UC
1) Oral azathioprine or mercaptopurine
29
Treatment peptic ulcer disease
Pylori -ve - PPI until healed | Pylori +ve - eradicaction
30
Diagnose peptic ulcer perforation
Clinical, but get CXR
31
Treatment peptic ulcer active bleeding
IV PPI | Endoscopic intervention, surgery if fails
32
Artery for peptic ulcer bleeding
Gastroduodenal artery
33
Identify refeeding syndrome
Low everything - phosphate, K, Mg
34
Screening malnutrition
MUST
35
Definition malnutrition
>10% weight loss in 3-6m | or BMI <18.5
36
Identify plummer vinson syndrome
Tirad: - Dysphagia secondary to webs - Glossitis - Iron deficiency anemia
37
Treatment plummer vinson syndrome
Iron and dilation webs
38
Identify mallory-weiss syndrome
Severe vomiting in alcoholics cause painful laceration
39
Identify Boerheave syndrome
Severe vomiting causing oesophageal rupture
40
Identify peptic stricture
Longer history dysphagia not progressive | Symptoms GORD
41
Identify achalasia
Dyphagia both solids and liquids | Regurgitation food
42
Treatment achalasia
1) Pneumatic balloon dilation | 2) Surgery
43
Diagnose pharangeal pouch
Barium swallow
44
Vit A deficiency
Night blindness
45
Vit B1 deficiency
Wernicke-Karottkoff syndrome
46
Vit C deficiency
Scurvy - bleeding and poor wound healing
47
Vit B3 deficiency
Pallagra - dermatitis and dementia
48
Vit B6 deficiency
Peripheral neuropathy and sideroblastic anaemia
49
Vit B12 deficiency
Degermation cord
50
Treatment hep B
1) Pegylated interferon alpha
51
Hepatitis vaccines
A and B
52
Hepatitis foecal oral
A and E
53
Hepatitis needs B
D
54
Hepatitis greatest risk cancer
Hep C
55
Hepatitis worse in pregnancy
Hep E
56
Treatment autoimmune hepatitis
1) Steroids | 2) Liver transplant
57
Identify autoimmune hepatitis
Anti-nuclear antibody
58
Identify alcoholic liver disease
AST:AKT 2:1 Increased gamma GT U and E derranged in hepatorenal syndrome
59
Diagnose alcoholic liver disease
US - increased echogenicity | CT and MRI
60
Treatment alcoholic liver disease acute
1) Glucocorticoids
61
Alcohol screening
CAGE | AUDIT
62
Calculate units
(ml x ABV) / 1000
63
Ascites cause if SAAG > 11
Portal hypertension: - liver - cardiac - Budd Chari
64
Ascites cause if SAAG < 11
Hypoalbuminaemia - nephrotic syndrome Malignancy Infection
65
Treatment ascites
1) Spironolactone and consider drainage
66
Prophylactic antibiotics in ascites
Oral ciprofloxacin
67
Measure severity liver cirrhosis
Child-Pugh score
68
Treatment liver cirrhosis
1) Lifestyle and US every 6m | 2) Consider transplant
69
Liver cirrhosis US
Nodularity | Corkscrew appearance arteries
70
Treatment hepatic encephaltis
1) Lactulose and rifaximin
71
Identify non-alcoholic fatty liver disease
ALT>AST
72
Identify acute liver failure
Decreased albumin and prolonged prothrombin time
73
Diagnose lower GI bleeding
Unstable - CT angiogram | Stable - colonscopy
74
Diagnose intestinal ischaemia
CT scan
75
Diagnosis SBP
Paracentesis - neutrophil count >250
76
Most common cause SBP
E coli
77
Treatment SBP
IV cefotaxime
78
Identify primary biliary colangitis (AKA cirrhosis)
Anti-mitochondrial antibody (AMA) positive | Increased IgM
79
Diagnose primayr biliary colangitis
MRCP and immunology
80
Treatment primary biliary colangitis
1) Ursodeoxycholic acid | 2) Liver transplant
81
Identify primary sclerosing colangitis
Associated UC Cholestasis Maybe pANCA positive
82
Diagnose primary sclerosing cholanigits
ERCP or MRCP
83
Diagnose acute cholecystitis
1) US
84
Treatment acute cholecystitis
IV antibiotics and laparoscopic cholecystectomy
85
Identify ascending cholangitis
Charcots triad: - RUQ pain - fever - jaundice Renolds pentad: - hypotension - confusion
86
Diagnose ascending cholanigtis
US
87
Treatment ascending cholanitis
IV antibiotics and ERCP to relive obstruction
88
Identify biliary colic
Colicky abdominal pain worse after fatty food | No fever
89
Diagnose biliary colic
US
90
Treatment biliary colic
Elective laparoscopic cholecystectomy
91
Diagnose hiatus hernia
bariums swallow
92
Treatment hiatus hernia
1) Conservative 2) PPI 3) Surgery
93
Acute pancreatitis signs
Cullens - periumbilical discolourisation | Grey turner - flank discolourisation
94
Diagnose acute pancreatitis
Amylase/lipase and symptoms, or imaging with CT
95
Scoring systems acute pancreattiis
Randon Glasgow APACHE II
96
Treatment acute pancreatitis
IV opiods and aggressive fluid | Surgery to rleieve obstruction or necrosis
97
Oestophageal cancer histology
Upper 2/3 - SCC | Lower 1/3 - adenocarcinoma
98
Oesophageal cancer smoking
SCC
99
Treatment Barrets
Endoscopic surveillance and biopsy every 3-5y | PPI
100
Pancreatic cancer histology
Adenocarcinoma
101
Identify pancreatic cancer
Painless jaundice Cholestatic LFTs Pale stools
102
Diagnose pancreatic cancer
CT scan - double duct sign
103
Most common cause small bowel obstruction
Adhesions
104
Diagnose small bowel obstruction
1) Xray first | 2) CT definitive
105
Diagnose chronic pancreatitis
CT - calcifications
106
Diagnose gastric cancer
Endoscopy and biopsy - signet ring cells | CT for staging
107
Diagnose appendicitis
Men - clinical | Female - US
108
Treatment appendicitis
Appendicectomy and IV antibiotics
109
Colorectal cancer screning
Every 2y to people aged 50-74y: - Foecal immunochemical test Colonoscopy if abnormal
110
Diagnose colorectal cancer
Colonoscopy and biopsy, sigmoidoscopy if bleeding | CT CAP staging
111
What is diverticular disease
Herniation colonic mucosa through muscle wall
112
Diverticular disease diagnosis
Clinic - colonoscopy | Acute - identified on xray for perforation
113
Diverticular classification
Hickley
114
Diverticular treatment
Increase fibre Mild - antibiotics Abscess - drainage Recurrent - consider surgery
115
What is diverticulitis
Infection of diverticulum
116
Treatment diverticulitis
Mild - antibiotics | Severe - IV antibiotics
117
Identify haemorrhoids
Painless bleeding | Pruritis
118
Treatment haemorrhoids
1) Increase fibre and fluid 2) Rubber band ligation 3) Surgery
119
Sigmoid volvulus identify
Most common | Coffee bean sign
120
Coecal volvulus identify
Looks like foetus
121
Volvulus diagnosis
Xray
122
Volvulus treatment
Sigmoid - right sigmoidoscopy with rectal tube | Caecal - right hemicolectomy
123
Anal cancer histology
SCC
124
Anal fissure treatment
1) bulk forming laxative and lubricants 2) Topical GTN 3) Surgery
125
Diagnose necrotising enterocolitis
Neonate | AXR - dilated bowel loops, intramural gas
126
Inguinal hernia location and treatment
Superior and medial to pubic tubercle | Surgery
127
Femoral hernia location and treatment
Inferior and lateral to pubic tubercle | Surgery
128
Identify alcoholic ketoacidosis
Metabolic acidosis increase anion gap Increased ketones Normal glucose
129
Treatment alcoholic ketoacidosis
Saline infusion and thiamine
130
Identify Budd Chairi syndrome
AKA hepatic vein thrombosis Triad: - abdominal pain sudden and severe - ascites - tender hepatomegaly
131
Diagnose Budd chari
US
132
Blood film pernicious anaemia
Hypersegmented polymorph
133
Treatment perncious anaemia
B12 replacement then folic acid
134
Variceal haemorrhage treatment
1) Endoscopy and band ligation 2) Sengstakan blackmore tube 3) TIPS
135
Prevention variceal haemorrhage
Propranolol
136
Treatment Wilsons
Penicillamine
137
Diagnose Wilsons
Decreased copper
138
Diagnosis Borheaves syndrome
CT contrast swallow
139
Oesophageal cancer barium sign
"Apple core"
140
Carcinoid syndrome treatment
Octreotide
141
Cause of pigmented gallstones
Sickle cell disease
142
Colorectal cancer histology
Adenocarcinoma
143
Incercerated hernia
Unable to be reduced
144
Body area for burns
Wallace rules of 9 | Lund and Browder chart
145
Classification burns
Superficial - red and painful Partial thickness (superficial dermal) - painful and blisters Partial thickness (deep dermal) - white, reduced sensation Full thickness - white/brown/black, no blisters no pain
146
Burn when to refer
All deep dermal and full thicken Superficial if >3% body Inhalation injnury
147
Parkland formula for IV fluid
4 x surface area x body weight 50% first 8h

Finals - Systems Paper (20 decks)

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