Gastrointestinal Flashcards Preview

Revision > Gastrointestinal > Flashcards

Flashcards in Gastrointestinal Deck (29):
1

Management of acute liver failure

30º tilt - to minimise ICP elevation
Intubation
NGT
Urinary cathether/CVC
Analgesia
Sedation
10% dextrose - for hypoglycaemia
Dialysis - for renal failure
Treatment of underlying cause

2

Features of Korsakoff's syndrome

Anterograde/retrograde amnesia
Aphasia, apraxia, agnosia
Confabulation
Lack of insight

3

Causes of cirrhosis

HANDWAVE:
-Haemochromatosis
-Autoimmune - autoimmune hepatitis, PBC, PSC
-Non-alcoholic steatohepatitis (NASH)
-Drugs - amoxicillin, flucloxacillin, amiodarone, methotrexate
-Wilson's disease
-Alpha-1 antitrypsin disease
-Viral hepatitis - hepatitis B, hepatitis C
-Ethanol

4

Pathology of cirrhotic nodules

Fibrous bands subdivide liver parenchyma into regenerative nodules - micro/macro/mixed

5

Serum albumin ascites gradient (SAAG)

SAAG = serum albumin - ascitic fluid albumin

>11 g/L - transudate

6

Causes of liver decompensation

DIGROCK:
-Dehydration
-Infection (SBP)
-GI bleeding
-Renal failure
-Opioids
-Constipation
-Killing liver by other means (benzodiazepines, hypoxia, surgery, hyponatraemia, hypokalaemia)

7

Management of ascites

Fluid/salt restriction
Paracentesis
Transjugular intrahepatic portosystemic shunt (TIPS)

8

Management of hepatic encephalopathy

Laculose
Rifaximin

9

Most common pathogens in SBP

Gram-negative bacteria (E. coli, Klebsiella)

10

Management of SBP

Ceftriaxone/cefotaxime (IV)

11

Management of hepatorenal syndrome

Albumin

12

Child-Pugh score

ABCDE:
-Albumin
-Total bilirubin
-Clotting time (PT)
-Distended abdomen (ascites)
-Hepatic encephalopathy

13

Extraintestinal features of coeliac disease

Anaemia
Bleeding diathesis (vitamin K deficiency)
Osteoporosis
Neurological features (hypocalcaemia)
Hormonal disorders

14

Pathological process in gastritis

Metaplasia

15

Management of Crohn's disease

Induction:
-Prednisolone
-Anti-TNF (infliximab)
-Immunomodulatory agents (azathioprine, mercaptopurine, methotrexate)

Maintenance:
-Anti-TNF
-Immunomodulatory agents

16

Management of ulcerative colitis

Induction:
-Mesalazine + 5-ASA
-Corticosteroids

Maintenance:
-Mesalazine + 5-ASA
-Immunomodulatory agents

17

Management of primary biliary cirrhosis

Ursodeoxycholic acid

18

Management of GORD

Lifestyle modification:
-Limit trigger foods
-Eat smaller meals
-Avoid eating/drinking 2-3 hrs before bed/exercise
-Stop smoking
-Lose weight

Medications:
-PPI (esomeprazole, omeprazole, pantoprazole)
-H2 receptor antagonist (ranitidine)
-Antacid (Mylanta)

Surgery:
-Nissen fundoplication (upper stomach wrapped around LOS)

19

Complications of GORD

-Reflux oesophagitis
-Oesophageal stricture
-Barrett's oesophagus (requires monitoring)
-Oesophageal adenocarcinoma

20

Avoid antibiotics in which gastroenteritis pathogen and why?

EHEC - may cause HUS

21

H. pylori triple therapy

PPI - esomeprazole/omeprazole
Amoxicillin (or metronidazole)
Clarithromycin

22

Location and epithelium of external vs. internal haemorrhoids

External: distal to dentate line; anoderm (specialised squamous epithelium)
Internal: proximal to dentate line; transitional epithelium

23

Grades of haemorrhoids

1 - no prolapse
2 - prolapse upon bearing down with spontaneous reduction
3 - prolapse upon bearing down requiring spontaneous reduction
4 - irreducible prolapse

24

PBC vs. PSC antibodies

PBC: AMA, ANA
PSC: ANA, pANCA, anti-SMA

25

Transmission of viral hepatitis

A - faecal-oral
B - sexual contact, vertical transmission (and other blood contact)
C - IVDU (and other blood contact)

26

Interpretation of HBV serology – HBsAg, anti-HBs, anti-HBc

HBsAg - active infection (acute or chronic)
Anti-HBs - immune (due to vaccination or infection)
Anti-HBc - active or previous infection

27

Dukes' classification

A - no penetration of muscularis propria
B - invasion of muscularis propria
C - lymph node involvement
D - distant metastasis

28

TNM staging of colorectal cancer

Definitions:
♣T:
• is – confined to mucosa
• 1 – invasion of submucosa
• 2 – invasion of muscularis propria
• 3 – invasion of subserosa or beyond
• 4 – invasion of adjacent organs or visceral peritoneum
♣N:
• 1 – 1-3 lymph nodes
• 2 – 4+ lymph nodes
♣M:
• 1 – distant metastasis

Stages:
♣0 – Tis, N0, M0
♣I – T1/2, N0, M0
♣IIA – T3, N0, M0
♣IIB – T4, N0, M0
♣IIIA – T1/2, N1, M0
♣IIIB – T3/4, N1, M0
♣IIIC – any T, N2, M0
♣IV – any T, any N, M1

29

Most common cause of hepatocellular carcinoma

Chronic viral hepatitis