GI Flashcards by Huda Khalid

How to differentiate upper vs lower GI bleed

High urea&raquo_space; upper GI

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Amylase in pancreatitis

Diagnostic only mot prognostic

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Management of acute alcoholic hepatitis

Prednisolone

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Dietary modification in IBS

Limit intake of insoluble sources of fibre such as bran and wholemeal

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First line in mild/moderate flare of distal ulcerative Colitis

Topical/Rectal Aminosalicylate

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Features of hemochromatosis reversible with time

Cardiomyopathy and skin pigmentation

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Management of ongoing diarrhoea in Crohn’s patient post-resection with normal CRP

cholestyramine

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When to treat alcoholic hepatitis with corticosteroids

If Maddrey’s discriminant function > 40

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UC had severe relapse or >= 2 relapses per year, how to maintain remission?

Oral azathioprine
Or
Oral mercaptopurine

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Drugs that cause cholestasis

Sulphonylureas (Gliclazide)
COCPs
Flucloxacillin
Co-Amoxiclav

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Before urea breath test stop:

Antibiotics for 4 weeks
PPI for 2 weeks

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Mainstay treatment for hydatid cysts

Surgery

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Coeliac disease HLA association

HLA DQ2

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Laxative with carcinogenic potential

Co-danthramer
Contains dantron> carcinogenic
Used only in palliative patients

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Contraindications to percutaneous liver biopsy

• deranged clotting (e.g. INR > 1.4)
• low platelets (e.g. < 60 * 10°/l)
• anaemia
• extrahepatic biliary obstruction
• hydatid cyst
• haemoangioma
• uncooperative patient
• ascites

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ZES stimulation test?

Secretin

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Most common location for gastrinoma

Duodenum
Then pancrease

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Inv of choice for primary sclerosing cholangitis?

MRCP

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Eosinophilic esophagitis first line

Topical fluticasone
(Not oral steroids)

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Heyde’s syndrome

Aortic stenosis and angiodysplasia
Do capsule endoscopy

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Wilson inv

Decreased cerruloplasmin

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Clindamycin side effect

Diarrhea (C difficile)

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Clindamycin side effect

Diarrhea (C difficile)

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Wilson inv

Decreased cerruloplasmin

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UC in biopsy?

Depletion of goblet cells

Prophylaxis against SBP?

If ptn concentration <=15 Oral cipro or norfloxacin

Prophylaxis for hepatic encephalopathy

Ist>> lactulose 2nd>> Rifaximin

Angiodysplasia associated with

Aortic stenosis

Prophylaxis for hepatic encephalopathy

Ist>> lactulose 2nd>> Rifaximin

Prophylaxis for hepatic encephalopathy

Ist>> lactulose 2nd>> Rifaximin

High anion gap metabolic acidosis

Methanol Uremia D ketoacidosis Paracetamol Iron/INH Lactic acidosis Ethylene glycol Salicylate overdose

Assessed before starting azathioprine or mercaptopurine?

Thiopurine methyltransferase (TPMT) activity

Immunoglobulin subtypes associated with liver diseases

Primary biliary cirrhosis >> IgM Autoimmune hepatitis >> IgG Alcoholic liver disease >> IgA

Empirical antibiotic ttt for liver abscess

Amoxicillin + Clindamycin + metronidazole

Most VIPoma arise from

Pancrease (tail)

Barcelona Classification of liver cancer ttt for HCC

Patients with Child-Pugh A cirrhosis without signs of portal hypertension who have single lesions <2cm in size should be treated with surgical resection. For those patients with Child-Pugh A and B cirrhosis and 2-3 tumours <= 3 cm or 1 tumour <=5 cm without vascular invasion or extrahepatic spread should be considered for liver transplantation. As a bridge to liver transplantation these patients can be treated with TACE or RFA. For those patients who have Child-Pugh A or B cirrhosis, good performance status, and evidence of vascular, lymphatic or extrahepatic spread the multiple tyrosine kinase inhibitor, Sorafenib, has been shown to prolong survival. Those with Child-Pugh C cirrhosis have end-stage liver disease and are poor candidates for therapy as they lack any hepatic functional reserve to tolerate either resection, TACE or RFA. These patients are best treated symptomatically.

SIBO first line inv

Hydrogen breath test

Indicator of pancreatitis severity

Hypocalcemia

Strongest risk factor for anal cancer

HPV infection

Primary biliary cholangitis (the M rule)

• IgM • anti-Mitochondrial antibodies, M2 subtype • Middle aged females

Cells that secrete hormone responsible for fatty food triggered biliary colic

I cells>> CCK

Eosinophilic esophagitis mx

Dietary modification and topical steroids

Monoclonal antibody that targets C. Difficile

Bezlotozumab

Inv of choice for primary sclerosing cholangitis

MRCP

Inv for microscopic colitis caused by PPIs

Colonoscopy and biopsy

Percentage of people with occult blood in stool who develop colorectal cancer

10%

Tool to screen for malnutrition

MUST

Inv of choice for bile acid malabsorption

SeHCAT

Monitoring ttt of hemochromatosis

Transferrin sat + ferritin

Hall mark of refeeding syndrome

Hypophosphatemia

Most common extra colonic cancer with HNPCC

Endometrial cancer

Autoimmune hepatitis has elevated

IgG

Risk of HCC in primary biliary cirrhosis compared to general population

20 fold increase

Antiretroviral associated with pancreatitis

Didanosine

APC gene is present on chromosome

Gastrin release is stimulated by

Luminal peptides

HNPPC due to defect in MSH2 gene, whats its function

DNA mismatch repair

Clotting factor increased in liver disease

Factor VIII

Ttt of choice for PBC

Ursodeoxycholic acid

Secretin function

Increases secretion of bicarbonate rich fluid from pancreas and hepatic ducts

Associations

JAK-STAT is the mutation associated with primary polycythaemia ruba vera. ATP/B is the dysfunctional protein associated with Wilson's disease. Glucuronyl transferase deficient in Gilbert

Association with celiac disease

HLA DQ2

Most likely symptom for carcinoid

Facial flushing Occur in 90% Episodic Provoked by alcohol stress foods

Ttt of choice for SIBO

Rifaximin 550 mg three times daily for 14 days

Plummer Vinson syndrome triad

Iron deficiency anemia Dysphagia due to esophageal webs Atrophic glossitis

Ischemic colitis mainly affects

Splenic flexure

Recurrent C difficile management

Within 12 weeks of symptom resolution > Oral Fidaxomicin After 12 weeks >> oral vanco or fidaxomycin

Primary sclerosing cholangitis is mostly associated with

Ulcerative colitis

Most common site affected with ulcerative colitis

Rectum

Test to assess exocrine function in chronic pancreatitis

Faecal elastase

Most common complication of ERCP

Acute pancreatitis

Most common arrythmia is refeeding syndrome

Torsade de pointes, due to hypomagnesemia

Best marker for acute pancreatitis severity

CRP (not lipase pr amylse)

Chronic anal fissure

Topical glyceryl trinitrate

Brush border enzymes

Brush border enzymes: • maltase: glucose + glucose • sucrase: glucose + fructose • lactase: glucose + galactose

Drug that causes acute pancreatitis

Na valproate

Pancreatitis in pregnancy

Gallstone induces

GI Flashcards

(77 cards)