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Flashcards in GI Deck (491)
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181

DD for lower GI bleeds?

haemorrhoids, diverticulitis, IBD, malignancy, polyps. angiodysplasia, infectious diarrhoea, anal fissure

182

What is a femoral hernia?

Weakness in the femoral canal, lateral and inferior to the pubic tubercle, more common in females, presenting with a mass in the groin.

183

Treatment of a Mallory-Weiss tear?

Can heal spontaneously, or can use surgery to over sew the tear. IV omeprazole to reduce re-bleeding rates and reduce the need for surgery.

184

Treatment of peritonitis?

NPO status, nasogastric tube to suction and decompress stomach, IV fluids, antibiotics, analgesics, oxygen and electrolyte replacement, surgery to identify cause and repair, drain peritoneal fluid, colon resection, antimicrobials, ascitic tap if >250PMN/uL and positive culture

185

What are some complications of acute cholecystitis?

Empyema (pus), perforation and peritonitis

186

What is the management of ulcerative colitis when there is not a flare up?

5-ASA therapy via rectal or oral and then oral prednisolone, colectomy

187

Treatment of infective diarrhoea?

Bacterial - fluoroquinolones, azithromycin, susceptibility testing C.diff - metronidazole or oral vancomycin Giardia - metronidazole or tinidazole Cryptosporidium - nitazoxanide Virus - self limited Amoebiasis - metronidazole and intraluminal agent e.g. paromycin or diloxanide

188

What do investigations show with diverticular disease?

Increased WCC, ESR, CRP and leucocytosis. CT shows paracolic abscess, colonic wall thickening, US shows thickened bowel and large pericolic collections

189

What is the difference between 2nd and 3rd degree haemorrhoids and what is their treatment?

2nd is prolapse through anus on defecation but spontaneously reduces and 3rd degree is the same but needs digital reduction. Treatment via rubber band ligation, scerolsant injection, infrared coagulation or cryotherapy.

190

How does smoking affect the two IBD?

Aggravates Crohns but protects against ulcerative colitis

191

DD for LUQ pain?

gastric ulcer, pancreatitis

192

DD for LI pain?

diverticular disease, IBD, ectopic pregnancy, ovarian torsion, inguinal or femoral hernia

193

What is an umbilical hernia?

Weakness in the umbilicus, mainly in males, and is self resolving.

194

What is skip lesions in the colon referred as?

Crohn's colitis

195

Causes of liver cirrhosis?

Chronic viral hepatitis, alcoholic liver disease, hemochromatosis, autoimmune hepatitis, Wilson's disease and coeliac disease

196

What is the pathogenesis behind genetic chronic pancreatitis?

There is a mutation in the PRSSI gene which codes for cationic trypsinogen (the main trysinogen produced by the pancreas).

197

How does the sliding hiatus hernia occur?

The sphincter and top part of the stomach push upwards into the chest and cause heart burn due to reflux. They can slide back and forth through the hiatus, so symptoms can come and go.

198

Where is fasciola acquired from and what does it cause?

Fluke acquired from livestock in wetlands. Larvae picked up from plants, leads to hepatitis followed by biliary tract infestation with eoisinophilia

199

What is the treatment of acute pancreatitis?

IV fluids, nasogastric suction prevents abdominal distension and vomit, analgesics, prophylactic antibiotics, NBM, LMW heparin for DVT, ERCP for gallstone extraction, low fat diet

200

What are some acute causes of gastritis?

stress, NSAIDs, uraemia, Curling's ulcer, alcohol, spicy food

201

What type of cell produce HCl acid in the stomach?

Parietal cells

202

What are prebiotics?

non-digestible food supplements that are fermented by host bacteria, altering the microbiota of the host, stimulating the growth of healthy bacteria.

203

Symptoms of primary biliary cirrhosis?

Fatigue, pruritus, dry mouth and eyes, RUQ discomfort, hepatomegaly, hyperpigmentation of skin, jaundice, pigmented xathelasma, association with other autoimmune diseases

204

Apart from UC and Crohns, what are other IBDs?

infective colitis, diverticulitis, ischaemic colitis

205

What is chronic pancreatitis?

structural integrity of the pancreas permanently altered due to chronic inflammation

206

Diagnosis of varice?

EGD to confirm diagnosis, identify bleeding site, estimate risk of bleeding , stop NSAIDs and start PPI post endoscope

207

Investigations in liver abscess?

LFT, elevated AST/ALT/ALP/bilirubin, low albumin, US shows hypo echoic mass and CT scan shows huge abscess, CXR shows pneumonia and air under diaphragm from complications

208

What causes black pigment stones?

A decrease in bile salts causes an increase in solubilization, colonic reabsorption of bilirubin, enterohepatic circulation and therefore an increase in biliary bilirubin secretion and increased stones

209

Complications of portal hypertension?

Gastro-oesophageal varicies, splenomegaly, thrombocytopenia, low platelet count, anaemia, leucopoenia, haemorrhoids, hepatic encephalopathy due to excess ammonia, loss of memory, confusion, coma, hepatic pulmonary syndrome,

210

DD for hypogastrium pain?

UTI, appendicitis, IBD, diverticular disease