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GI Flashcards

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1
Q

What is haemochromatosis?

A

An iron storage disorder- deposition of iron in tissues

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2
Q

What is the inheritance of haemochromatosis?

A

Autosomal recessive mutation on the HFE gene on chromosome 6

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3
Q

When does haemochromatosis usually present?

A

Age > 40

later in females

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4
Q

Presentation of haemochromatosis

A

Chronic tiredness, joint pain, pigmentation (bronze), hair loss, ED, amenorrhoea, memory and mood problems

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5
Q

Investigations in haemochromatosis

A

High serum ferritin, transferrin saturation
Liver biopsy with Perl’s stain- iron concentration in parenchymal cells
Genetic testing
CT/MRI for iron deposits

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6
Q

Management of haemochromatosis

A

Venesection

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7
Q

Complications of haemochromatosis

A
  • Type 1 diabetes
  • Liver cirrhosis, HCC
  • Cardiomyopathy
  • Iron in pituitary + gonads- hypogonadism, infertility
  • Hypothyroidism
  • Pseudogout
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8
Q

What is Wilson’s disease?

A

Excessive accumulation of copper in the body

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9
Q

What is the pattern of inheritance of Wilson’s disease?

A

Autosomal recessive

Mutation of ‘Wilson disease protein’ on chromosome 13

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10
Q

Clinical features of Wilson’s disease

A

Hepatic- chronic hepatitis, liver cirrhosis
CNS- dysarthria, dystonia, Parkinsonism, depression, psychosis
Kayser-Fleischer rings
Haemolytic anaemia, renal tubular acidosis, osteopenia

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11
Q

What can be seen in the eyes in Wilson’s disease?

A

Kayser-Fleischer rings

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12
Q

Investigations in Wilson’s disease

A

Serum caeruloplasmin
24hr urine copper assay
Liver biopsy

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13
Q

Management of Wilson’s disease

A

Copper chelation- Penicillamine, Trientene

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14
Q

What is the aetiology of Alpha-1-Antitrypsin deficiency?

A

A1AT inhibits neutrophil elastase –> excessive protease enzymes –> liver cirrhosis and lung disease

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15
Q

What is the inheritance pattern of Alpha-1-Antitrypsin deficiency?

A

Autosomal recessive defect on chromosome 14

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16
Q

What are the 2 key clinical features in Alpha-1-Antitrypsin deficiency?

A

Liver cirrhosis

Pulmonary basal emphysema

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17
Q

What is found on liver biopsy in Alpha-1-Antitrypsin deficiency?

A

Acid-Schiff positive staining globules

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18
Q

Management of Alpha-1-Antitrypsin deficiency

A

Stop smoking
Manage symptoms
Organ transplant

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19
Q

What is the aetiology of Primary Biliary Cirrhosis?

A

Immune system attacks small bile ducts –> cholestasis –> fibrosis –> cirrhosis –> liver failure
–> decreased excretion of bile acids, bilirubin and cholesterol

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20
Q

Clinical features of Primary Biliary Cirrhosis

A
  • Bile acids cause jaundice
  • Bilirubin causes jaundice
  • Cholesterol causes xanthelasma + CV disease
  • GI disturbance, malabsorption, greasy stools
  • Cirrhosis- ascites, splenomegaly, spider naevi
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21
Q

Investigations in Primary Biliary Cirrhosis

A

Raised ALP
Antimitochondrial antibodies
Liver biopsy to diagnose and stain

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22
Q

Management of Primary Biliary Cirrhosis

A

Ursodeoxycholic acid- reduces absorption of cholesterol
Cholestyramine- reduces absorption of bile acids
Liver transplant
Immunosuppression

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23
Q

What is the aetiology of Primary Sclerosing Cholangitis?

A

Intrahepatic/Extrahepatic ducts become strictured/fibrotic

  • -> Obstruction to flow of bile out of liver and into intestines
  • -> Hepatitis, Cirrhosis + Fibrosis
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24
Q

Risk factors for Primary Sclerosing Cholangitis

A

Ulcerative colitis
Male
Age 30-40
FH

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25
Presentation of Primary Sclerosing Cholangitis
``` Jaundice RUQ pain Pruritus Fatigue Hepatomegaly ```
26
LFTs in Primary Sclerosing Cholangitis
ALP most deranged, raised bilirubin
27
Diagnosis of Primary Sclerosing Cholangitis
MRCP --> bile duct lesions/strictures
28
Management of Primary Sclerosing Cholangitis
Liver transplant curative ERCP + stent Ursodeoxycholic acid, Cholestyramine
29
Complications of Primary Sclerosing Cholangitis
Colorectal cancer Cholangiocarcinoma Cirrhosis Fat-soluble vitamin deficiencies
30
How do you test for H pylori?
C13 urea breath test/Stool antigen test + CLO test
31
Management of H pylori
Triple therapy: 1. PPI 2. Amoxicillin 3. Clarithromycin + Metronidazole
32
What is Achalasia?
Disorder of motility of lower oesophageal sphincter --> impaired peristalsis + fails to relax Often due to an acquired aganglionic segment
33
Presentation of achalasia
Dysphagia, regurgitation, chest pain
34
CXR finding in achalasia
Dilated oeseophagus
35
Gold standard investigation in achalasia
Manometry
36
Finding on barium swallow in achalasia
Bird's beak
37
Management of achalasia
CCB/Nitrates | Surgery
38
Causes of upper GI bleed
Peptic ulcer disease Varices, Mallory-Weiss tear Malignancy Drugs
39
Investigation required in upper GI bleed
Endoscopy
40
What is a Mallory-Weiss tear?
Mucosal tear at the oesophago-gastric junction | Caused by persistent vomiting/wretching
41
Risk factors for Mallory-Weiss tear?
Alcohol, Bulimia, raised ICP, Gastroenteritis
42
What are oesophageal varices?
Dilated veins at junction between portal and systemic venous circulation In distal oesophagus/proximal stomach
43
Risk factors for oesophageal varices
Portal hypertension from chronic liver disease
44
What score is used for mortality risk in GI bleed?
Rockall score
45
What are the 3 types of liver cancer?
Hepatocellular carcinoma (80%) Cholangiocarcinoma Mets
46
What are the common primary sites for liver mets?
GI, pancreas, breast, melanoma
47
Risk factors for Hepatocellular carcinoma
Hep B/C, Alcohol, NAFLD, chronic liver disease
48
Presentation of Hepatocellular carcinoma
Asymptomatic and presents late | Weight loss, abdo pain, anorexia, N&V, jaundice, pruritus
49
Tumour marker for Hepatocellular carcinoma
AFP
50
Management of HCC
Surgery | + Sorafenib etc for viral hepatitis
51
Risk factors for Cholangiocarcinoma
Primary Sclerosing Cholangitis
52
Presentation of Cholangiocarcinoma
Painless jaundice
53
Tumour marker for Cholangiocarcinoma
Ca19-9
54
Investigations for Cholangiocarcinoma
Ca19-9 CT/MRI ERCP
55
Management of Cholangiocarcinoma
Symptomatic management with bile duct stent | Surgery
56
What is peritonitis?
Inflammation of the peritoneum due to blood, air, bacteria or GI contents
57
Causes of peritonitis
AEIOU Peritoneum: - Appendicitis - Ectopic pregnancy - Infection with TB - Obstruction - Ulcer - Peritoneal dialysis
58
Aetiology of pancreatitis
Pancreatic enzymes destroy pancreas and it's blood supply
59
Presentation of pancreatitis
N&V, epigastric pain radiating to back, relieved on sitting forwards, tachycardia
60
Signs on examination of pancreatitis
Cullen's sign- superficial oedema and bruising around umbilicus Grey-turner's sign- bruising of flanks
61
Raised blood result in pancreatitis
Amylase
62
Management of pancreatitis
IV fluids | pain relief
63
Blood derangements in alcoholic liver disease
Raised MCV LFT: Raised AST, ALT, GGT, later on ALP, Low albumin, Raised bilirubin Clotting: Raised PT
64
Complications of alcohol
``` Alcoholic liver disease, cirrhosis and HCC Alcohol dependence and withdrawal Wernicke-Korsakoff syndrome Pancreatitis Alcoholic cardiomyopathy ```
65
Presentation of alcohol withdrawal
6-12hrs: tremor, sweating, headache, craving, anxiety 12-24hrs: hallucinations 24-48hrs: seizures 24-72hrs: delirium tremens
66
Management of alcohol withdrawal
Benzodiazepine- Chlordiazepoxide 5-7 days | IV B vitamins- Pabrinex
67
What is the aetiology of delirium tremens?
Chronic alcohol use --> GABA system up-regulated + glutamate system down-regulated --> opposite when alcohol removed --> excess adrenergic activity
68
Presentation of delirium tremens
Acute confusion, agitation, delusions, hallucinations, tremor, tachycardia, hypertension, hyperthermia, ataxia, arrhythmias
69
Aetiology of Wernicke-Korsakoff syndrome
Thiamine deficiency
70
Presentation of Wernicke's encephalopathy
Confusion, oculomotor disturbance, ataxia
71
Presentation of Korsakoff's syndrome
Memory impairment, behavioural changes
72
Causes of liver cirrhosis
Alcoholic liver disease, NAFLD, Hep B/C
73
Presentation of liver cirrhosis
Jaundice, hepatosplenomegaly, spider naevi, palmar erythema, gynaecomastia, bruising, ascites
74
Investigations in liver cirrhosis
USS Fibroscan for transient elastography Liver biopsy confirms diagnosis Screened for HCC with AFP and USS every 6mth
75
Scoring systems for Liver cirrhosis
Child-Pugh score A, B, C for severity | MELD score for mortality
76
Management of liver cirrhosis
High protein low sodium diet Propranolol reduces portal hypertension Liver transplant
77
Complications of liver cirrhosis
Malnutrition, portal hypertension, varices, ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, hepatic encephalopathy, HCC
78
Stages of NAFLD
1. NAFLD 2. Non-alcoholic steatohepatitis 3. Fibrosis 4. Cirrhosis
79
Risk factors for NAFLD
Obesity, T2DM, hypercholesterolaemia, age, smoking, hypertension
80
What is the aetiology of Meckel's diverticulum?
Vestigial remnant of vitello-intestinal duct at distal ileum
81
Clinical features of Meckel's diverticulum
Asymptomatic/haemorrhage/obstruction
82
Aetiology of Acute Mesenteric Ischaemia
Embolus/Thrombosis reduces blood flow to intestine --> bacterial translocation --> systemic inflammatory response
83
Presentation of acute mesenteric ischaemia
Severe, colicky, poorly localised pain | No real tenderness/peritonitis
84
How is acute mesenteric ischaemia diagnosed?
CT Angiography
85
Management of acute mesenteric ischaemia
O2, IV fluids Papverine to relieve spasm IV Unfractionated Heparin/Surgical angioplasty
86
Causes of ischaemic colitis
Thrombosis, emboli, reduced cardiac output, shock, trauma, COCP, cocaine, strangulated hernia, vasculitis, clotting disorders
87
Clinical features of ischaemic colitis
Acute LIF pain N&V Loose stools containing blood
88
What blood gas abnormality is seen in ischaemic colitis?
Metabolic acidosis
89
Investigation and finding in ischaemic colitis
Colonoscopy- blue swollen mucosa | Barium enema- thumb printing
90
Which blood vessels are affected in ischaemic colitis?
Inferior and Superior mesenteric artery
91
Differential diagnosis of malabsorption
Coeliac, HIV, Lymphoma, TB, Pancreatic insufficiency, Crohn's, Amyloidosis, Hyper/pothyroidism, diabetes, eating disorders
92
Define ileus
A non-mechanical obstruction of bowel
93
Causes of intestinal obstruction
Adhesions, strangulated hernia, malignancy, volvulus, post-operatively, CF, Hirschsprung's
94
Presentation of intestinal obstruction
N&V- faeculant, abdo pain, failure to pass bowel movements or flatus, abdominal distension, high-pitched bowel sounds, dehydration
95
What is heard on auscultation of bowel sounds in intestinal obstruction?
High-pitched bowel sounds
96
Management of intestinal obstruction
NBM Fluids Intestinal decompression- endoscopy/NG tube Laparotomy +/- stoma
97
What is sigmoid volvulus?
Faeces and gas-filled sigmoid loop twists on mesentary
98
Risk factors for sigmoid volvulus
Elderly, constipation, megacolon, history of sigmoid volvulus, pregnancy, pelvic masses
99
Presentation of sigmoid volvulus
Sudden onset lower abdominal colicky pain, distension, failure to pass flatus or stool, empty rectum
100
What findings are present on AXR of sigmoid volvulus?
Coffee-bean sign
101
Management of sigmoid volvulus
Urgent admission + decompression
102
What is paralytic ileus?
Lack of peristalsis in the bowel due to an autonomic imbalance causing sympathetic overactivity affecting the colon
103
Presentation of paralytic ileus
Nausea and faeculant vomiting, NO pain, failure to pass bowel movements or flatus, NO bowel sounds, abdominal distension
104
Risk factors for paralytic ileus
Chest infection, MI, stroke, AKI, trauma, elderly
105
What findings are present on AXR of paralytic ileus?
Fluid levels, small bowel distension
106
What is the aetiology of diverticular disease?
Herniation of mucosa through thickened colonic muscle
107
What are the commonest sites of diverticular disease?
Sigmoid and descending colon
108
Risk factors for diverticular disease
Age, obesity, low dietary fibre
109
Presentation of uncomplicated diverticular disease
Left iliac fossa pain, worse on eating, better on flatus/defaecation, bloating, bleeding, constipation
110
Presentation of diverticulitis
``` Diverticular disease (Left iliac fossa pain, worse on eating, better on flatus/defaecation, bloating, bleeding, constipation PLUS fever, tachycardia ```
111
Management of diverticular disease
Asymptomatic- high fibre diet Symptomatic- bulk-forming laxative, paracetamol Diverticulitis- fluids, antibiotics (Co-amoxiclav 7 days), Surgery
112
Complications of diverticular disease
POFASH: - Perforation - Obstruction - Fistula - Abscess - Stricture - Haemorrhage
113
Risk factors for GORD
Male, increased abdominal pressure (pregnancy, obesity etc), smoking, hiatus hernia
114
Management of GORD
Antacids eg gaviscon | PPI eg Lansoprazole
115
Complications of GORD
Peptic stricture, Barrett's oesophagus
116
What is the transformation in Barrett's oesophagus?
Squamous to columnar epithelium
117
What is the most common location of peptic ulcers?
Duodenal/lesser curvature of stomach
118
How do you test for H pylori?
Urea breath test | Stool antigen
119
Management of H pylori
Triple therapy: 1. PPI- Lanzoprazole 2. Clarithromycin 3. Metronidazole
120
What is the aetiology behind NSAIDs causing peptic ulcers?
NSAIDs inhibit prostaglandin production for mucous production --> no mucus to protect stomach
121
What is the aetiology of coeliac disease?
Autoimmune gluten-sensitive enteropathy | Gliadin protein --> immune cell reaction at HLADQ8 --> produces toxic T cells --> villous atrophy
122
Presentation of coeliac disease
Bloating, FTT, diarrhoea, anaemia | Dermatitis herpetiformis
123
Name of skin condition seen in coeliac disease
Dermatitis Herpetiformis
124
Blood tests for coeliac disease
Tissue transglutaminase antibodies IgA | Endomysial antibody IgA
125
How long does gluten need to be consumed to test for coeliac disease?
6 weeks
126
Investigations for coeliac disease
Tissue transglutaminase antibodies IgA Endomysial antibody IgA FBC for anaemia Duodenal biopsy
127
What is found on duodenal biopsy in coeliac disease?
Villous atrophy and crypt hyperplasia
128
What criteria is used to diagnose coeliac disease on duodenal biopsy?
Marsh criteria
129
Complications of Coeliac disease
Vitamin D/Iron deficiency Osteoporosis Infertility Malignancy
130
IBD affecting whole GI tract, skip lesions, no blood/mucus, transmural inflammation
Crohn's disease
131
IBD with continuous inflammation, limited to colon and rectum, blood and mucus
Ulcerative colitis
132
Features of Crohn's disease
NESTS: - No blood or mucus - Entire GI tract - Skip lesions - Terminal ileum/Transmural inflammation - Smoking is RF
133
Features of Ulcerative Colitis
CLOSE UP: - Continuous inflammation - Limited to colon and rectum - Only superficial mucosa - Smoking protective - Excrete blood and mucus - Use aminosalicylates (Sulfasalazine) - Primary sclerosing cholangitis
134
Which of Crohn's and UC is smoking a risk factor and which is smoking protective for?
Crohn's- smoking is a risk factor | UC- smoking is protective
135
Presentation of IBD
Diarrhoea, abdominal pain, bloating, pasing blood
136
Investigations of IBD
CRP, faecal calprotectin for inflammation | Endoscopy and biopsy diagnostic
137
Management of Crohn's
Acute: Steroids (oral prednisolone), Immunosuppressant (eg Azathioprine) Maintain remission: Azathioprine, Mercaptopurine
138
Management of Ulcerative Colitis
Aminosalicylate- Sulfasalazine, Corticosteroids Azathioprine Panproctocolostomy + ileostomy
139
Presentation of IBS
Diarrhoea, constipation, fluctuating bowel habit, abdo pain, bloating Symptoms worse after eating, improves after defaecation
140
Criteria for IBS
``` Abdo pain/discomfort relieved on opening bowels or associated with a change in bowel habit AND 2 of... - Abnormal stool passage - Bloating - Worse after eating - PR mucus ```
141
Management of IBS
``` Lifestyle: fluid intake, limit caffeine/alcohol intake, low FODMAP diet, probiotic supplement 1st line meds: - Loperamide for diarrhoea - Laxatives for constipation - Antispasmodic- Hyoscine bromide 2nd line: Amitriptylline ```
142
Common causative organisms of infective diarrhoea
Viral- rotavirus, norovirus, adenovirus Bacteria- Campylobacter jejuni, E coli, Salmonella, Shigella Parasite- Giardia lamblia
143
Risk factors for gastric cancer
Age, male, H pylori, diet, smoking, FH
144
Most common location of gastric cancer
50% pylorus
145
Types of gastric cancer by location
Cardia/GO junction- adenocarcinoma | Distal- carcinoma
146
Presentation of gastric cancer
Dyspepsia, Dysphagia, weight loss, anaemia, vomiting
147
Investigations of gastric cancer
FBC, LFT | Endoscopy/sigmoidoscopy + biopsy
148
Common sites of metastasis of gastric cancer
Lung, liver, ovary
149
Management of gastric cancer
Surgery + pre-op chemo with 5-FU
150
What condition are gastrointestinal stromal tumours associated with?
Neurofibromatosis type 1
151
Management of gastrointestinal stromal tumour
Complete surgical resection + Imatinib
152
Presentation of gastrointestinal stromal tumour
Early satiety, bloating, fever, weight loss, night sweats
153
What type of cancer is a gastrointestinal stromal tumour
Soft tissue sarcoma
154
What is the aetiology of MALT Lymphoma?
Mucosa-associated lymphoid tissue | Extra-nodal type of Non-Hodgkin's lymphoma
155
Where is MALT Lymphoma most common?
Gastric
156
What infections is MALT Lymphoma associated with?
H pylori | Campylobacter jejuni
157
Presentation of MALT Lymphoma
Dyspepsia, fever, nausea, constipation, weight loss, pain, ulcer
158
Management of MALT Lymphoma
Eradication of H pylori may induce remission | Rituximab + chemo + radio +/- surgery
159
Presentation of Topical Sprue
Diarrhoea, weight loss, steatorrhoea, fatigue | Deficiency of iron, folate, vit B12, vit A/D/K
160
Investigations in Topical Sprue
Bloods: Deficiency of iron, folate, vit B12, vit A/D/K | Jejunal biopsy: incomplete villous atrophy
161
What does jejunal biopsy show in topical sprue?
Incomplete villous atrophy
162
Management of topical sprue
Fluids Tetracycline Nutritional supplements- folic acid, B12, iron
163
Risk factors for acute mesenteric ischaemia
Age > 50, MI, endocarditis, atherosclerosis, hypotension, vasodepressive drugs, hypercoagulability disorders (Protein C+S deficiency), intra-abdominal infection
164
Aetiology of chronic mesenteric ischaemia
Chronic atherosclerotic disease of vessels supplying intestine
165
Presentation of chronic mesenteric ischaemia
Colicky/constant poorly localised pain Weight loss, post-prandial pain and fear of eating N&V
166
Investigations of chronic mesenteric ischaemia
Arteriography gold standard
167
Management of chronic mesenteric ischaemia
Asymptomatic: smoking cessation, antiplatelet Symptomatic: open or endovascular revascularisation
168
Aetiology of ischaemic colitis
Compromise of blood supply to colon
169
Management of ischaemic colitis
Bowel rest + supportive care Broad spectrum abx Laparotomy and removal of necrotic part
170
Peak age for appendicitis
Age 10-20
171
Presentation of appendicitis
Abdo pain- central then settles in RIF Loss of appetite, N&V, guarding, rebound and percussion tenderness Tender in McBurney's point Rovsing's sign
172
What is Rovsing's sign?
Palpation of the LIF causes RIF pain
173
Management of appendicitis
Diagnostic laparoscopy + appendicectomy
174
Define cholestasis
Blockage to the flow of bile
175
Define cholelithiasis
Presence of gallstones
176
Define choledocholelithiasis
Gallstones in the bile duct
177
What is biliary colic?
Intermittent RUQ pain caused by gallstones irritating bile ducts
178
Define cholecystitis
Inflammation of gallbladder
179
Define cholangitis
Infection and obstruction of biliary system
180
What is gallbladder empyema?
Pus in the gallbladder
181
Investigation/Management of suspected Gallstones
1. LFT + USS- raised bilirubin 2. MRCP- if USS doesn't show stones 3. ERCP- down to sphincter of oddi to remove stones from bile duct 4. Cholecystectomy
182
What is the significance of a raised bilirubin in biliary disease?
Obstruction of the bile duct | Stone/head of pancreas tumour/cholangiocarcinoma
183
What does a raised AST/ALT suggest?
Hepatocellular injury
184
What is Murphy's sign?
RUQ pain exacerbated by deep inspiration --> gallbladder pathology
185
What is Charcot's triad?
1. RUQ pain 2. Fever 3. Jaundice
186
What is the name of the group of symptoms which suggest cholangitis?
Charcot's triad 1. RUQ pain 2. Fever 3. Jaundice
187
Causes of Hepatitis
Alcoholic hepatitis, NAFLD, viral hepatitis, autoimmune hepatitis, drug-induced hepatitis (paracetamol)
188
Presentation of hepatitis
Abdo pain, fatigue, pruritus, muscle and joint aches, N&V, jaundice, fever (viral)
189
What happens to LFTs in hepatitis?
Raised AST/ALT | Raised bilirubin
190
Which is the most common viral hepatitis worldwide?
Hepatitis A
191
How is Hepatitis A transmitted?
Faeco-orally
192
Management of Hepatitis A
Resolves without treatment in 1-3mths Analgesia Vaccine prevention
193
How is Hepatitis B transmitted?
Blood/bodily fluids + vertical transmission
194
What do each of the following proteins show in Hepatitis B? - HBsAg - HBeAg - HBcAb - HBsAb - Hep B virus DNA
- HBsAg- active infection - HBeAg- high infectivity - HBcAb- past or current infection - HBsAb- vaccination or past or current infection - Hep B virus DNA- viral load
195
What does the Hepatitis B vaccine contain?
Hep B surface antigen- then testing for HBsAb to confirm response
196
Investigations in Hepatitis B
Fibroscan for cirrhosis and USS for HCC
197
Management of Hepatitis B
Antivirals- Tenofovir | Liver transplant
198
How is Hepatitis C transmitted?
Blood + bodily fluids
199
What proportion of people infected with Hepatitis C become chronic?
75%
200
How is Hepatitis C diagnosed?
Hep C antibody screening test | Hep C RNA testing to confirm diagnosis
201
Management of Hepatitis C
Antivirals- Pegylated interferon/Ribavirin | Liver transplant
202
How is Hepatitis D transmitted?
Can only survive in patients with Hep B as attaches to HBsAg to survive
203
How is Hepatitis E transmitted?
Faeco-oral route
204
Management of Hepatitis E
Usually self-limiting within 1 month
205
What type of cell response is autoimmune hepatitis?
T-cell mediated response
206
What is an important step in management of all viral hepatitis?
NOTIFICATION of public health
207
Describe the types of autoimmune hepatitis
Type 1: adults (40/50s)- fatigue + features of liver disease- most chronic Type 2: children/teenage/early 20s- acute hepatitis with rise in AST/ALT and jaundice- more acute
208
Which antibodies are found in type 1 autoimmune hepatitis?
ANA, anti-actin, anti-soluble liver antigen
209
Which antibodies are found in type 2 autoimmune hepatitis?
Anti-LKM1, Anti-LC1
210
Diagnosis of autoimmune hepatitis
Liver biopsy
211
Management of autoimmune hepatitis
High dose prednisolone + azathioprine | Liver transplant
212
What are the 2 types of volvulus and how do they differ?
Sigmoid- anticlockwise | Caecum- clockwise
213
Investigations in volvulus
AXR- coffee bean sign | CT scan to confirm diagnosis
214
Complications of volvulus
Obstruction, ischaemia, perforation

Finals Revision (13 decks)

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