GI exam notes Flashcards
(158 cards)
1
Q
hepatocytes
A
liver endothelial cells
2
Q
stomach layers
A
extra muscularis layer
3
Q
enterocytes
A
SI: siimple columnar epithelium with a brush border
4
Q
primary and secondary bile salts
A
primary: cholic
chendeoxycholic acid
secondary: deoxycolic and lithocholic acid
5
Q
russels sign and murphy sign
A
murphy: cholecystitiis
russel: eating disorder
6
Q
fractitoius disorder
A
fake symptoms for no seconday gain
7
Q
malingering
A
fake symptoms for secondary gain e.g. benefits
8
Q
brunnels glands
A
duodenum and neutralise chyme
9
Q
ascities treatment
A
1: spironolactone
2: tips
3: transplant
10
Q
treatment of itch
A
sodium bicarbonate
11
Q
coeliac investugation
A
check IgA to make sure not deficient then TTG, if +ve then biopsy
12
Q
arcodermatitis enteropathica
A
zinc malabsorption
13
Q
endoscopic treatment of bleeds
A
heater probe coagulation
hemospray
clips
inject medication that causes vasoconstriction
14
Q
crypt cells
A
large and small intestine
15
Q
colonocytes
A
large intestine epithelium
secretes ions
16
Q
major difference between segmentation and hasutra
A
segmentation: minutes
haustra: hours
17
Q
causes of chronic gastritis
A
autoimmune
bacterial: H.pylori
chemical: NSAIDS alcohol
18
Q
histology of coeiliac
A
flattened glands :no villi
19
Q
acinar cells
A
cells of the pancreas
20
Q
zymogens
A
pancreatic proteases
stored in inactive form, activated by proteases and stored in zymogen granules surrounded by protease inhibitors
21
Q
tripsin
A
released from pancreas as tripsinogen and activated in duodenum by enteropeptidase so can now activate zymogens
22
Q
cholangiocarcinoma
A
bile duct cancer
23
Q
peyers patches
A
ileum of the SI
24
Q
mucosal immune system parts
A
epithelium: CD8 T cells
lamina propria: CD4 t cell
25
main antibody of mucosal immunity
IgA
26
key features of PBC
t cell mediated
cholestatic LFTs
AMA
t: deoxycholic acid
27
autoimmune hepatitis
hepatomegaly
jaundice
must give prednisolone
28
PSC
liver transplant
ultrasound/ MRCP
UC
29
where does the parotid gland drain into mouth
2nd molar tooth
30
where does the submandibular gland drain into mouth
lingual caruncle
31
metoclopramide
inc gastric emptying via vagus nerve
32
cells and secretion of stomach
HCL: parietal
pepsinogen: chief
mucus: gastric pits
histamine: enterochromaffin
gastrin: G cells
somatostain: D cells
33
additional stomach secretions
intrinsic factor: B12 absorption
enterochromaffin: iron absorption
Ach: inc acid secretion
prostaglandin: dec acid secretion
34
faecal peritonitis
complication of diverticulus where the bowl perforates and faeces enter the peritoneum
35
normal portal system pressure
8mmHg
36
oesophagus blood supply
thoracic: inferior thyroid artery and vein, aorta and azygous
abdomen: left gastric artery, azygous vein
portal vein: left gastric vein
37
what causes a volvulus
pregnancy
| severe constipation
38
portal triad
hepatic artery
hepatic portal vein
bile duct
39
cantor string sign
crohns
40
achalasia treatment
ca channel blocker
| or b blocker
41
virchows node
supraclavicular bump
| suggests gastric cancer
42
oxalate renal stones
present in crohns bc of malabsorption
43
pharyngeal pouch
regurg
cough
dysphagia
halitosis: bad breath
44
treatment of hepatic encelopathy
lactulose and rifampicin
45
meissners plexus
enteric nervous system in the submucosa
46
complications of coeliac
osteoporosis
| lymphoma
47
wilsons disease complication
haemolytic anaemia
48
femoral hernia
high risk of strangulation
emergency repair
below and lateral to pubic tubercle
females
49
inguinal hernia
superior and medial to pubic tubercle
50
indirect inguinal hernia
kiddos
lateral to inferior of epigastric artery
inguinal ring
51
direct inguinal ring
hasselbach triangle
abdo wall
disappears when cough
52
pylonephritis symptoms
kidney inflammation
fever
rigors
back pain
53
hepatoduodenal ligament
hepatic artery
hepatic duct
hepatic portal vein
54
hepatogastric ligament
right and left gastric vein
55
renal colic
pain in back in waves
| blood in urine
56
lynch syndrome
HNPCC
| mismatch repair
57
FAP
100s of polyps
mutation in APC tumour supressor
present young
58
angiodysplasia of the colon
```
degenerative vascular malformation
intermittent gi bleed (upper and lower)
>60
aortic stensois
Treatment: endoscopic ablation of the abnormal vessels
```
59
prognostic indicator of alcoholic liver disease
```
encelopathy
albumin
albumin
ascities
PT time
```
60
pancreatic prognostic indicator
```
Pa02 <8pKa
Age >55
Neutrophil WBC >15
Calcium <2
Renal function Urea>16
Enzymes AST/ALT>200 LDH >600
Albumin <32
Sugar >10
```
3= sever, CRITICAL CARE
61
blood supply of the small intestine
gastroduodenal artery till bile duct then SMA and SMV
gastropancreatic and superior mesenteric nodes
62
nerve that supplies the rectum
s4
63
thumb printing at splenic flexure
ischaemic colitis
64
abdominal pain
rectal bleeding
metabolic acidosis
mesenteric ischaemia
65
signet rings on biopsy
stomach cancer
66
alphafeto protein
gastric cancer
67
adrenal gland position
suprarenal
68
ampulla of vater
union of the pancreatic and bile duct
69
zollinger ellison syndrome
gastrin secreting tumour that causes hypersecretion of acid leading to gastric ulcer disease
70
mallory hyaline bodies
alcoholic hepatitis
71
coeliac trunk: where it arises and divisions
T12
splenic artery
hepatic artery
left gastric artery
72
holes in diaphragm
T8: vena cava
T10: oesophagus
T12: aortic hiatus
73
cheek msucle that moves food during mastication
buccinator
74
onion skinning fibrosis and beading of bile ducts
PSC
75
caput medusae
medusa from umbilicus
| portal hypertension
76
tinkling bowel sounds
bowel obstruction
77
```
role of gastrin
cck
somatostatin
glucagon
GLP1 GLIP
```
```
inc HCL
inc bile, pancreatic protease and lipase
dec HCL and inc HCO3
hunger hormone
inc insulin
```
78
what gastroenteritis cause bleeding
e coli
shigella
salmonella
campylobacter
79
first line for ascities
ascitic tap/ paracentesis: aspirate ascities and see if SBP(>250 cells per mm2)
then spironolactone
80
serum results in haemochromatosis and wilsons and treatment
haemachromatosis: high iron: venesection
wilsons: low copper: pecillamine a copper chealting agent
81
granulomas and IBD
crohns:non caseating granulomas
82
hep B or hep C acute
hep B: jaundice, asia
| hep c acute: asymptomatic
83
prolonged laxative use
melanosis coli
brown pigmentation of coli
asymptomtic
causes death to colonic mucosa so lots of macrophages
84
recurrent peptic ulcers
gastrinoma: test gastrin levels
| neuroendocrine tumour
85
Peutz Jeghers syndrome
multiple polyps
brown pigements at hand feet face
inc risk of cancer
dominant
86
UC endoscopy screening
low risk: every 5 years
medium risk: 3 years
high risk: annual
87
inc in ethogenicity
bigger
88
hyatid disease
sheep farming
uncooked meat
cysts: mainly liver or lung
drain with albendazole
89
cannot identify bleeding cause
capsule endoscopy
90
resistant c diff
faecal transplant:
| bacterial flora from a healthy donor is given b=via enema
91
gilberts syndrome
```
jaundice
genetic
pre hepatic jaundice
if stressed/ fatigues or viral illness can get an isolated rise in bilirubin
benign
```
92
pain at night and relieved by milk
duodenal ulcer
93
diagnosis of achalasia
oesophogeal manometry study
94
dysphagia:
1) solids and liquids from start?
2) is it difficult to initiate a swallowing movement?
3) odonophagia?
4) intermittent or constant and worsening?
5) does the neck gurgle/ bulge?
1) yes: achalasia/ motility problem
no: structure
2) yes: blaber palsy, esp if cough on doing so
3) ulcer, malignancy, virus
4) intermittent: oesophogeal spasm, constant/ worsening: malignant
5) pharyngeal pouch
95
treatment of achalasia
endoscopic balloon dilation
| hellers cariomyotomy
96
acute and prophylactic management of gasto-oesophogeal varices`
acute: banding or sclreotherapy
prophylaxis: b blocker
97
carcnoid tumour
neuroendocrine tumour of enterochromaffin cells
98
haemochromotosis
bronzed diabetic
tired
slate grey pigemntation
99
anti mitochondrial
PBC
100
ANTI SM
autoimmune
101
TTG
coeliac
102
ANA
autoimmune
103
anti GBM
goodpastures
104
ANCA
vasculitis
105
cantor string om CXR
crohns
106
leadpipe colon
UC
107
achalasia pharmacological treatment
B-blocker
| Ca channel antagonist
108
halitosis
bad breath
109
coffee bean xray
sigmoid volvulus
110
corkscrew xray
midgut volvulus
111
birdspeak oesophagus
achalasia
112
hepatic encelopathy treatment
rifampicin and lactulose
113
gene in lynch vc FAP
lynch:HNPCC
FAP: APC
114
beta oxidation/lipolysis
fatty acid conversion to acetyl co A
- fatty acid to acyl coA (2ATP)
-acyl CoA to creatinine to cross memb then back to acyl CoA
beta oxidised
115
lipogenesis
acetyl CoA to citrate (TCA) to cross memb then back to acetyl Co-A. activated to menalyl Co-A by acetyl CoA carboxylase. acetyl A and menayl coA a are precursors for fatty acid synthesis.
116
amylase and lipase levels in hyperglycaemia induced pancreatitis
reduced
117
calcium and peptic ulcer
hypercalcaemia
118
increase alpha-fetoprotein
hepatocellular carcinoma
119
apart from dec acid, other role of PGE2
inc mucus and bicarbonate secretion
120
treatment of budd chairi
1) angicoagulation
2) angioplasty + thrombolysis
3) TIPS
4) in rapid developing ascities liver transplant
121
ESR
monitors inflammation
122
scalloping on endoscopy
coeliac
| HIV
123
diarrhoea in immunocompromised
isospara belli
| crpytosporidium
124
palmar arythema
liver cirrhosis
125
pyoderma gangrenosum
| erythema nodosum
Crohns and UC
126
tropical sprue
```
chronic diarrhoea
weight loss
vitamin b12
folate deficiency
give b spec: tetracycline and folate supplement
```
127
what is the meckels diverticulum a remnant of?
vitello intestinal duct
128
coeliac disease grading
```
0=normal
1=increased lymphocytes
2= crypt hyperplasia
3=blunt villi
4=total villious atrophy and atrophic crypts
```
129
C13 breath test
eradication of H.pylori
130
gold standard for H.pylori
breath test
131
h.pylori antibody
IgG ... chronic
132
hep C investigation
1) hep C antibody
| 2) hep C RNA and genotype
133
treatment of hep C
genotype 1: PEG interferon, protease inhibitor and ribavirin
134
anal fissure: symptoms and treatment
pain on defecation
bloody stools
laxatives and GTN cream
if does not resolve surgery
135
hypercalcaemia
lethargy
nausea
confusion
stones
136
proctitis syndrome
blood and tenesmus
| ceftriaxome for goonorrhea
137
budd chairi symptoms and affected vessel
hepatomegaly
abdominal pain
ascities
hepatic vein affected`
138
complication of e.coli and how to diagnose it
haemolytic uremic syndrome :
1. haemolytic uremia
2. acute kidney injury
3. low platelet
139
foecal occult blood
screening for colorectal cancer
| detects blood not visible by eye
140
alpha fectoprotein
liver tumour
141
cancer antigen 19-9
pancreas
142
carcinoembryonic antigen
large intestine
143
ca 125
ovarian maligancy
144
ACEI levels
low: obstructive pulmonary disease, hypothyroidism
high: sarcoidosis, PBC, hyperthyroidism
145
AMA
PBC
146
ANA
autoimmune:
- hepatitis
- rheumatoid
147
ANCA
vasculitis
PSC
IBD
autoimmune
148
ct of bowel obstruction
transition point of collapsed(black filled with air)/ distented bowel
149
management of painful hernia
surgery: suggests strangulation
150
paralytic ileus
disruption of the normal propulsive activity of the GI tract due to peristalsis failure
risk factors: recent surgery, inflammation
treatment: drip and suck
151
ogilvies syndrome
acute dilation of the bowel in the absence of any bowel obstruction in the acutely unwell
152
haemorrhoids
enlarged vascular cushion in the lower rectum/anal canal
painless bleeding
not mixed with stool usually bright red on paper
colonoscopy if red flags >55
treatment: grade 1: topical corticosteroid
grade 2: rubber band ligation
grade 3: rubber band ligation
grade 4: surgical haemorrhoidectomy
153
rectal prolapse
protruding pass from anus especially during defecation
mucus and blood are common
poor anal tone
154
anal prolapse
tear in the anus while passing a constipated stool
| multiple fissures think crohns
155
fistula in ano
opening in the peri-anal skin
most commonly due to ano-rectal abscess
can be due to: crohns, carcinoma or TB
156
hod you test for wilsons
serum ceruloplasmin
157
ESR
inflammmation
158
causes of AF
chest infections
valve disease
alcoholism
MI
