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GI > GI year 3 > Flashcards

GI year 3 Flashcards

1
Q

Antibodies in coeliac

A

anti tTG, anti EMA, anti gliadin

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2
Q

Histological changes in coeliac

A

villous atrophy
crypt hyperplasia
lymphocyte infiltration

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3
Q

Endoscopic changes in coeliac

A

scalloping of folds
mosacic pattern
nodular pattern
patchy change

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4
Q

complications of coeliac

A

osteoporosis
small bowel malignancy
IDA
hyposplenism

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5
Q

Systemic complications of IBD

A 
primary sclerosing cholangitis
(joints eyes skin)
uvetitis 
spondylarthopathy
erythema nodosum
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6
Q

Clinical signs of IDA

A

glossitis
angular stromatitis
kolionychia
pallor mucous membranes

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7
Q

Histological features UC

A 
AAIM 
Crypt abscesses
Loss of normal architecture
Infiltration of lamina propria with leukocytes
Musosa only
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8
Q

Complications of UC

A

toxic dilatation colon
VTE
colonic cancer

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9
Q

Histological features Crohn’s

A

Cobblestoning and skip lesions
deep abscesses
fistuale
intestinal wall thickening

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10
Q

complications of crohn’s

A

small bowel obstruction
colon cancer
toxic dilatation and perforation
abscess formation

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11
Q

Acute severe colitis

A

hospital admin for IV hydrocortisone

rescue therapy - ciclosporin, infliximab, surgery

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12
Q

Microscopic colitis

A

normal colonoscopy
histology shows lymphocytic and collagenous colitis
thickened sub epithelial collagen

common middle aged females with a history of autoimmune disease

5ASA

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13
Q

Aziothioprine mechanism

A

prevent t cell clonal expansion by messing with CD28

conv to adenosine analogue and incorporated into DNA causing termination of nucleic acid chains

TPMT activity

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14
Q

Methotrexate

A

dihydrofolate reductase inhibitor

only in crohns

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15
Q

Causes haematemesis

A 
peptic ulcer
gastritis
oesophageal varicies
pulmonary TB
lung malignancy
PE
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16
Q

what is barretts oesophagus

A

metaplasia of cells from stratified squamous to simple columnar
premalignant to oesophageal adenocarcinoma

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17
Q

3 features of metaplastic cells

A

hyperchromatic, pleomorphic and have enlarged nuclei

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18
Q

Associations of oesophageal SQUAMOUS carcinoma

A

smoking and alcohol

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19
Q

Cancer associations with h. pylori

A

MALT lymphoma

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20
Q

Autoimmune gastritis

A

anti parietal cell and anti intrinsic factor AB
loss of parietal cells and pyloric metaplasia
persistent inflammation and t cell infiltration can predispose to cancer
pernicious anaemia

21
Q

Bacterial gastritis

A

colonisation with h.pylori in gastric mucosa (antrum)

- atrophy and intestinal metaplasia of the gastric mucosa

22
Q

Chemical gastritis

A

LT use of NSAIDs

bile refluxes into stomach - causes cellular injury to gastric epithelium

23
Q

Familial gastric cancer

A

CDH1 e cadherin mutation

24
Q

causes peptic ulcer disease

A 
GORD 
NSAIDs
smoking
obesity
crohns 
zollinger ellison syndrome
25
Q

Adenoma carcinoma sequence

A

most carcinomas arise from pre existing benign adenoma

stepwise pattern of activation of oncogenes and inactivation of TSGs

26
Q

Presentation CRC

A 
bleeding PR
abdominal mass
bowel perforation
haemorrhage
altered bowel habit 
weight loss 
anaemia 
pain
27
Q

Lynch syndrome

A 
HNPCC
autosomal dominant 
MLH1 and MSH2
endometrium, ovary and stomach cancers
colonoscopic survelliance
28
Q

FAP

A

APC on chromosome 5

a lot of polyps which undergo malignant transformation

29
Q

MYH polyposis

A

autosomal recessive

defect in BER gene

30
Q

Name the three pathways in CRC

A

chromosomal, microsatellite and epigenetic instability

31
Q

Antibodies in primary biliary cirrhosis

A

antimitochondrial antibodies and high IgM

32
Q

Ascot with primary sclerosing cholangitis

A

ulcerative colitis

33
Q

causes of hepatitis

A 
Viral (ABCDE)
malaria
epstein barr virus
toxins 
drugs eg. paracetemol
autoimmune 
alcoholic 
haemochromatosis
34
Q

methods of transmission hep B

A

mother to baby
contaminated blood products
contaminated needles
MSM

35
Q

treatment hep B

A

pegylated interferon alpha

anti virals eg. tenofovir

36
Q

treatment hep C

A

pegylated interferon alpha
ribavirin

direct acting antivirals

37
Q

Clinical signs of liver disease

A

Plamar eryhtema
spider naevi
ascietes
encephalopathy

38
Q

Feature of ascites fluid, management

A

high albumin
low salt diet
diuretics: spironolactone and frusomide
paracentesis (needle to drain fluid)

39
Q

mechanism acute cholecystitis

A

obstruction of cystic duct leads to distension of GB
stasis of bile causes inflammation of mucosa
bacterial growth eg. e.coli
bacteria invade through wall and cause peritonitis
compromise of blood flow: mucosal ischaemia and necrosis
GB RUPTURE

40
Q

murphy sign

A

pain on inspiration of the right upper q (below costal margin mid clavicular line

41
Q

charcots triad

A

indicates cholangitis

fever, jaundice and RUQ pain

42
Q

Causes of acute pancreatitis

A 
idiopathic
gallstones
ethanol
trauma 
steroids
malignancy
autoimmune
scorpion 
hypercalcaemia 
ercp
drugs (aziothioprine)
43
Q

complications pancreatitis

A

pancreatic abscess
pseudocyst
haemorrhage

44
Q

causes chronic pancreatitis

A 
TIGARO
toxic smoking, alcohol
idiopathic
genetic 
autoimmune 
recurrent acute pancreatitis 
obstructive
45
Q

presentation pancreatic cancer

A

painless obstructive jaundice
steatorrhoea
new onset diabetes

46
Q

causes of pancreatic insufficiencyfs and features, treatment

A 
acute and chronic pancreatitis
cystic fibrosis
pancreatic cancer
coeliac 
IBD

malnutrition, steatorrhoea, weight loss, fatigue

pancreatin

47
Q

whipple’s triad

A

weight loss
diarrhoea
arthritis

48
Q

lymphocytic duodenosis

A

intraepithelial lymphocytosis without villous atrophy

non gluten hypersensitivity
h. pylori infection
tropical sprue

GI (3 decks)

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