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Flashcards in GI year 3 Deck (48):
1

Antibodies in coeliac

anti tTG, anti EMA, anti gliadin

2

Histological changes in coeliac

villous atrophy
crypt hyperplasia
lymphocyte infiltration

3

Endoscopic changes in coeliac

scalloping of folds
mosacic pattern
nodular pattern
patchy change

4

complications of coeliac

osteoporosis
small bowel malignancy
IDA
hyposplenism

5

Systemic complications of IBD

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

6

Clinical signs of IDA

glossitis
angular stromatitis
kolionychia
pallor mucous membranes

7

Histological features UC

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

8

Complications of UC

toxic dilatation colon
VTE
colonic cancer

9

Histological features Crohn's

Cobblestoning and skip lesions
deep abscesses
fistuale
intestinal wall thickening

10

complications of crohn's

small bowel obstruction
colon cancer
toxic dilatation and perforation
abscess formation

11

Acute severe colitis

hospital admin for IV hydrocortisone

rescue therapy - ciclosporin, infliximab, surgery

12

Microscopic colitis

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

common middle aged females with a history of autoimmune disease

5ASA

13

Aziothioprine mechanism

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

14

Methotrexate

dihydrofolate reductase inhibitor
only in crohns

15

Causes haematemesis

peptic ulcer
gastritis
oesophageal varicies
pulmonary TB
lung malignancy
PE

16

what is barretts oesophagus

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

17

3 features of metaplastic cells

hyperchromatic, pleomorphic and have enlarged nuclei

18

Associations of oesophageal SQUAMOUS carcinoma

smoking and alcohol

19

Cancer associations with h. pylori

MALT lymphoma

20

Autoimmune gastritis

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

Bacterial gastritis

colonisation with h.pylori in gastric mucosa (antrum)
- atrophy and intestinal metaplasia of the gastric mucosa

22

Chemical gastritis

LT use of NSAIDs
bile refluxes into stomach - causes cellular injury to gastric epithelium

23

Familial gastric cancer

CDH1 e cadherin mutation

24

causes peptic ulcer disease

GORD
NSAIDs
smoking
obesity
crohns
zollinger ellison syndrome

25

Adenoma carcinoma sequence

most carcinomas arise from pre existing benign adenoma
stepwise pattern of activation of oncogenes and inactivation of TSGs

26

Presentation CRC

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

27

Lynch syndrome

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

28

FAP

APC on chromosome 5
a lot of polyps which undergo malignant transformation

29

MYH polyposis

autosomal recessive
defect in BER gene

30

Name the three pathways in CRC

chromosomal, microsatellite and epigenetic instability

31

Antibodies in primary biliary cirrhosis

antimitochondrial antibodies and high IgM

32

Ascot with primary sclerosing cholangitis

ulcerative colitis

33

causes of hepatitis

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

34

methods of transmission hep B

mother to baby
contaminated blood products
contaminated needles
MSM

35

treatment hep B

pegylated interferon alpha
anti virals eg. tenofovir

36

treatment hep C

pegylated interferon alpha
ribavirin

direct acting antivirals

37

Clinical signs of liver disease

Plamar eryhtema
spider naevi
ascietes
encephalopathy

38

Feature of ascites fluid, management

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

39

mechanism acute cholecystitis

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

murphy sign

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

41

charcots triad

indicates cholangitis

fever, jaundice and RUQ pain

42

Causes of acute pancreatitis

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

43

complications pancreatitis

pancreatic abscess
pseudocyst
haemorrhage

44

causes chronic pancreatitis

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

45

presentation pancreatic cancer

painless obstructive jaundice
steatorrhoea
new onset diabetes

46

causes of pancreatic insufficiencyfs and features, treatment

acute and chronic pancreatitis
cystic fibrosis
pancreatic cancer
coeliac
IBD

malnutrition, steatorrhoea, weight loss, fatigue

pancreatin

47

whipple's triad

weight loss
diarrhoea
arthritis

48

lymphocytic duodenosis

intraepithelial lymphocytosis without villous atrophy

non gluten hypersensitivity
h. pylori infection
tropical sprue