GORD and gall bladdrt

Question 1

which muscles contract during no eating

Answer 1

two sphincters

Question 2

when does the lower oesophageal sphincter relax

Answer 2

swallowing

Question 3

pre disposing factors for GORD

Answer 3

obesity
sclerosis
hiatus hernia

Question 4

symptoms of GORD

Answer 4

heartburn
cough
nocturnal asthma

Question 5

when to give an OGD

Answer 5

over 55 with alarm symptoms

Question 6

alarm symptoms which equire ODG

Answer 6

weight loss, dysphagia, haematemesis, anaemia

Question 7

difference between magnesium and aluminium antacids

Answer 7

Magnesium-containing antacids cause diarrhoea aluminium-containing may cause constipation

Question 8

how do dopamine antagonist prokinetic agents help

Answer 8

speed peristalsis

Question 9

examples of dopamine antagonist prokinetic agents

Answer 9

metoclopramide

Question 10

H2-receptor antagonists examples

Answer 10

cimetidine, ranitidine

Question 11

PPI reduce

Answer 11

gastric acid secretion

Question 12

what can barrets turn into

Answer 12

oesophageal adenocarcinoma

Question 13

most common type of gall stone

Answer 13

cholesterol

Question 14

what is cholesterol held by so it cant cause stones

Answer 14

bile salts

Question 15

bile salt + cholesterol =

Answer 15

micelles

Question 16

gall stones risk factors

Answer 16

age, female, family history
Obesity metabolic syndrome
Rapid weight loss, Ileal disease or resection, Multiparity
Diet, Diabetes mellitus, octreotide, Liver cirrhosis

Question 17

why does ileal disease cause gall stones

Answer 17

bile salt loss

Question 18

other type of gall stone

Answer 18

pigment stone

Question 19

whats in pigment stones

Answer 19

bilirubin polymers and calcium bilirubinate

Question 20

which people get pigment stones

Answer 20

people with chronic haemolysis

Question 21

what is biliary pain

Answer 21

pain associated with the temporary obstruction of the cystic duct or CBD

Question 22

where might gall stone pain radiate

Answer 22

right shoulder and the right subscapular region

Question 23

other symptom with gall stones

Answer 23

vomitting

Question 24

what serum levels are high in gall stones

Answer 24

ALP

billirubin

Question 25

inflammation of the gall bladder

Answer 25

cholecystitis

Question 26

what happens to get cholecystitis

Answer 26

impaction of a stone in the cystic duct or neck of | the gall bladder

Question 27

acalculous cholecystitis

Answer 27

cholecystitis without a stone

Question 28

sign with cholecystitis

Answer 28

murphys

Question 29

what is murphys sign

Answer 29

more pain on inspiration

Question 30

what scan to do for cholecystitis

Answer 30

US

Question 31

what will an US show for cholecystitis

Answer 31

thickened walls and distended

Question 32

management of cholecystitis

Answer 32

nil by mouth, intravenous fluids, pain | relief and intravenous antibiotics

Question 33

what antibiotic might you give for cholecystitis

Answer 33

cefotaxime

Question 34

when might the gall bladder appear small and shrunken

Answer 34

chronic cholecystitis

Question 35

what will you be intollerant to with cholecystitis

Answer 35

fatty food

Question 36

Acute cholangitis

Answer 36

infection of the biliary tree

Question 37

Acute cholangitis symptoms

Answer 37

fever, jaundice and right upper quadrant pain rigors dark urine, pale stool, itchy skin

Question 38

investigations for Acute cholangitis

Answer 38

``` WWC Blood cultures are positive Liver biochemistry US MRCP can further assess the site and cause of obstruction ERCP ```

Question 39

WCC for Acute cholangitis

Answer 39

leucocytosis

Question 40

Acute cholangitis liver biochem

Answer 40

raised serum bilirubin and and alkaline phosphatase.

Question 41

Acute cholangitis US shows

Answer 41

dilated CBD

Question 42

Acute cholangitis ERCP is an investigation but can also

Answer 42

allow biliary drainage

Question 43

Acute cholangitis antibiotic

Answer 43

third-generation cephalosporin

Question 44

third-generation cephalosporin example

Answer 44

cefotaxime

Question 45

choledocholithiasis

Answer 45

Common bile duct stones