Med: Gastro Flashcards
(15 cards)
Tx pathway for bleeding varices on OGD
Band ligation, sclerotherapy, balloon tamponade, TIPSS, surgery
The point at which bleeding stops band to eradicate varices then regular F/U or if recur surg referral
Achalasia vs Nutcracker Oesophagus
Manometry
Tx of Achalasia
Aim to loosen the lower oesophageal sphincter
Med: CCBs + Nitrates (but not first line)
Intv: balloon dilatation + botulinum toxin injection
Surg: Heller’s myotomy +/- Nissen fundoplication
Plus referral to SALT
What is the weak area called that leads to a pharyngeal pouch?
Killian’s Dehiscence
PVS Triad
Dysphagia, IDA, Webs
What is characteristic of angiodysplasia on endoscopy?
Cherry Red Spot
What is the anatomical significance of the dentate line?
Watershed separating different epithelial types and NV/lymph supply
Above: columnar, autonomic, branches of inf mesenteric, mesenteric LNs
Below: stratified squamous, somatic, branches of internal iliac, inguinal LNs
Ix for Rectal Bleeding
- A-E + Resus
- Protoscopy +/- Rigid Sigmoidoscopy
- OGD/Colonoscopy
- Mesenteric/CT Angiography
- Radionuclide Imaging
What bilirubin is required to become visibly jaundiced?
> 40uM
What are the clinical signs of chronic stable liver disease? (4)
PDGS
Palmar Erythema
Dupuytrens Contracture
Gynaecomastia
Spider Naevi
What are the clinical signs of portal HTN? (4)
SAVE
Splenomegaly
Ascites
Varices
Enlarged Abdo Veins
Imaging for PSC
US + MRCP
When would you ix for UC?
Diarrhoea >4wks +/- blood, abdo pain, systemic sx
Which hepatitis virus inc the risk of HCC?
B
What are the indications for an ascitic tap?
Sx (tense or SOB) + Diagnostic (SBP)
