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Gastroenterology > Passmed/pastest > Flashcards

Flashcards in Passmed/pastest Deck (33)
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1
Q

Isolated hyperbilirubinaemia in asymptomatic person?

A

Gilbert syndrome

2
Q

In Gilbert syndrome why is bilirubin not seen in the urine?

A

Disorder of bilirubin conjugation; causes build-up of unconjugated bilirubin which is not water-soluble

3
Q

Sudden onset abdominal pain, tender hepatomegaly and ascites due to hepatic vein thrombosis

A

Budd-Chiari syndrome

4
Q

What test is used to distinguish between ascites due to portal hypertension or other causes?

A

Serum-ascites albumin gradient (SAAG). Raised SAAG indicates portal hypertension

5
Q

Budd-Chiari syndrome is usually seen in the context of…

A

Underlying pro-coagulant condition e.g. thrombophilia, pregnancy, malignancy

6
Q

Transaminitis (elevated ALT and AST) in the 10,000s is most commonly caused by…

A

Paracetamol overdose

7
Q

Treatment of paracetamol overdose?

A

Acetylcysteine if:
staggered overdose/doubt over time of ingestion;

plasma paracetamol concentration is above the treatment line from 4hrs-15hrs

8
Q

How is the number of units of alcohol in a drink calculated?

A

Volume in ml * ABV / 1000

9
Q

Guidelines for alcohol intake?

A

Men and women- max 14 units, ideally spread over 3 days or more

10
Q

Autosomal dominant condition characterised by multiple telangiectasia over the skin and mucuous membranes

A

Hereditary haemorrhagic telangiectasia (Osler-Weber-Rendu syndrome)

11
Q

Most common cause of liver disease in the developed world?

A

Non-alcoholic fatty liver disease (NAFLD)

12
Q

NAFLD associations?

A

Obesity, hyperlipidaemia, T2DM (metabolic syndrome)

13
Q

Describe the spectrum of NAFLD?

A

Steatosis –> steatohepatitis –> fibrosis –> cirrhosis

14
Q

Test results in NAFLD? (2)

A
Elevated transaminases (ALT usually greater than AST)
Increased echogenicity on USS
15
Q

Management of NAFLD?

A

Lifestyle changes and monioring

? possible role for gastric banding/metformin

16
Q

Commonest causative organisms in pyogenic liver abscesses?

A

Staph aureus in children

E coli in adults

17
Q

Management of pyogenic liver abscess?

A

Antibiotics + image guided percutaneous drainage

18
Q

What is the most important factor indicating need for liver transplant following paracetamol overdose?

A

Arterial pH under 7.3

19
Q

Histology in bowel wall, demonstrating pigment laden macrophages

A

Melanosis coli

20
Q

Melanosis coli is associated with…

A

laxative abuse

21
Q

Sudden onset severe abdominal pain +/- PR bleeding, PMHx of atrial fibrillation/atherosclerotic disease

A

?Ischaemic colitis

22
Q

Where does ischaemic colitis most commonly occur and why?

A

Splenic flexure; this is a watershed area between the areas supplied by the superior and inferior mesenteric arteries

23
Q

Symptoms of the classic carcinoid syndrome?

A

Wheezing, flushing and diarrhoea

24
Q

Commonest causes of an exudative ascites?

A

Infection, malignancy

25
Q

Causes of a transudative ascites? (4)

A

Hepatic failure
Portal hypertension
Budd-Chiari
Cardiac failure

26
Q

Malabsorption + thickened small bowel folds on barium enema

History of living/working in India/Asia/S.America/Carribean

A

Tropical sprue

27
Q

Malabsorption, large-joint arthralgia and lymphadenopathy

A

Whipple’s disease

28
Q

Triad of dysphagia, glossitis and iron deficiency anaemia

A

Plummer-Vinson syndrome

29
Q

Severe vomiting –> mucosal lacterations –> haematemesis

A

Mallory-Weiss syndrome

30
Q

Oesophageal rupture as a result of severe vomiting

A

Boerhaave syndrome

31
Q

Cysts in the liver/lungs, often as a result of eating infected undercooked meat

Also- history of sheep farming

A

Hydatid disease

32
Q

History of abdominal surgery, presenting with malabsorption and low vitamin B12

A

Small intestinal bacterial overgrowth (SIBO)

33
Q

Treatment for SIBO?

A

Antibiotics