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Flashcards in Passmedicine Deck (35):
1

Features of biliary colic

Colicky abdominal pain, worse postprandially, worse after fatty foods

May radiate to the right shoulder

Nausea and vomiting are common

2

What condition is associated with pigmented gallstones?

Sickle cell
(this is because sickle cell anaemia results in increased red cell haemolysis and thus pigmented gallstones)

Pigmented gallstones are associated with haemolytic anaemia and liver cirrhosis

3

What is whipples procedure

Operation to remove the head of the pancreas

4

Why do you need to sort out jaundice?

Patients with unrelieved jaundice have a much higher incidence of septic complications, bleeding and death

5

What is murphys sign?

You hook your fingers under the liver border and ask the patient to breath in -on inspiration the gallbladder will descend onto the fingers - in acute cholecystitis this will cause the patient to jump because it will be sore

6

Why are patients with Crohn's more likely to develop bile duct stones?

Normally bile salts are absorbed in the terminal ileum.
In Crohn's, absorption is impaired and so they may develop bile duct stones - these can pass into the common bile duct and cause obstructive jaundice

7

This bacteria causes chronic diarrhoea in immunocompromised patients

Mycobacterium avium complex

8

Most common causative organism of ascending cholangitis

E. coli

(then followed by Klebsiella)

9

What is Lemierre syndrome?

Starts with sore throat and fever - bacteria then spread through the lymphatic vessels
Internal jugular then swells and pus-containing tissue moves from the original location to other organs (most commonly the lungs)

10

Which bacteria causes Lemierre syndrome?

Fusobacterium necrophorum

11

Isograft

Transplant to identical twin

12

Autograft

Transplanting a tissue in your body to a different site (e.g. using saphenous vein for coronary artery bypass)

13

Allograft

When you donate e.g. a kidney to another human

14

Duodenal ulcers and eating

Pain relieved by eating

15

Gastric ulcers and eating

Pain worsened by eating

16

Are gastric or duodenal ulcers more common?

Duodenal ulcers more common

17

"tinkling" bowel sounds

SMALL BOWEL obstruction

18

"A 40 year old women with a history of Crohn's disease presents with abdominal pain and distension. She describes constipation for the past 4 days"

Intestinal obstruction

19

Histological scoring system for prostate cancer?

Gleason score
Score of 6 or less - cancer cells look like normal cells, likely to grow slowly

Score 7 - intermediate risk for aggressive cancer

Score 8 and above - cancer likely to spread more rapidly

20

FIGO staging system

Used for gynaecological malignancy

21

Complications of hernia repair (early and late)

Early - bruising, infection
Late - chronic pain, recurrence

22

Which medication should you avoid in bowel obstruction?

Avoid metoclopramide as can it is a pro-kinetic and may cause perforation

23

What part of the colon is most likely to be affected in ischaemic colitis?

The splenic flexure

24

How might oesophageal candidiasis present?

With odynophagia and episodic dysphagia

25

What would you give as prophylaxis to prevent variceal bleeding?

Propanolol/ Endoscopic band ligation

26

What is a faecal occult test?

Looks for occult (hidden) blood in the stool

27

If NAFLD is found incidentally, which test should you perform?

Perform an enhanced liver fibrosis test to assess for more severe liver disease

28

Management of NAFLD

The mainstay of treatment is lifestyle changes (particularly weight loss) and monitoring

29

What is pellagra?

A deficiency of vitamin B3 (niacin)

30

Sun-burn like dermatitis rash
Diarrhoea
Cognitive deficit

Pellagra (vitamin B3 deficiency)

31

What tests would you do if you suspected liver cancer

FBC, clotting, LFTs, hepatitis serology, ALPHA FETOPROTEIN

32

The most common presenting complaint of Crohn's in adults?

Diarrhoea

33

The most common presenting complaint of Crohn's in children?

Abdominal pain

34

Nausea medication you should avoid in parkinsons?

Metaclopramide

35

A 41-year-old man with cerebral palsy is admitted with abdominal pain and diarrhoea. His carers report him passing 5-6 watery stools per day for the past four days. On examination he has a mass in the left side of the abdomen.

Constipation overflow