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Upper and lower GI Flashcards

1
Q

What should be monitored in post-op ileus?

A

Potassium, Magnesium and Phosphate (deranged electrolytes can contribute to post op ileum)

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2
Q

Management of Wilson’s disease?

A

Penicilliamine (mental chellating agent)

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3
Q

Type of inguinal hernia common in children?

A

Indirect inguinal hernia

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4
Q

1st line investigation for suspected perianal fissure in Chron’s?

A

MRI

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5
Q

Management of recurrent C. diff (within 12 weeks)?

A

Fidaxomicin

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6
Q

Cell change in Barret’s oesophagus?

A

Intestinal metaplasia

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7
Q

What testing is required in NAFLD to aid diagnosis of liver fibrosis?

A

ELF

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8
Q

NAFLD associated with?

A

Sudden weight loss

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9
Q

How do spider nevi fill compared to telangiectasia?

A

Spider nevi: from the centre
Telangiectasia: from the edge

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10
Q

Management of hiatus hernia?

A

PPI and weight loss
Surgery is rarely required, only a role in symptomatic paraoesophageal hernia

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11
Q

Initial management of abdominal wound dehiscence?

A

Coverage of wound with saline impregnated wound gauze and IV broad spectrum antibiotics

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12
Q

Neutrophil count from paracentesis to confirm SBP?

A

> 250

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13
Q

Most sensitive blood test in cirrhosis?

A

ALT

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14
Q

Which type of ulcer is most strongly associated with H. pylori?

A

Duodenal ulcer

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15
Q

Hernia between umbilicus and xiphisternum?

A

Epigastric hernia

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16
Q

Which antibiotic is associated with increased risk of C. Diff?

A

Clindamycin

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17
Q

Units =

A

(volume (mls) x %)/1000

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18
Q

Which 2 veins does trans jugular intra hepatic shunt connect?

A

Hepatic and portal

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19
Q

Crypt abscesses found in?

A

Ulcerative colitis

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20
Q

Mild C. diff features ?

A

Normall WCC

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21
Q

Moderate C. Diff features?

A

WCC (<15)
3-5 loose stools a day

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22
Q

Severe c diff features?

A

WCC (>15) or acutely raised creatinine (>50%)
Temp >38.5
Evidence of severe colitis (abdo/radio signs)

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23
Q

Life threatening c diff features?

A

Hypotension
Partial or complete ileus
Toxic megacolon
CT evidence of severe disease

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24
Q

Management of c diff (1st episode of infection)?

A

1st line: Vancomycin (10 days)
2nd line: oral findaxomicin
3rd line: oral vancomycin +/- IV metronidazole

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25
Management of recurrent c diff?
Within 12 weeks: oral fidaxomicin After 12 weeks: oral vancomycin or fidaxomicin
26
Management of life-threatening c diff?
Oral vancomycin and IV metronidazole
27
Malnutrition definition? (3)
1. BMI < 18.5 or 2. Unintentional weight loss > 10% within last 3-6months or 3. BMI <20 and unintentional weight loss > 5% within last 3-6 months
28
Management of gastric varicies (UGIB)?
Injection of N-butyl-2 cyanocrylate
29
When do patients require a platelet transfusion in UGIB?
If actively bleeding and PLT < 50
30
When to transfuse FFP in UGIB?
In patients who either have a fibrinogen level < 1g/L or activated partial thromboplastin time > 1.5x normal
31
When to give prothrombin complex concentrate in UGIB?
In patients taking Warfarin and actively bleeding
32
PPIs and endoscopy in UGIB?
NICE do NOT recommend the use of PPIs before endoscopy to patients with suspected no varriceal bleed BUT Patients should be given PPIs with non-variceal bleeding and stigmata of recent haemorrhage shown at endoscopy
33
First line investigation in Budd-Chiari Syndrome?
USS with doppler (highly sensitive)
34
Duration of post-exposure prophylaxis in HIV?
4 weeks Started within 72 hours
35
Vitamin B3 (niacin) deficiency?
Pellagra (diarrhoea, dementia, dermatitis)
36
Liver haemangioma on USS?
Hyperechoic lesion Normal AFP
37
Investigation if dx of cholecystitis remains uncertain after USS?
Technetium-labelled HIDA scan
38
Where should biopsy be taken for definitive diagnosis in Coeliac's?
Jejunum
39
TPN affect on blood tests?
Derranged LFTs
40
Management of femoral hernias?
Need to be repaired, regardless of whether they are symptomatic, due to the risk of strangulation
41
In what condition is amenorrhoea a common feature (and deranged LFTs)?
Autoimmune hepatitis
42
How can you distinguish inguinal hernia types clinically?
Apply pressure to deep inguinal ring
43
What cancer is strep Bovis associated with?
Colon cancer
44
Where is most likely to be affected in ischaemic colitis?
Splenic flexure
45
Features of achalasia?
Dysphagia of BOTH solid and liquids from onset Regurgitation of food - cough, aspiration pnemonia
46
What cancer does achalasia increase risk of?
Squamous cell carcinoma
47
Drug used in obesity?
Orlistat (inhibiting pancreatic and gastric lipase to decrease digestion of fat)
48
Management of umbilical vs inguinal hernia (paediatric)?
Inguinal: surgical repair immediately Umbilical: Conservative management (may resolve spontaneously by 4-5 years)
49
Bile acid malabsorption management?
Cholestyramine
50
First line management for achlasia?
Pneumatic (balloon) dilation 2nd line = heller cardiomyotomy
51
Increased goblet cells is in what IBD?
Crohn’s
52
Complication of coeliacs?
Hyposplenism
53
Most common cause of large bowel obstruction?
Bowel cancer
54
Imaging used to ensure no anastomotic leak following surgery?
Gastrogafin enema
55
Pseudomembranous colitis?
C. diff Clindamycin and cephalosporins cause it
56
Management of patient with ascites and protein count is < /= 15g/l?
Ciprofloxacin - for SBP
57
Cause of gas gangrene?
Clostridium perfrigens
58
Management of biliary colic ?
Elective lap cholecystectomy
59
Score for frailty assessment?
Prisma-7
60
What score do nice recommend is calculated every 6 months in patients with compensated liver disease? And other monitoring?
Meld score AFP and USS also every 6 months OGD every 3 months
61
WHO what is sign in?
Before anaesthesia
62
What is time out? (WHO)
Before skin incision
63
WHO what is sign out?
Before patient leaves theatre
64
Sister Mary Joseph nodule?
Sign of metastasis to periumbilical lymph nodes, classically from gastric cancer primary
65
What drug increases risk of perforation in diverticulitis?
Nicorandil - causes gi ulceration

PassMed facts (18 decks)

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