passmed ! > gastro > Flashcards

gastro Flashcards

(56 cards)

Study These Flashcards
1
Q

prophylaxis of oesophageal varices?

A

propranolol -> non-selective B blocker

endoscopic variceal band ligation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

tx for active variceal bleeding

A

A-E
correct clotting
terlipressin
prophylactic ABX -> reduces mortality
endoscopic band ligation
TIPSS if above fails

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the best test to measure and monitor acute liver failure

A

prothrombin
as it has a shorter half life than albumin

ALT and AST arent great indicators of liver function in acute liver failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

after blood tests what scan/imaging can be used to determine the extent of alcoholic liver disease

A

transient elastography
-> also known as a fibroscan which looks at the extent of fibrosis by looking at the elasticity of the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how to distinguish between upper and lower GI bleed

A

high urea levels= upper GI as blood is digested into proteins which are metabolised into urea in the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

alcohol units calculation?

A

total vol x ABV / 1000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

iron studies for haemochromatosis

A

raised transferrin saturation,
raised ferritin
low TIBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

why does haematochromatosis cause hypogonadotrophic hypogonadism

A

due to iron deposition in pituitary gland causing impaired function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

ix of choice for pharyngeal pouch

A

barium with fluoroscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

radiology sign of pancreatic cancer

A

double duct
- dilation of pancreatic and cbd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

derranged LFT with T2DM

A

NAFLD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is gilberts syndrome

A

autosomal recessive* condition of defective bilirubin conjugation due to a deficiency of UDP glucuronosyltransferase

unconjugated hyperbilirubinaemia
jaundice seen only in times of stress

no TX, just reassure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is melanosis coli

A

disorder of pigmentation of the bowel wall. Histology demonstrates pigment-laden macrophages.

It is associated with laxative abuse-> senna

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is a carcinoid tumour

A

produce vasoactive amines -> 5HT, bradykinin, adrenaline, prostaglandins

these are inactivated by the liver and cause mets there

flushing
diarrhoea
bronchospasm
hypoT

ix: urinary 5HIAA
Mx: ortreotide
cyproheptadine might help

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ix for post eradication of h pylori

A

urea breath test

stool not an option !!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

why would ALP be raised in coeliac

A

due to low calcium so bone is broken down to increased this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is seen on paracentesis that confirms SBP

A

> 250 neutrophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

side effect with TIPSS

A

exacerbates hepatic encephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

plummer vinson symptoms

A

Plummers DIE: Dysphagia, Iron deficiency anemia, Esophageal webs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

blood test results for anaemia of chronic disease

A

low Hb
low MCV
proportional rise of urea and creatinine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

early signs of haemochromatosis

A

fatigue
erectile dysfunction
arthralgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

ABG renal tubular acidosis?

A

hypercholraemic met acidosis with normal anion gap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

type 1 renal tubular acidosis

Study These Flashcards
A

cant generate acid urine
causes hypokalaemia

24
Q

complications type 1 RTA

Study These Flashcards
A

nephrocalcinosis and renal stones

25
causes type 1 RTA
idiopathic rheumatoid arthritis, SLE Sjogren's, amphotericin B toxicity analgesic nephropathy
26
type 2 RTA causes
decreased HCO3- reabsorption in proximal tubule causes hypokalaemia
27
complications of type 2 RTA
osteomalacia
28
causes type 2 RTA
diopathic, as part of Fanconi syndrome, Wilson's disease, cystinosis, outdated tetracyclines, carbonic anhydrase inhibitors (acetazolamide, topiramate
29
cause of type 3 RTA
carbonic anydrase 2 def results in hypokalaemia really rare
30
type 4 RTA
reduction in aldosterone causes reduction in ammonium excretion causes hyperkalaemia caused by hypoaldosteroism diabetes
31
2 1 4 low low more?
mnemonic for RTA type 2 proximal CT type 1 distal CT type 4 CD low low more potassium !!
32
sodium rapidly high to low causes?
high to low, brain will blow cerebral oedema
33
sodium rapidly low to high?
low to high -> brain will die central pontine myelinolysis
34
how to rule out pseudohyponatremia
calculate osmolar gap = measured serum osmol - calculated serum osmol if gap if <10 then its normal
35
how does acute pancreatitis cause reduced calcium
lipase causes liberation of free acids which bind to calcium and reduce its circulating concentration
36
vitamin def that can cause haemorrhagic disease of the newborn
vit k def
37
what is pellagra
niacin (b3) def causes diarrhoa, dermatitis, dementia
38
ways to do rta qu
1. Is urine pH > 5.3? => if Yes, it's Type 1 RTA. => confirm w/ hypoK + kidney stones ('stONE for type ONE') 2. If urine pH < 5.3, check K+ level. => if high, it's Type 4 RTA ('MORE k+ for type FOUR') => if low, it's Type 2 RTA 3. Know the typical underlying causes - Type 1: Autoimmune = RA, Sjogren, SLE - Type 2: Fanconi syndrome - Type 4: DM nephropathy
39
iron def anaemia vs anaemia of chronic disease bloods
TIBC is high in iron def
40
tests needed before fundoplication surgery
Oesophageal ph manometry studies
41
hepatorenal syndrome mx
vasopressin analogues -> increases splanchnic circulation volume expansion with 20% albumin TIPSS
42
what is the most sensitive marker of CLD -> cirrhosis
thrombocytopenia
43
ix and mx of SIBO
ix: hydrigen breath test Mx: correct underlying disease rifaximin trial co-amox/metronidazole if this doesnt work
44
RF for SIBO
neonates with congential abdo issues scleroderma DM
45
pellagra symptoms
Dermatitis, diarrhoea, dementia/delusions, leading to death
46
how to maintain remission of UC in patient who has: severe relapse or >2 exacerbations within one year
oral azathioprine oral mercaptopurine
47
first line ix for acute mesenteric ischaemia
venous BG -> lactate
48
child pugh score includes?
A - albumin B - bilirubin C - clotting D - distention (ascites) E - encephalopathy
49
treatment of achalasia
1. pneumatic (balloon) dilation is increasingly the preferred first-line option less invasive and quicker recovery time than surgery patients should be a low surgical risk as surgery may be required if complications occur 2. Heller cardiomyotomy should be considered if recurrent or persistent symptoms 3. intra-sphincteric injection of botulinum toxin is sometimes used in patients who are a high surgical risk 4. drug therapy (e.g. nitrates, calcium channel blockers) has a role but is limited by side-effects
50
ix for achalasia
oesophageal manometry -> EXS tone on swallowing barium swallow -> birds beak chest xray - wide mediastinum
51
what is achalasia
Failure of oesophageal peristalsis and of relaxation of the lower oesophageal sphincter (LOS) due to degenerative loss of ganglia from Auerbach's plexus
52
who is achalasia more common in
middle aged men and women
53
px of achalasia
dysphagia to solids and liquids heatburn regurg of food
54
blood results of a patient with alcoholic hepatitis
raised GGT macrocytic anaemia -> due to deficiencies ratio AST/ALT x2
55
constipation mx
1st line: bulk forming e.g. Ispaghula Husk 2nd line hard stools: osmotic e.g. Macrogol 2nd line soft stools with tenesmus: stimulant e.g. Senna Opioid induced: osmotic e.g. macrogol + stimulant e.g. Senna Faecal impaction: high dose macrogol +/- disimpaction/enema/suppository Note: Avoid stimulant in long term as causes electrolyte abnormalities
56
what is the anatomical landmark for an upper gi bleed
origin proximal to the ligament of Treitz this is the suspensory muscle of duodenum ans marks boundary between first and second parts
passmed !
flashcards
Decks in class (19)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions