AAAMedicine > GI quick > Flashcards

GI quick Flashcards

(56 cards)

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1
Q

SAAG> 11

A

Portal HTN

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2
Q

SAAG <11

A

Hypoalbuminaemia
Malignancy
Bowel obstruction

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3
Q

gastric carcinoma

A

pernicious anaemia can be a cause

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4
Q

SBP

A

Paracetesis - neutrophil count >250
E coli most common
IV ceftoxamine

ABX prophylaxis - had episode of SBP - oral copra

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5
Q

C diff treatment

A

1.Oral vanc (10 days)
2. Oral fidoxamicin
3. Oral vanc +/- IV metronidazole

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6
Q

Recurrent C diff

A

Within 12 weeks of symptom onset - oral fidoxanicin

After 12 weeks of symptom onset - oral vanc OR fidoxanicin

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7
Q

Life treatening C diff

A

Oral vanc and IV metronidazole

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8
Q

IBS treatment

A

Pian cramping etc = mebeverine

Laxatives and loperamide

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9
Q

CROHNS FEATURES

A

No blood or mucus
Entire GI tract
Skip lesions
Terminal ileum, transmural
Smoking is a RISK FACTOR
Deep ulcers
Goblet cells and granulomas
Kantors string adn rose thorn ulcers

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10
Q

CROHNS TREATMENT

A

Inducing remission
- glucocorticoids
mesalazine
azathriopine
metronidazole ( also for fistula)

Maintaining remission
- azathioprine or mercaptopurine
methotrexate

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11
Q

UC features

A

Continuous inflammation
Limited to the colon and rectum
Only superficial mucosa
Smoking protective
Excrete blood and mucus
PSC
No inflammation beyond submucosa
Crypt abscesses
Pseudopolyps
Barium enema shows loss of haustration
DRAINPIPE COLON
GET BLOOD AND PIAN IN LEFT LOWER QUADRANT

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12
Q

UC treatment

A

Inducing remission
Topical aminosalicyate
Rectal aminocysalicate
Topical/oral corticosteroid

Extensive - Topical aminosalicyate and oral
Severe = IV steroids or IV ciclosporin

Maintaining
- Topical rectal aminosalicyate
left sided/ extensive - oral aminosalicyate

Severe relapse or >2 exacerbations in last year = oral azaioopthrine/ oral mercapnione

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13
Q

What to check for azaithoprine

A

TPMT

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14
Q

Alchasia

A

Solids and liquids
Heartburn, regurgitation

Oesphageal manometry - excesive LOS tone
Barium swallow = birds beak

Pneumatic dilation, Heller cadiomyotomy surgery if recurrent

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15
Q

Pharyngeal pouch

A

Dysphagia, regurgitation, aspiration, neck swelling, halitosis

barium swallow and dynamic video fluoroscopy

Surgery

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16
Q

HCC

A

High ALT/ALT
Liver cirrhosis
Surgical resection
SORAFENIB for metastatic

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17
Q

Gilbert

A

Autosomal recessive
Defective bilirubin coagulation
Unconjugated bilirubinaemia
Jaundice during illness

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18
Q

Wilsons

A

Autosomal recessive, copper deposition in tissues
Hepatitis, speech, behavioural and psych problems, Kayser fleshier rings, renal tubular acidosis, haemolysis
Slit lamp, increased copper urinary 24hr excretion
—> penacillaemine ( chelates copper)

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19
Q

Haemorrhoids

A

Increased fibre and fluid intake
Soften teh stools
Anusol, lidocaine
Rubber band ligation

Acutely thromboses
- within 72hours = excision

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20
Q

Low albumin?

A

Malnutrition or liver disease

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21
Q

Ascending cholangitis

A

E coli commonly
Obstruction or infection ( post ERC)

Charcot
- RUQ pain, fever, jaundice, hypotension, confusion

USS, CT, MRCP

—-> IV abx and ERCP

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22
Q

Cholangiocarcinoma

A

Adaenocarcinoma
Obstructive jaundice, weiht loss
Staging CT, Ca19.9

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23
Q

Alcoholic hepatitis

Study These Flashcards
A

AST: ALT more than 2:1

Symptomatic

–> give red

24
Q

Pancreatitis

Study These Flashcards
A

Elastase can show function
Blood glucose, hypoxia and hypocalcaemia is prognostic
Lipase has a longer half life than amylase - good in conditions >24 hours presentations

25
Cholecystitis
Inflammation of gallbladder RUQ pain anTs often normal USS and MRCP IV abx and ercp Cholecystectomy
26
PBC
Females, IGM, AMA Shortens associated Fatigue, prutitism jaundice HCC
27
PSC
Intra and extra hepatic MEN Associated USI/IBD pANCA Beaded on ERCP Cholangiocarcinoma
28
gastric cancer
H pylori abdo and n+V and bleeding Oesphagogastroduodenoscopy + biopsy SIGNET rings
29
Colorectal cancer
1. Lynch 2. FAP FIT Colonoscopy, CEA, caging CT
30
Pancreatic cancer
High ALP HNPCC Migratory thormboplebitis. new DM High resolution CT = double duct WHipples
31
PPI side effects
Hyponatraemia, hypomagnesionia, osteoporosis, microscopic colitis and increased risk of c diff
32
Budd chiari
Hepatic vein thrombosis PRV, pregnancy and COCP causes Ascites. abdo pain ---> USS with doppler
33
PPI mechanism of action
Block of H+/K+ ATPase of gastric parietal caell
34
Coeliac
T1DM, autoimmune hepatitis Can get T cell lymphoma Gluten free = rice, potatoes, corn Endoscopy and biopsy - villous atrophy, crypt hypertrophy Pneumococcal vaccine every 5 years
35
Undiagnosed dyspepsia
1. review meds 2. lifestyle 3. trial PPI for 1 month of test and treat for H pylori urea breath test Amxo and clarithromycin
36
Oesphageal cancer
Adeno = lower 1/3, good and barrets SCC= upper 2/3, smoking and alcohol
37
Barrets
Consent refill changes in lower oesphagus epithelium Get improvement in reflux Ablation during endoscopy Endoscopic surveillance every 3-5 years
38
High amylase cause?
Pancreatitis, bowel obstruction, morphine, renal failure, mumps
39
Haemochromatosis
Autosomal recessive Chronic fatigue, ED, arthralgia, hair loss, pigmentation, diabetes Excessive deposition of IRON Ferritin goes UP Tramsferrin saturation high Vesection, monitor transferrin, avoid alcohol Liver biopsy with pearls stain
40
TIBC in iron deficiency anaemia vs anaemia of chronic disease?
Iron deficiency anaemia = high TIBC Anaemia of chronic disease = low TIBC
41
Femoral vs inguinal hernia
Femoral - inferiolateral to pubic tubercule Inguinal - superiomedial to pubic tubercule
42
Femoral strangulation
Tender, non reducible Systemically unwell
43
Complications of inguinal surgery
Ilioingunial nerve damage.
44
Anal fissures
Acute <6 weeks Soften soil, dietary advice Topical GTN if chronic If ineffective ---> sphinectomy
45
UTIs treatment
Non pregnant = Trimethoprim or nitro 3 days MSU if >65 or blood Pregnant = MSU, nitro 7 days (avoid. near term), amox 2nd line Men = trimethoprim 7 days msu pyelonephritis = ceftriaxone, 10-14 days
46
Peutz jeghers
Autosomal dominant Pigmented freckles and polyps Intussecption and SBO = presentation
47
Upper GI bleed
Raised urea = protein meal Glasglow blatchford = ?managed as outpatients or not Rockall = after endoscopy. Endoscopy within 24 hours variceal bleeding = abx and terlipressin Non variceal - PPIs before endoscopy
48
Colostomy vs ileostomy
Ileostomy is RIF , spouted and liquid Colostomy is LIF, flushed and solid
49
Bowel ischaemia
Sudden onset abdominal pain, out of keeping with examination findings Increased WCC and lactic acidosis High resolution CT angiography IMMEDIATE LAPAROTOMY usually small bowel
50
Iscaemic colitis
Large bowel, less severe Splenic flexure Thumbrinting on abdo xray
51
SBP
Paracetesis >250 neutrophil E coli IV ceftoxamine Prophylaxis with oral cipro
52
Hepatic encephalopathy
Confusion, astrexis, high ammonia, cant draw a star Give them lactulose and rifaximin - SBP, GI bleeding consitpaiton etc can precipitate
53
What can cause liver cirrhosis?
Methyldopa, amiodarone, methotrexate Jaundice, hepatomegaly etc etc Albumin low, PT higher Hyponatraemia USS: corkscrew MELD every 6 months Fibroscan every 2 years
54
Hepatitis
High AST/ALT HSAg - ongoing HbC = caught e.g. negative in immunised. IgM in acute. HBS = immunity. Negative in chronic disease T1 autoimmune ANA or SMA t2 - LKM1, children only
55
Colorectal cancer - treatments for: - Caecal, ascending proximal transverse - Distal transverse or descending - Sigmoid - Upper and lower rectum - Anal verge
Caecal ascending proximal transverse - right hemicolectomy Distal transverse or descending - left Sigmoid - high anterior resection Upper and lower rectum = anterior resection Anal verge (<5cm)= abdominoperineal resection
56
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