im a doctor :) > msra gastro > Flashcards

msra gastro Flashcards

(88 cards)

Study These Flashcards
1
Q

chrons most common presentation adults

IN CHIDREN

does a negative fit mean you dont have cancer

A

DIARRHEA

ADOMINAL PAIN

YES!its very sensitive

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

TREATMENT TO INDUCE REMSIION IN CHRONES

A

1st line steroid
2nd line 5 ASA drugs (mesalazine)

methotrextae or azathirpine

fistula - infliximba
anal disease - metronadiazole

tell them to stop smoking - but oddlly helps in UC

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

MAINTENCE OF REMISSION

A

AZATHIRPRINE /MERCAPTOPURINE
SECOND LINE METHOTREXATE

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

if you suspect perianal fistual what invetsiagtion to do +TX

complciations of chrons

A

MRI

metronadizole
infliximab -too

osteoprois- lack of vitamind
colon cancer
small bowel cancer

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

tpmt acttivity what do we have to look out for

A

some people naturally have lower levels so we check the actiivty before giving azathiprpine or mercaptopurine

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

which UC - site most affected

A

rectum

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

classifcation of UC severtity

A

Mild: < 4 stools/day, only a small amount of blood.
* Moderate: 4–6 stools/day, varying amounts of blood, no systemic upset.
* Severe: > 6 bloody stools per day + features of systemic upset (pyrexia,
tachycardia, anaemia, raised inflammatory markers).

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

tx UC

A

INDUCE REMISSION:
local -
limited to rectum/left side
topical mainosalicylates 5sa

severe- iv steroids first line
if cant have steroids then iv cyclosporin

MAINTAIN REMISSION
oral aminosalicyliates -5sa

if loads of relapses - azathorpine or mercaptopurine

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

methotexate IBD

WHICH ONE HAS HIGHER RISK OF COLORECTAL CANCER

A

USED FOR CD
BUT NOT FOR UC

UC

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

primary scelorising cholangitis is associated with

A

ibd BUT MAINLY UC

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

IBS

treatment

A

> 6 MONTHS
abdo pain relieved by defection
bloating
made worse by food
mucous

if constipated isphagula husk is recommended laxatives in general but avoid lactulose (is a fodmap makes it worse)

diarrhea- loperamide

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

mebeverine

ibs and antidepressant

A

used in IBS -antispasmodic- abdo pain

somehow helps?? especially amitryptilline so we prefer TCAS over SSRIS

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

what happens if patient has IBS really bad consipation and youve tried laxatives

ADVCE FOR IBS

A

uses linaclotide

regular meals
low fodmap diet
restrict tea and cofee
plenty of water
limit fruits
alochol and fizzy drinks :(

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

causes of dysphagia

A

CANCER
OESAPHGAITIS
STRICTURE
CANDIADIASIS
CREST
GLOBUS HYSTERICUS
schatzki ring-linked to gerd

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

PRESSURE O OESAPGAGEAL SPHINCTER IN ACHLASIA

most common cause for barrets

A

LES -is high

GERD

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

manometry

fundupilication surgery

A

used to test the pressure of the esaphageal sphincter - achlasia + gerd

where you wrap the top of the fundus around the LES- to reinfocre
used for GERD

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

IF SOMEOEN HAS GERED WHAT INVETSIGATIONS DO WE DO

A

they are high risk for barrets so need endoscopy every 3 years if found we need to do endoscopic intevrentions like ABLATION OR RESECTION

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

BEFORE ENDOSCOPY WHAT DO WE NEED TO DO

A

2 WEEKSBEFORE STOP PPIS (can mask problems)

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

duodenal vs gastric ulcer

A

weight gain
night pain more common
food helps so they keep eaating
relief with food/antacids

gastric
antacids less helpful here

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

Prothrombin complex concentrate

A

Prothrombin complex concentrate (PCC) is a rapid-acting, plasma-derived medication containing blood clotting factors II, VII, IX, and X (often with proteins C and S) used for the urgent reversal of vitamin K antagonists like warfarin in cases of major bleeding or emergency surgery.

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

ffp vs ptc

A

FFP
-ALL COTTING FACTOR S

PCC
select clotting fcators
rapid in emergency conditions

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

esophageal bleeding nice guidelines

A

no ppis before endoscopy but for non varicela bleeding its calm

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

tx oesageal varices bleeding

A

terlipressin - can use octreortide if not avilable
abx

endocsopcy
band ligation- more superior
sclerotherapy -

BLAKEMORE TUBE - emergency
TIPS-DEFICINTIVE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

BILE ACID MALABSORPTION SYNDROME symptoms and treatments and diagnosis

A

CHRONIC DIARRHEA
STEATORHHEA
FAT SOLUABLE VITAMINS KADE

bile acid sequestrants cholestyramine

nuclear medicicne scane SecAT evry 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
c diff signs EVEYTHING TO KNOWN ABOUT Diagnois treatment MEASURES
bloods -infection nb!WCC abdo pain diarrhea toxic megacolon bowel obstruction -ileus relpase is very common and you fix with fidaxomycine witin 12 weeks-fidazomycine >12 weeks vancor fidax stool - toxin in stool TX VANCOMYCIN 10 DAYS fidaxomicin Third-line therapy: oral vancomycin +/- IV metronidazole can give monoclonal ab BEZLOTUXAMAB FECAL TRANSPLANT SIDE ROOM -UNTIL NO DIARRHEA FOR 48 H PPI washing hands- alcohol wont kill spores
26
ppi long term use urgent endocspy 2 week wait GI
osteorosis low maneisuam can mask symptoms of gastic cancer ALL DYSPHAGIA >55 weight loss, dyspepsia, reflux
27
zenkers TIPPS
more common in men first biteful is easy then becomes more difficult as pouch fills up weakenss through killian triangle treatment-remove the pouch myotomy palpable swelling in neck may gurgle FOR LIVER CIRROHIS esp varices and ascites
28
cholecystitis diagnosis NAFLD treatment
usually uss but nowdays we ct everything weight loss
29
charcots triad SBP most common organism treatment
fever jaunidce ruq e.coli cefotaxime
30
reynolds pentad b3st measure for acute liver failure
hypotnesion altered mental status PT TIME! liver fucntion tests do not always reflect all clottig facotrs will be low apart from factor 8
31
autoimmune hepatiis
young females amenorrhea is common also asociated with other autoantibodies abdo pain juandice anitmitochorndiral ab antismooth muscle ab
32
ascites management
reduce sodium levels diuertics- like spironolactone prophylactic ab- SBP -fluorquniolone
33
child pugh score marker for liver cancer TREATMNET FOR LIVER CANCER
liver cirrohis mortality AFP 1.RESECTION 2.abaltion 3.transplant 4. TACE 5.sorafenib
34
AST/ALT drugs that cause liver cirrohis
>2 - ast will be 2x higher - alcohol <1 fatt liver methotrexate amiodorone methyldopa
35
metclopramide CI side effects
BOWEL OBSTRUCTION PARKINSONS YOUNG WOMEN diaarrhea hyperprolactin parkinonism
36
celiac genotype types of oesaphageal ca
associated HLA DQ2 DQ8 squamous/adeno s: upper 2/3rds, smoking, diet riched in nitrosamines, achlasia A:lower 1/3, smokking, gerd,
37
diagnosis of celiac disease
TTG (Ig a) but if the patient has an IGA deficiecy biopsy -traditionally duodenum
38
Cyclical vomiting syndrome: treatment
Severe nausea and sudden vomiting lasting hours to days * Prodromal intense sweating and nausea * Well in between episodes. often associated with migraines TX
39
hematochromis s
autosomal recessive Cardiac failure (secondary to dilated cardiomyopathy) * Hypogonadism (secondary to cirrhosis and pituitary dysfunction Arthritis (especially of the hands)
40
time fram for diarrhea how can we monitor progression of chrons
acute <14 chronic >14 days calprotectin _crp (not specific)
41
pernicious anemia what antibodies regimen for b12 injections
parietal cell antibody intrinsic factor antibodies TDS for 2 weeks followed by 3 monthly
42
most commonly site of pancreatic cancer pancreatic cancer investigations
Adenocarcinoma 80% head of pancreas often diagnosed late as it tends to present in a non-specific New-onset diabetes may be an indication for an urgent CT to rule out pancreatic cancer. USS CT ABDOMEN
43
fanconi syndrome
kidney problem glucose in urine amino acid in urine Excessive urination and thirst: Polyuria and polydipsia
44
Carcinoid syndrome
Usually occurs when metastases are present in the liver and release serotonin into the systemic circulation. * May also occur with lung carcinoid as patient ar eoften deficient in niacine causing pellegra
45
urinary 5-HIAA plasma chromogranin A seen where?
CARCINODI SYNDROME
46
PELLEGRA anal fistula signs
niacin deficiency usually history of abscess pain mucous draining
47
tx carcinodi syndrome
somatostatin analogues e.g. octreotide * diarrhoea: cyproheptadine may help
48
birds beak finding rectal prolaps
achlasiam barium swallow common in eldelry women childbirth straining differnet levels, -can be just mucosa poking through or more layers usually they try to push it in tx pelvic floor excercise rectopexy
49
x ray findiings achlasia tretaments
may show a wide mediastinum (due to swollen oesophagus) o fluid level seen if food and drink are stuck in the oesophagus Pneumatic (balloon) dilation – first-line: Heller cardiomyotomy (surgery): Botulinum toxin (Botox) injection: Medications: o such as nitrates or calcium channel blockers to relax the sphincter o rarely used due to side effects and limited effectiveness
50
Primary Sclerosing Cholangitis (PSC) and Primary Biliary Cholangitis
PSC-linked to IBD affects both inside and outside lived high risk of cancer cholangiocarcinoma PBC- just the inside ducts autoimmune -antimitochondiral ab first-line: ursodeoxycholic acid slows disease progression and improves symptoms ASSOCIATED WITH XANTHELESMA CAN ALSO HAVE SICCA SYDNROME
51
Melanosis coli: MOST COMMON LOCATION OF COLON CANCER
a disorder of pigmentation of the bowel wall. Histology demonstrates pigment-laden macrophages. * It is associated with laxative abuse, especially anthraquinone compounds such as senna. RECTUM THEN SIGMOID
52
Peutz-Jeghers syndrome
autosomal dominant condition characterised by numerous hamartomatous polyps in the gastrointestinal tract. It is also associated with pigmented freckles on the lips, face, palms, and soles.
53
important side effect of isonaziad pernianal hematoma
a vitamin B6 deficiency, leading to peripheral neuropathy. often mistaken for a thrombosed external hemorroid! bluish/black swelling near anus history of straining, lifting objects very acute -pain is the main reason people seek attention feels firmer than a hemorroid usually will go away by itself
54
PPI AND CLOPIDOGREL normal CBD SIZE
known to decrease the efficacy of clopidogrel, so lansoprazole would be the most effective pharmacological option to manage dyspepsia symptoms secondary to antiplatelet therapy. espcially O+E around 6
55
risk for stomach cancer pilonidal cyst
diet low in fruits and vegetable high salt blood group A FH Smoking h.pylori Ménétrier disease pain in the sacrococcyz region usually caused by hairs getting trapped in there can drain fluid can develp into abscess
56
constipation in the elderly sevre anal pain at night, which is selft limiting, brief andn ot related to bowel movements
an empty rectum does not exlclude constipation as the feces could be impcted higher proctalgia fugax
57
pseudo obstruction in terms of bowels
where we cant find a mechanical cause common in eldelry patients +bedridden patients GAS IN RECTUM there is usually n/little abdo pain
58
sigmoid volvulus most common site
mostly eldelry almost always hav e a history of contiation inverted u shape/cofee bean sigmoid
59
gall bladder mucocele WHICH ELECOTRYE ABNORMALITY IS ASSOICTED WITH CONSTIPATION
a complciation of gallstones cause by stone in cystic duct get a mucous filled cyst HYPERCALCEMI A
60
budd chiari
a rare disorder caused by the obstruction of hepatic venous outflow, trapping blood in the liver and leading to congestion, swelling, and damage its associated with pro thrombotic states classic triad ascites abdo pain enlarged liver
61
congential hyperbilrubinemias hematochromoatosis complications
criggler gilbert dubin johson rota diabete s cardiomyppathy hypogonadims (build up in pituitary gland) hypothyroidism hepatocellular carcinoma impotence
62
gilbert MESENTERIC ISCHEMIA
usually mild often incidental finiding unconjugated hb mild impairment in uDp enzyme need to avoid drugs that depend on udp to metabolise may get jaundice if stressed or ill but its not serious its self limiiting these people should avoid drugs which rely on udp-hiv drugs /cholesterol drugs - google PAIN OUT OF PROPORTION TO FINDINGS ,pain is often poorly localised late stages may be peritonitic
63
left sided colon cancer most commonc ause of gasteroenteritis
blood in stools males NOROVIRUS
64
right sided cancer sister mary joseph nodule
more so anemia from bleeding females are always right metastatic from abdomen plevis frim umbilical nodule
65
Chronic mesenteric ischemia main cause diagbois of toxic mega criteria
pain after eating fear of eating main cause-atherosclerosis abdominal x ray >6cm, loss of haustra ct avoid colonscopy /barium risk of perf jalans criteria 1. evidence of dilation on x ray 2. either fever, wbc, tachy, anemia - any 3 3. electrolyte abnormalities dehdrated mental status hypotensive
66
colonic ischemia most common cause of fresh lower gi bleeding needing admission
crampy type of pain usually left side(rectosigmoid junction is vulnerable) has the msot favourable prognosis diverticular disease
67
small vs large bowel obstruction
small more acute valuvulae conniventes-traverse bowel main cause is adhesionsnb! crampy intermittent abdo pain mainly vomiting (more proximal ) distention (mainlydistal) ng tube can still pass small amounts of poo bowel sounds hyperactive (tinkiling) large more insiduous main cause volivuls or cancer mainly consitpations
68
parlaytic ileus causes
>3 days drugs electroltes after infections , sepsis MI bowel sounds will not be tinkinling will be more hypoactive mostly see in small intestine but can be both treatment is usually supportive
69
e.histolytica how do you get symptoms yersinia entercolitica
fecal oral -ingest cyst liver abscess diarrhea - bloody can cause bloody diarrhea pain can mimic chrones or appendiictis - often got from eating pork
70
associations of campylobacter symptoms
GBS recative arthititis usually food poisioning abdo pain diarrhea- can be bloody
71
nice guidelines what constitures urgen refereal for colon cancer
fit test over 10 of blood and if there is a rectal mass or ulceration
72
need to diagnose h pylori what do you need to ensure beforehand
1. no ppis 2 weeks 2. no abx 4 weeks
73
alpha 1 antitrypsin deficiency
affects the alveoli they develop emphysema liver problems and similar to copd symptoms
74
cholestatic picture gallstones can celiacs have rice how to diagnose celiac
raised br GGT ALP aye make sure the person has been having gluten in order to test for the antibodies. if poistive then you need to do a bipsy to confirm at least 2 meals a day over the last 6 weeks
75
DIAGNOAIS OF PANCREATITIS MONITORING IBD SURVEILLANCE
amylase 4 x > limit need colonscopy with multile biopsies, after 10 years of diagnoiss
76
femoral NAV OR VAN which type of hernia is more common in women
NAV N(most lateral) v(most medial) just think of fascia iliac blcok femoral
77
anal fissure treatemnts femoral hernia
topic anaesthetic if that doesnt work then gtn spray below inguinal ligamnt lateral to pubci tubercle and inferior
78
which type of heria is strangulation most likely
femoral
79
spiegeln hernia
lateral hernia usually on the RHS Often no visula swellling usually small, therfroe risk of strangaultion is high lump will be under the belly button
80
deficiency in b2
riboflavin crcackled lips mouth ulcers angles of the mouth eyes blood shot , photosensitivity
81
pellegra is caused by
b3 deficiency
82
Oculo-Orogenital Syndrome:
B3 DEFICIECY
83
DYSPEPSIA MANAGMENT NICE GUIDELINES ALARM SYMTPOMS
patient had epigastic tenderness if no ALARMING SYMPTOMS nice suggests trialing a ppi or testing for h.pylori . Need to be off abx 4 weeks ppi 2 weeks epigastric mass dysphagia persistent vomiting weight loss >55 years with peristent dyspepsia
84
rockall risk score when you should ussupect Primary biliary scleois in a UC patient
identify patients at risk of adverse outcome following acute upper gastrointestinal bleeding known uC, but have abnormal lFTS, esp ALP
85
DEGREES OF HEMORROIDS treatment
GRADE 1 -internal grade 2- spontaneous reducement 3. have to be pushed in 4. always out increase fiber dont sit too long on toilet 1st line-rubber band ligation sclerotherapy last resort- surgery
86
glugaonoma symptoms
4D DIARRHEA DERMATOSES (RASH) DVT DEPRESSION DIARRHEA DECREASED WEIGHT
87
which ehtnic group increasedin gallbladder cancer AAA DIAGNOSIS
hispanic USS CT ANGIO
88
SEECSY IS FOR HAITUS HERNIA ON X RAY hiatus hernia signs
ORGANISMS WHICH CAUSE BLOODY DIARRHEA retrocardiac air fluid level chest pain dysphagia wheezing, cough early satiety
im a doctor :)
flashcards
Decks in class (65)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions