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Flashcards in GI Bible Deck (66)
1

which nerve supplies the rectum?

S4
inferior rectal nerve

2

how is H. Pylori diagnosed/treated?

diagnosed via Urea breath test
Treated with triple therapy:
- PPI + amoxy (metronidazole if allergic) + clarythromicin

3

what differentiates a gastric vs duodenal ulcer?

duodenal relieved by milk

4

what is the sign of achalasia and how is it treated?

birds beak appearance on barium swallow
hellers cardiomyotomy or balloon dilatation

5

what is the acute presentation of oesophageal varices?

massive bleeding - haematomesis and malaena
history of liver disease or portal hypertension

6

how is an oesophageal variceal bleed treated?

recuscitation (correct clotting abnormalities)
IV terlipressin/vasopressin
Banding
Sengstaken Blakermore Tube
TIPSS?

7

How are oesophageal varices prevented?

TIPSS
Beta blockers
Endoscopy and banding

8

what are some trademarks of crohns?

cobblestone mucosa
recurrent oral stomatitis
deep fissuring ulceration of mucosa

9

what is the treatment for crohns?

Mesalazine (5-ASA)
immunosuppression - Azathioprine
Steroids - Prednisolone?

10

what is barrets oesophagus?

replacement of normal stratified squamous epithelium by simple columnar epithelium with goblet cells
- development of goblet cells = adenocarcinoma risk

11

what is murphy's sign?

Tests for gallbladder inflammation
Examiner hooks fingers under liver and asks patient to exhale, if gallbladder descends into hands causing pain = inflammation

12

what is duke's classification?

staging system for colorectal cancer
A = confined to submucosa
B1 = not crossed bowel wall
B2 = crossed bowel wall
C = not crossed bowel wall + lymph node metastases
D = crossed bowel wall + lymph node metastases

13

how is ascites managed?

spironolactone
paracentesis

14

what are the side effects of spironolactone?

gynaecomastia
hyperkalaemia

15

what can hyperkalaemia cause?

risk of arrhythmais

16

what does thumb printing at the splenic flexure indicate?

ischaemic colitis

17

what is another name for the external urethral orifice?

meatus

18

which foods take the longest to digest?

fatty foods

19

what is the difference between haemorrhoids and rectal prolapse?

haemorrhoids:
- prolapse of rectal venous plexus due to chronic constipation/pregnancy/portal hypertension
Rectal prolapse = the actual rectal tissue comes out

20

What does BUFALO stand for (sepsis management)?

Bloods
Urine output (measure)
Fluids
Antibiotics
Lactate (measure)
Oxygen

21

what is wilsons disease?

autosomal recessive disease of copper metabolism
Low caeruloplasmin
Kayser-fleischer rings

22

what is grey turner's sign?

bruising of flanks
acute pancreatitis

23

what is Cullen's sign?

umbilical bruising
acute pancreatitis

24

what are the symptoms of acute pancreatitis?

cullens sign
grey turner's sign
epigastric pain radiating to the back
vomiting
raised amylase
raised lipase

25

what is virchows node?

left supraclavicular lymph node
enlarged in gastric cancer

26

what do signet ring cells on biopsy indicate?

diffuse stomach cancer (linitis plastica)

27

what does high AFP (alphafeto protein) indicate?

hepatocellular carcinoma

28

what will oesophageal spasm look like on barium swallow?

corkscrew oesophagus

29

abdominal pain and diarrhoea after sour milk or shellfish?

campylobacter

30

what is charcot's triad?

fever, jaundice, abdominal pain
indicates acute cholangitis

31

what is short bowel syndrome?

bowel <2m due to surgical resection

32

what is the blood supply to the foregut?

coeliac trunk:
- common hepatic
- left gastric
- splenic

33

what is the blood supply to the midgut?

superior mesenteric:
- ileal and jejunal arteries
- ileo colics
- right colics
- middle colics

34

what is the blood supply to the hindgut?

inferior mesenteric:
- left colics (goes up becoming marginal artry which anastomoses with middle colics)
- sigmoid arteries

35

where is the adrenal gland?

suprarenal (above kidney)

36

what cells produce each substance in the GI tract?

CCK = I cells
Gastrin = G cells
Somatostatin = D cells
GIP = K cells
GLP-1 = L cells
HCl =
Secretin = S cells
Motilin = M cells
Ghrelin = Gr cells

37

what is Zollinger Ellison Syndrome?

recurrent peptic ulcers due to gastrin secreting tumour

38

antibiotics are always used in gastroenteritis, true or false?

false
not given and stopped if they are causing it
especially in Ecoli

39

what is HUS?

haemolytic uraemic syndrome
- haemolytic anaemia
- acute kidney failure
- low platelets
caused by E.Coli

40

what often causes toxic megacolon?

UC

41

what is haemochromatosis and how is it treated?

Iron overload disease
treated with phlemotomy and blood letting (regular blood removal)

42

what is leukonychia?

white nails
sign of hypoalbuminaemia

43

what is koilonychias?

nail spooning
sign of iron deficiency anaemia

44

what can cause prehepatic jaundice?

gilberts
haemolytic anaemia
newborn
trauma

45

what can cause intrahepatic jaundice?

viral hepatitis
alcoholic hepatitis
autoimmune hepatitis
decompensated cirrhosis
PSC
PBC

46

what can cause post hepatic jaundice?

obstruction:
- gallstones
- head of pancreas cancer
- gallbladder cancer

47

what are Mallory hyaline bodies?

darker splodges in cytoplasm of liver cells
indicate alcoholic lover disease

48

which muscle is important in urination and defaecation?

levator ani
must relax to allow urination and defaecation

49

what vertebral level does the coeliac trunk arise?

T12

50

at what vertebral level does the vena cava pass through the diaphragm?

T8
(8 letters)

51

at what vertebral level does the oesophagus pass through the diaphragm?

T10
(10 letters)

52

what is the aortic hiatus?

hole in diaphragm at T12 where aorta, azygous vein and hemiazygous vein pass through
(12 letters)

53

what is PSC and what are the signs?

primary sclerosing cholangitis
beading of the bile ducts
assoc with UC
"onion skinning fibrosis"
pANCA +ve

54

what is the lowest part of the peritoneal cavity when lying supine?

hepatorenal recess/Morrison's pouch

55

what is the rectouterine pouch/pouch of douglas?

area between rectum and uterus in females

56

what is the rectovesical pouch?

area between rectum and bladder in males

57

what does a very high creatinine indicate?

renal problem

58

what is the buccinators?

muscle of cheek that moves food during mastication

59

antibody for PBC?

anti-mitochondrial antibody

60

antibody for autoimmune hepatitis?

anti-smooth-muscle antibody

61

antibody for coeliac disease?

Anti transglutaminase antibody
endomysial antibody

62

antibody for UC and PSC?

pANCA
also cANCA in PSC

63

what does CA-125 cause?

ovarian cancer

64

how does hemochromatosis present?

pigmentation
diabetes

65

what is PBC assoc with?

rheumatoid disease
thyroid disease

66

what is PSC assoc with?

IBD, esp. UC