GI Bible Flashcards
which nerve supplies the rectum?
S4
inferior rectal nerve
how is H. Pylori diagnosed/treated?
diagnosed via Urea breath test
Treated with triple therapy:
- PPI + amoxy (metronidazole if allergic) + clarythromicin
what differentiates a gastric vs duodenal ulcer?
duodenal relieved by milk
what is the sign of achalasia and how is it treated?
birds beak appearance on barium swallow
hellers cardiomyotomy or balloon dilatation
what is the acute presentation of oesophageal varices?
massive bleeding - haematomesis and malaena
history of liver disease or portal hypertension
how is an oesophageal variceal bleed treated?
recuscitation (correct clotting abnormalities) IV terlipressin/vasopressin Banding Sengstaken Blakermore Tube TIPSS?
How are oesophageal varices prevented?
TIPSS
Beta blockers
Endoscopy and banding
what are some trademarks of crohns?
cobblestone mucosa
recurrent oral stomatitis
deep fissuring ulceration of mucosa
what is the treatment for crohns?
Mesalazine (5-ASA)
immunosuppression - Azathioprine
Steroids - Prednisolone?
what is barrets oesophagus?
replacement of normal stratified squamous epithelium by simple columnar epithelium with goblet cells - development of goblet cells = adenocarcinoma risk
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
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
how is ascites managed?
spironolactone
paracentesis
what are the side effects of spironolactone?
gynaecomastia
hyperkalaemia
what can hyperkalaemia cause?
risk of arrhythmais
what does thumb printing at the splenic flexure indicate?
ischaemic colitis
what is another name for the external urethral orifice?
meatus
which foods take the longest to digest?
fatty foods
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
What does BUFALO stand for (sepsis management)?
Bloods Urine output (measure) Fluids Antibiotics Lactate (measure) Oxygen
what is wilsons disease?
autosomal recessive disease of copper metabolism
Low caeruloplasmin
Kayser-fleischer rings
what is grey turner’s sign?
bruising of flanks
acute pancreatitis
what is Cullen’s sign?
umbilical bruising
acute pancreatitis
what are the symptoms of acute pancreatitis?
cullens sign grey turner's sign epigastric pain radiating to the back vomiting raised amylase raised lipase
what is virchows node?
left supraclavicular lymph node
enlarged in gastric cancer
what do signet ring cells on biopsy indicate?
diffuse stomach cancer (linitis plastica)
what does high AFP (alphafeto protein) indicate?
hepatocellular carcinoma
what will oesophageal spasm look like on barium swallow?
corkscrew oesophagus
abdominal pain and diarrhoea after sour milk or shellfish?
campylobacter
what is charcot’s triad?
fever, jaundice, abdominal pain
indicates acute cholangitis
what is short bowel syndrome?
bowel <2m due to surgical resection
what is the blood supply to the foregut?
coeliac trunk:
- common hepatic
- left gastric
- splenic
what is the blood supply to the midgut?
superior mesenteric:
- ileal and jejunal arteries
- ileo colics
- right colics
- middle colics
what is the blood supply to the hindgut?
inferior mesenteric:
- left colics (goes up becoming marginal artry which anastomoses with middle colics)
- sigmoid arteries
where is the adrenal gland?
suprarenal (above kidney)
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
what is Zollinger Ellison Syndrome?
recurrent peptic ulcers due to gastrin secreting tumour
antibiotics are always used in gastroenteritis, true or false?
false
not given and stopped if they are causing it
especially in Ecoli
what is HUS?
haemolytic uraemic syndrome - haemolytic anaemia - acute kidney failure - low platelets caused by E.Coli
what often causes toxic megacolon?
UC
what is haemochromatosis and how is it treated?
Iron overload disease
treated with phlemotomy and blood letting (regular blood removal)
what is leukonychia?
white nails
sign of hypoalbuminaemia
what is koilonychias?
nail spooning
sign of iron deficiency anaemia
what can cause prehepatic jaundice?
gilberts
haemolytic anaemia
newborn
trauma
what can cause intrahepatic jaundice?
viral hepatitis alcoholic hepatitis autoimmune hepatitis decompensated cirrhosis PSC PBC
what can cause post hepatic jaundice?
obstruction:
- gallstones
- head of pancreas cancer
- gallbladder cancer
what are Mallory hyaline bodies?
darker splodges in cytoplasm of liver cells
indicate alcoholic lover disease
which muscle is important in urination and defaecation?
levator ani
must relax to allow urination and defaecation
what vertebral level does the coeliac trunk arise?
T12
at what vertebral level does the vena cava pass through the diaphragm?
T8
8 letters
at what vertebral level does the oesophagus pass through the diaphragm?
T10
10 letters
what is the aortic hiatus?
hole in diaphragm at T12 where aorta, azygous vein and hemiazygous vein pass through
(12 letters)
what is PSC and what are the signs?
primary sclerosing cholangitis beading of the bile ducts assoc with UC "onion skinning fibrosis" pANCA +ve
what is the lowest part of the peritoneal cavity when lying supine?
hepatorenal recess/Morrison’s pouch
what is the rectouterine pouch/pouch of douglas?
area between rectum and uterus in females
what is the rectovesical pouch?
area between rectum and bladder in males
what does a very high creatinine indicate?
renal problem
what is the buccinators?
muscle of cheek that moves food during mastication
antibody for PBC?
anti-mitochondrial antibody
antibody for autoimmune hepatitis?
anti-smooth-muscle antibody
antibody for coeliac disease?
Anti transglutaminase antibody
endomysial antibody
antibody for UC and PSC?
pANCA
also cANCA in PSC
what does CA-125 cause?
ovarian cancer
how does hemochromatosis present?
pigmentation
diabetes
what is PBC assoc with?
rheumatoid disease
thyroid disease
what is PSC assoc with?
IBD, esp. UC
