Gastroenterology & Hepatology — Flashcards

Flashcard 341: Vitamin B12-IF complex from the duodenum is absorbed in the _____

Answer: terminal ileum

Flashcard 342: What is the standard triple therapy for _____-positive peptic ulcers? PPI + Amoxicillin + Clarithromycin

Answer: H. pylori

Extra: Triple therapy (PPI + Amoxicillin + Clarithromycin) is the standard first-line treatment for H. pylori eradication. Quadruple therapy (PPI + Bismuth + Metronidazole + Tetracycline) is an alternative, especially in areas with high clarithromycin resistance.

Flashcard 343: What is the second-line investigation for acute cholecystitis if ultrasound is inconclusive? _____

Answer: HIDA scan

Flashcard 344: Ascites presents with _____ over days or months

Answer: abdominal distension

Flashcard 345: _____ is also recommended in ascites if sodium is < 125 mmol/L

Answer: Fluid restriction

Flashcard 346: _____ acute cholecystitis typically occurs in critically ill patients

Answer: Acalculous

Flashcard 347: Gallstones in different locations can manifst in disease: Biliary colic: _____ Acute cholecystitis: RUQ pain + fever Acute cholangitis: Charcot's triad ± Reynold's pentad Gallstone Pancreatitis: epigastric pain radiating to back

Answer: postprandial RUQ pain

Flashcard 348: Investigation of choice for asymptomatic gallstones: _____

Answer: Ultrasonography (USG)

Extra: Asymptomatic gallstones (incidental gallstones) usually require no treatment (Expectant management/Observation). Prophylactic cholecystectomy is only indicated in specific cases (e.g., porcelain gallbladder, stones >3cm, calcified/porcelain gallbladder, or sickle cell anemia).

Flashcard 349: What is the definitive management of acute cholangitis?

Answer: Biliary decompression (primarily via ERCP ± sphincterotomy; alternatively PTBD or surgery)

Flashcard 350: Acute cholangitis will have _____ CRP, ↑ WCC & may have +ve blood cultures

Answer: ↑