Gastroenterology & Hepatology — Flashcards

Flashcard 81: What is Acute Mesenteric Ischaemia typically caused by, and what do patients classically have in their history?

Answer: • Typically caused by an embolism resulting in occlusion of an artery which supplies the small bowel • Classically patients have a Hx of Atrial Fibrillation

Flashcard 82: What are the common Full Blood Count (FBC) / Peripheral Smear findings in Celiac Disease?

Answer: • Iron deficiency anemia (Microcytic) • Vitamin B12/Folate deficiency anemia (Macrocytic) • Functional hyposplenism (Target cells, Howell-Jolly bodies) • Thrombocytosis (reactive)

Extra: Celiac disease most commonly causes iron deficiency anemia (microcytic) due to malabsorption in the duodenum. It can also cause macrocytic anemia (B12/Folate deficiency) or a mixed picture (normocytic). Functional hyposplenism is a recognized association, which may show Howell-Jolly bodies and target cells on a peripheral smear.

Flashcard 83: What is an adenocarcinoma?

Answer: • Type of cancer that originates in the glandular cells • which line organs and secrete substances like mucus (secretory)

Flashcard 84: What is Diversion Colitis?

Answer: • A condition in which a person's colon becomes inflamed following ostomy surgery

Flashcard 85: What is the investigation of choice for suspected perianal fistulae in patients with Crohn's?

Answer: • MRI pelvis

Flashcard 86: What type of antibiotics can influence the risk of C.Diff infection?

Answer: High-risk antibiotics include the '4 Cs': 1. Cephalosporins (especially 2nd and 3rd gen) 2. Clindamycin 3. Ciprofloxacin (Fluoroquinolones) 4. Co-amoxiclav (Amoxicillin-clavulanate)

Flashcard 87: What gene is associated with HNPCC (Hereditary Non-Polyposis Colorectal carcinoma)

Answer: DNA Mismatch Repair (MMR) genes: MLH1, MSH2, MSH6, and PMS2.

Extra: HNPCC is also known as Lynch Syndrome. Mutation in MSH2 (approx 30%) and MLH1 (approx 30%) are the most common. These genes are responsible for correcting errors during DNA replication (Microsatellite Instability).

Flashcard 88: Courvoisier's law states that in the presence of painless obstructive jaundice, a palpable gallbladder is...

Answer: A palpable gallbladder is unlikely to be due to gallstones (more likely to be due to malignancy, e.g., pancreatic cancer).

Flashcard 89: What type of oesophageal cancers are associated with GORD or Barret's disease?

Answer: • Adenocarcinoma

Flashcard 90: If HBsAg is positive and Anti-HBc is positive what is the interpretation?

Answer: **Current Hepatitis B Infection** (Acute or Chronic) To differentiate: • **Acute Infection:** HBsAg (+), Anti-HBc (+), **IgM** anti-HBc (+) • **Chronic Infection:** HBsAg (+), Anti-HBc (+), **IgG** anti-HBc (+) / IgM anti-HBc (-)