3. GI Flashcards
Why does jaundice affect the clotting system?
Without bile there is a lack of ability to absorb fat soluble vitamins such as Vitamin K
What are the different types of jaundice?
Pre hepatic- haemolysis (increased bilirubin/impaired transport)
Hepatic- parenchymal discharge (Defective uptake of bilirubin)
Post hepatic- obstructive (defective transport of bilirubin by bilary ducts)
What are the liver function tests?
Aspirate amino transferase (AAT)- suggests liver damage
Gamma glutamyl transferase- non speicifc liver damage
Bilirubin- conjugated vs uncojugated
Alkaline phosphatase- elevated with obstruction or liver infiltration
Albumin- liver function
Prothrombin time- Degree of liver dysfucntion
How is gastric cancer established?
Chronic gastritis (inflammation)
Intestinal metaplasia
Dysplasia
Cancer
What skin condition is associated with coeliac disease?
Dermatitis herpetiiformis
What skin disease is associated with IBD?
Erythema nodosum
Discuss the various hormones that control the GI tract?
Gastric cells –> GaStrin (acts on parietal cells)
CCK
Motilin
Secretin?
How does bowel look on a scan when it is obstructed?>
Dilated central loops of bowel
What are the various disacharides?
Lactose- glucose and galactose
Sucrose- glucose and fructose
Maltose- glucose and glucose
What is Murphy’s triad?
Lower right quadrant pain, N+V and fever
Oesophageal carcinoma treatment?
Typically oesophagectomy +/- chemo due to late presentations
Liver cirrhosis
End stage chronic liver disease, response to liver to chronic injury
Normal tissue replaced by fibrous tissue
What are the nine quadrants of the abdomen?
R hypochondrium epigastrium L hypochondrium
R lumbar umbilical L lumbar
R iliac fossa Hypogastrium L iliac fossa
What are the muscles of the core?
Rectus abdominus- abdominal muscle
Transverse abdominal- deep and traverse
Internal oblique- middle layer, hands in back of pockets
External oblique- hands in front of pockets- superficial
What are the different types of hepatitis?
Hepatitis A- IgM, common infectious in children
Hep B- more serious may lead to cacner of end stage disease
Hep C- also serious
Hep D-
Hep E- self limiting, no long term effects
Differentials for hepatic encephalopathy?
Infection
Hypoglycemia
Intra cranial bleed
How do you treat alcoholic hepatitis?
Aregnicelone (steroid, gets them over 30 days)
Thiamine
High nutritional feeds
Describe the pathological process of GORD leading to oesophageal cancer?
Ulceration
Stricture
Glandular metaplasia (barrett’s oesophagus)
Carcinoma
What is whipples procedure
A pancreaticoduodenectomy, pancreatoduodenectomy, Whipple procedure, or Kausch-Whipple procedure is a major surgical operation most often performed to remove cancerous tumours off the head of the pancreas
What is mcburney’s point?
one-third of the distance from the anterior superior iliac spine to the umbilicus
What is the most common anatomical lie of the appendix?
retroceocal
What are the three specific aspects of the large colon?
teniae coli, haustra, and epiploic appendages
Describe the process of fat digestion?
Triglycerols (bile salts and phospholipids) Smaller fatty droplets (lipase) Very small subunits (micelles) Allow the molecules to cross into the intestine
What do the gastric pits produce?
Hydrochloric acid, intrinsic factor, mucous
