Abdo Flashcards
Portal hypertension
Splenomegaly
Ascites
Visible veins
Risk factors for peptic ulcer disease
H.pylori infection
NSAIDs
Rare: Zollinger-Ellison (high gastrin)
Management of PUD
Lifestyle
H.pylori positive: Triple therapy:
Amoxicillin or Metronidazole
Clarithromycin
PPI (eg omeprazole)
H.pylori negative: PPI or H2 antagonist
Extra GI features of IBD
Apthus in mouth Erythema nodosum Pyoderma gangrenosum Episcleritis/ anterior uveitis Arthritis
Coeliac disease features
Diarrhoea Weight loss Abdominal pain Bloating N&V
Signs:
Dermatitis herpetiformis
Angular stomatitis (Due to iron deficiency)
Causes of bloody diarrhoea
CHESS
Campylobacter/ Clostridium difficile
Haemorrhagic E.coli
Entamoeba hystolytica
Salmonella
Shigella
What are the causes of hepatomegaly?
3 Cs
Cancer
Cirrhosis (usually early)
Cardiac (Congestive heart failure, constrictive pericarditis)
Then Inflitration: fatty, amyloidosis, sarcoidosis
Causes of splenomegaly
Portal hypertension
Haematological
Infection
Inflammation
What does decompensated liver disease mean?
Jaundice
Encephalopathy
Ascites
Also varriceal bleeds can occur
Spontaneous Bacterial Peritonitis Diagnosis
Decompensated liver disease
Diagnosis: Tap ascites. Ascites neut >250 cells/mm3
5 causes of abdominal distension
5 Fs
Fluid (ascites) Flatus (obstruction, N&V, no bowel movement, high pitched BS) Faeces Fat Fetus
Ascites treatment
Decrease salt intake
Diuretics (furosemide, spironolactone)
Oesophageal varices acute management
Resuscitation
Terlipressin/ DDAVP
Or endoscopic ligation/ shunt
Prophylactic antibiotics
Oesophageal varices prophylaxis
b blocker
Causes of acute pancreatitis
I GET SMASHED
Idiopathic Gallstones Ethanol (alcohol) Trauma Steroids Mumps Autoimmune Scorpion bites Hyperlipidaemia/hypercalcaemia (metabolic disorders) ERCP Drugs
Primary Billiary Cholangitis key points
Anti mitochondrial antibody (AMA)
Diagnosis with biopsy
Associated with:
RA
Thyroid
Sjogren’s
Primary Sclerosing Cholangitis key points
pANCA antibody
Diagnosis with ERCP
Associated with UC
UC Management
Topical 5-ASA is the first step in mild disease
If extensive colitis, oral 5-ASA
In severe illness first step is IV corticosteroid and fluids, and ciclosporin/surgery if not better after 72 hours
Crohn’s disease Management
MDT, Education, Smoking cessation
Corticosteroid to induce remission, maintain with azathioprine or mercaptopurine
How do you diagnose hiatus hernia?
Barium studies
Smoking and IBD
Increases risk 3-4 times for Crohn’s
May be protective for UC
