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DPD > Abdo exam - AS > Flashcards

Abdo exam - AS Flashcards

1
Q

Summarise the main five causes of the liver disease?

A 
Alcohol
Autoimmune
Drugs
Viral
Biliary disease
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2
Q

Give some causes of hepatomegaly (three Cs plus I)

A

Cancer
Cirrhosis
Cardiac - congestive cardiac failure or constrictive pericarditis

Infiltration
- Fatty infiltration

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3
Q

Infiltrative causes of hepatomegaly

A 
Fatty infiltration
Haemochromatosis 
Amyloidosis
Sarcoidosis
Lymphoproliferative disease
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4
Q

Four broad causes of splenomegaly

A

Portal hypertension
Haematological causes
Infection
Inflammation

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5
Q

Infective causes of splenomegaly

A

Malaria
TB
Infective endocarditis

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6
Q

Inflammatory causes of splenomegaly

A

Sarcoid

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7
Q

Back pain + severe abdo pain

A

More likely: AAA

Could also be: Pancreatitis

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8
Q

Constant abdo pain suggests

A

Inflammation

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9
Q

Colicky abdo pain suggests

A

Obstruction

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10
Q

Epigastric pain causes according to organ and associated questions to ask

A

Stomach - Peptic ulcer - NSAID use?
GORD - better with antacids
Gastritis (retrosternal, ETOH)
Malignancy

Pancreas
Acute Pancreatitis (history of gallstones, high amylase) 
Think around the pain:
Above: MI
Below: AAA
Right: Cholecystitis
Hepatitis
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11
Q

Two most common cause of epigastric pain

A

Peptic ulcer

Pancreatitis

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12
Q

Differentiate between acute vs chronic pancreatitis

A

Acute - painful with high amylase

Chronic - pain with weight loss, loss of exocrine and endocrine function, NORMAL AMYLASE but ELASTASE detected in stool

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13
Q

RUQ pain

A

Gall bladder:

  • Cholecystitis
  • Cholangitis
  • Gallstones

Liver:

  • Hepatitis
  • Abscess

Above - basal pneumonia
Below - appendicits
Left (stomach and pancreas)
-pancreatitis, peptic ulcer

Pyelonephritis
(right, kidne)

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14
Q

Appendicitis can present with RUQ in which group of patients?

A

Pregnant women

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15
Q

RIF pain by system

A 
GI 
Appendicitis
Mesenteric adenitis
Colitis (IBD)
Malignancy

Gyanecological:
Ovarian cyst rupture, twister, bleed
Ectopic pregnancy

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16
Q

Suprapubic

A

Cystitis

Urinary retention

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17
Q

LIF causes

A

GI:
Diverticulitis
Colitis (IBD)
Malignancy

Gynaecological:
Ovarian cyst rupture, twist, bleed
Ectopic

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18
Q

Causes of generalised abdo pain

A 
Obstruction 
Infection - peritonitis, gastroenteritis 
Inflammation - IBD
Ischaemia - mestenteric 
Medical causes
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19
Q

Give medical causes of generalised abdo pain

A 
DKA
Addison's
Hypercalcemia
Porphyria
Lead poisoning
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20
Q

What might you see with someone who has addisons and why?

A

Hyperpigmentation
due to increased ACTH and alpha MSH production in response to unresponsive adrenals (they can’t produce cortisol or aldosterone)

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21
Q

Name some mesenteric arteries

A

Celiac artery
Superior mesenteric artery
Inferior mesenteric artery

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22
Q

Which organs are supplied by the celiac arteries?

A

Stomach, spleen, liver, gall bladder

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23
Q

After ischaemia, talk about bloods

A

Lactate would go up
so you’d be acidotic, so bicarbonate would not be up
Amylase is up in other causes of acute abdomen

24
Q

What marker is consistent with spontaneous bacterial peritonitis (SPB)?

A

Ascites with neutrophil count over 250 cells/mm

25
Q

IS

A

Bicarb - high in respiratory acidosis to compensate for CO2

but not high as it can’t compensate lactic acidosis

26
Q

Fluid in abdo suggests

A

Ascites

27
Q

Flatus suggests

A 
Obstruction with:
n and V
Constipation
High pitched, tinkling BS
Previous surgery
Tender irreducible femoral hernia in groin
28
Q

Classification of ascites

A

Transudate (without protein)

Exudate

29
Q

Causes of prehepatic jaundice

A

Haemolysis

Defective conjugation

30
Q

Hepatic causes of jaundice

A

Hepatitis

31
Q

Causes of transudate ascites

A

Cirrhosis
Cardiac failure
Nephrotic syndrome

32
Q

Causes of exudate ascites

A

Malignancy
Infection
Budd-chiari syndrome

33
Q

What is Budd-chiari syndrome

A

Clot in hepatic vein - hepatic vein thrombosis

??
Portal vein thrombosis

34
Q

What turns urobilinogen into the next product?

A

Bacteria - stercobilinogen hence colour of stool

35
Q

Which enzyme is involved in conjugation

A

Glucuronyl transferase

36
Q

Causes of hepatitis

A

Alcohol
Autoimmune
Drugs
Viruses

37
Q

Give causes of obstruction of the common bile duct which can result in post-hepatic jaundice?

A

Gallstones in CBD
Stricture
Cancer of head of pancreas

38
Q

What causes pale stool?

A

Low stercobilinogen

39
Q

Painless jaundice is caused by

A

Pancreatic cancer

40
Q

What is a sign associated with pancreatic cancer?

A

Throbophlebitis

Erythema nodosum (on signs)

41
Q

Obstructivee jaundice raised markers

A

ALP and GGT

42
Q

Hepatitic jaundice raised markers

A

AST

43
Q

Marker of pancreatitic cancer

A

CA19 9

44
Q

Hepatocellular carcinoma marker ?? (double checK)

A

Alfa-fetoprotein

45
Q

Bloody diarhhoea causes

A 
Infective colitis
Inflammatory colitis
Ischamic colitis
Diverticulits 
malignancy
46
Q

What would you suspect in elderly patients with bloody diarrhoea

A

Ischaemic colitis

47
Q

What would you suspect in elderly patients with bloody diarrhoea

A

Ischaemic colitis

48
Q

What would you suspect in young people with with bloody diarrhoea

A

Inflammatory colitis

49
Q

Give some causes of infective colitis

A 
Campylobacter
Haemorrhagic E.Coli
Entamoeba histolytica
Salmonella
Shigella
50
Q

Thick haustral folds is called

A

Thumbprinting sign

51
Q

Another sign with inflammatory / infective colitis

A

lead piping sign

52
Q

What do you call ‘lots of poo’

A

Faecal loading

53
Q

Managment of acute GI bleed

A

ABC
IV access
Fluids
G

54
Q

Management of acute abdo pain

A 
Nill by mouth 
IV fluids
Analgesics 
Analgesics
Consider antiemetics
ANtibotics
Moniror vials 
Investigations
55
Q

What would you give if smeone had vacriceal bleed?

A

Antibiotics

Terlipressin

56
Q

Why terlipressin?

A

Vasoconstriction of splanchnic vessels

DPD (38 decks)

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