Abdomen Conditions Flashcards
GORD definition?
Symptomatic passage of gastric contents > lower oesophagus
GORD Risk factors?
Decreased tone of LOS: caffeine, fatty foods, hiatal hernia
Impaired mucosal defences: smoking, alcohol
Increased IAP: pregnancy, obesity, ascites, lifting & bending
GORD clinical features?
retrosternal pain/heart burn.
Agg: big meals, acidic foods, bending, lying supine
Dysphagia/odonophagia
Acute gastritis definition?
Acute inflammation of the gastric lining, which is often diffuse
Acute gastritis clinical features?
epigastric discomfort, nausea, anorexia, haematmesis (blood in vomit)
Chronic gastritis definition?
Chronic inflammation of the stomach, associated with lymphocytic infiltration of the mucosa and damage to the epithelium
Pernicious anaemia?
Vitamin B12 deficiency anaemia that causes megaloblastic anaemia (structurally abnormal and larger RBC’s)
What condition can lead to pernicious anaemia?
chronic gastritis, where antibodies are produced against parietal cells and intrinsic factor
Peptic ulceration definition?
Ulceration in any part of the GIT that is exposed to gastric secretions.
Common sites of peptic ulcers?
duodenal ulcers are 4 x more common than gastric ulcers.
D1 most common in duodenum
Gastric ulcers most common: lesser curvature
Causes of peptic ulcers?
NSAIDs: reduce prostaglandin content of mucosal cells lowering mucous secretion
- Aspirin can directly damage cell membranes
Smoking: generation of ROS causes mucosal damage, and can also reduce healing rate of ulcer
Familial factors: 3 x higher risk if immediate family member has an ulcer
Peptic ulcer clinical features?
Epigastric pain of several weeks
Anorexia, dyspepsia, nausea
can be asymptomatic in elderly
Coeliac Disease definition?
Genetically-determined, abnormal, hypersensitivity reaction to gluten or its peptide derivative, gliadin
Coeliac disease clinical features? (Adult onset)
weight loss, diarrhoea, abdo discomfort, fatigue, amenorrhea
Oesophageal cancer risk factors?
smoking, excess alcohol consumption, Barrett’s mucosa
Oesophageal cancer clinical features? (often termed the classic triad)
Dysphagia
Odynophagia
Weight loss
Jaundice common sites?
yellow appearance of the skin, sclerae and mucous membranes
Jaundice cause?
Elevated bilirubin levels. causes include:
- haemolytic jaundice: excessive RBC destruction due to thalassaemia
- hepatic jaundice: impaired hepatocyte function: viral/alcoholic hepatitis
- cholestatic jaundice: obstruction of bile ducts
Jaundice exam:
yellowing of skin could be due to issues with the cells in your liver that could be caused by alcoholic or viral hepatitis, or obstruction of the bile ducts, potentially caused by gall stones
Acute hepatitis clinical features?
anorexia nausea vomiting malaise headache mild fever diarrhoea upper abdo discomfort jaundice hepatomegaly splenomegaly
Alcoholic liver disease?
alcohol intake causes the induction of oxidases that help metabolise alcohol. over/chronic exposure to these oxidases can lead to damage of the hepatocytes
Ascites?
- accumulation of fluid in peritoneal cavity
- abdominal distension with shifting dullness to percussion
Caput medusae?
sign of portal hypertension, can be due to liver failure or cirrhosis of the liver
Gall stone risk factors (Cholelithiasis)
- over 40 more common in women, no difference in elderly
- obesity
- increased age
- multi-parity
- diabetes
- diets high in refined sugar
- ileal disease
