Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y3 Core Conditions > Abdominal > Flashcards

Abdominal Flashcards

1
Q

GORD

A

Reflux of gastric contents causing mucosal damage and weakened muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Prevalence of GORD

A

15% in adults

Common in infancy but will resolve in 12-18 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Lifestyle risk factors of GORD

A

Obesity, smoking, alcohol, coffee, fatty food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Symptoms of GORD

A 
Heartburn 
Acid regurgitation, unpleasant taste in back of throat 
Dysphagia 
Oesophagitis 
Ulceration 
Bloating and Belching 
Bad breath 
Waterbrash/ Acidbrash (excess salivation)
Association with asthma.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Differential Diagnosis of GORD

A

Oesophagitis, Infection, Duodenal ulcer, gastric ulcers, Heart pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Investigations of GORD

A
  • Upper GI endoscopy: if oescophagitis or Barrett’s syndrome present the GORD confirmed
  • Intraluminal monitoring: 24 hour pH monitoring
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Management of GORD: Lifestyle choices

A
  • Encourage weight loss, smoking cessation, raise bed head, small regular meals
  • Avoid alcohol, eating before bed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Drugs to avoid in GORD

A
  • those that slow motility: nitrates, anticholinergics, TCA

- Those that damage mucosa: NSAIDS, bisphosphonates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Drugs to treat GORD

A
  1. Alginate containing antacids e.g. gaviscon
  2. H2-receptor anatgonist (reduced acid production by cells) e.g. cimetidine
  3. PPI e.g. omeprazole, lansoprazole
  4. Prokinetic agents e.g. metocloperamide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Surgery for GORD

A

Laparoscopic Nissen Fundoplication (LNF) - surgery tightening the ring of muscle at the bottom of the oesophagus to stop acid leaking from stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Complications of GORD

A

Ulcers, Peptic stricture, Barrett’s oesophagus, Oesophagitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Side effects of H2 receptor antagonists

A

Diarrhoea, headaches, rash and tiredness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pathology of Barrett’s oesophagus

A

Squamous mucosa replaced by columnar mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Peptic Ulcer

A

Breach in the mucosal lining of the stomach or duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where are gastric and duodenal ulcers most common?

A

Gastric ulcer- lesser curvature of the stomach

Duodenal ulcer- duodenal ampulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define Dyspepsia

A

Indigestion with pain or discomfort in the upper abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Prevalence of DU and GU

A

Du affects 10-15% of adults and are 4x more common than GU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Who is affected in Peptic Ulcers

A

Common in elderly, common in females, prevalent in developing countries due to high H. Pylori infection rates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Zollinger-Ellison Syndrome

A

Disease in which tumours cause the stomach to produce too much acid, resulting in peptic ulcers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What causes Zollinger-Ellison Syndrome

A

Gastronima, a tumour that secretes a hormone called gastrin stimulating release of gastric acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Causes and risk factors of Peptic Ulcers

A 
H.pylori
NSAIDs, steroids, SSRIs
Smoking
Stress
Delayed gastric emptying in GU
Increased gastric emptying in PU
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which blood group is most at risk of duodenal ulcers?

A

O

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what percentage of DU and GU does H.pylori cause?

A

95% of DU

80% of GU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Symptoms of peptic ulcers

A

Epigastric pain, N&V, bloating, weight loss, burping, reflux, back pain (suggest posterior ulcer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What mnemonic is used for the Peptic ulcer symptoms

A

ALARM

  • Anaemia
  • Loss of Weight
  • Anorexia
  • Recent onset/ Progressive symptoms
  • Meleana/ haematemesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

where does dark, tarry stools suggest bleeding comes from?

A

Bleeding in the upper part of GI tract. Blood is darker as it has been digested through the tract.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Differential diagnosis of Peptic Ulcer

A

Gastritis, GORD, pancreatitis, cholecystitis (gallstones) hepatitis, IBD, AAA, MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Cholecystitis

A

Inflammation of the gallbladder due to blockage by gallstones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Cholangitis

A

Inflammation of the bile duct caused by bacteria ascending from the junction with the duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Investigations for peptic ulcer

A
  • FBC blood test
  • H. Pylori testing
  • Urea Breath Test
  • Stool antigen test
  • Serology to detect IgG antibodies
  • Rapid urease test (CLO)
  • Endoscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Rapid Urease Test (aka Campylobacter-like organism test)

A

Fast test for diagnosing H.Pylori. If present, H.Pylori secretes urease which converts urea to ammonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Management for Peptic Ulcers

A

Smoking cessation, decrease alcohol intake, reduce stress, stop NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Recurrence rate of H. pylori after eradication

A

10-20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What does H. Pylori Eradication Triple Therapy Involve?

A

2 Antibiotics and 1 PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Antibiotics against H.Pylori in Triple Therapy

A

Amoxicillin, Clarithromycin, Metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

PPI used in Triple Therapy

A

Esomeprazole, Lansoprazole, Omeprazole, Pantoprazole, Rabeprazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Complications of Peptic Ulcers

A

Haemorrhage
Perforation of Ulcer
Malignancy
Gastric outflow obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Perforated Viscus

A

Loss of gastrointestinal wall integrity with subsequent leakage of enteric contents.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Commonest cause of Acute Upper GI bleeds

A

Peptic Ulcers (gastric and duodenal) and Oesopha-gastric varices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Mallory-Weiss syndrome

A

Bleeding from a tear in the lining of the oesophagus due to prolonged vomiting and increased intra-abdominal pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Risk Factors to Acute Upper GI bleeds

A

Alcohol abuse, chronic liver disease, NSAID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Symptoms for Actue Upper GI bleeds

A

Haematemesis, Malaena, PR bleeding, Nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Signs/ Examination of Acute Upper GI bleeds

A

Cold, clammy, capillary refill <2, hypotensive, tachycardic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the Rockall Score?

A

A scoring system used to identify patients at risk of adverse outcome following acute upper GI bleed. Criteria uses increasing age, co-morbidity, shock and endoscopic finding.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the Glasgow-Blatchford bleeding Score?

A

The GBS helps identify which patients with UGIB can be safely discharged from the emergency room.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Managing UGIB

A
  1. Blood volume: transfuse red cells
  2. Endoscopy
  3. Drug therapy: PPI- Omeprazole, prokinetics- erythromycin
  4. Surgery if persistent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Budd–Chiari syndrome

A

Occlusion of the hepatic veins that drain the liver. It presents with the classical triad of abdominal pain, ascites, and liver enlargement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Acute lower GI bleeds

A

Occurring from the colon, rectum or anus. Presenting as hematochezia or meleana.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Hematochezia

A

Bright red blood, clots or burgundy stools. Suggest bleeding from lower GI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Meleana

A

Dark sticky stools cwith digested blood. Suggest bleeding from upper GI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Causes of LGIB

A

Diverticulitis, Ischaemic colitis, Crohns, Haemorrhoids, Anal fissure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Investigations for LGIB

A
  1. Proctoscopy
  2. Flexible sigmoidoscopy or colonoscooy
  3. Angiography
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Proctoscopy

A

Uses a proctoscope to examine the anal cavity, rectum, or sigmoid colon.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Inflammatory Bowel Disease

A

Inflammatory, idiopathic, autoimmune conditions of the colon and GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Main IBD

A

UC and Crohns• Collagenous colitis, lymphocytic collitis, ischaemic collitis, diversion collitis and Behçet’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Behcet’s syndrome

A

Causes blood vessels to be inflammed throughout the body. Symptoms include mouth sores, eye inflammation, skin rashes and genital sores

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Location of UC and Crohn’s

A

UC affects the large intestines

Crohns affects any part of tract from the mouth to the anus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Prevalence of UC and Crohn’s

A

UC: 2/1000 in UK
CD: 1/1000 in UK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Who is affected by UC and Crohn’s

A

15-40 y.o
Affects males and females equally
Affected by race and ethnic origin
UC more common in non-smokers. CD more common in smokers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Crohn’s disease

A

Skip lesions, deep ulcers, cobblestone appearance, granulomas, Transmural, strictures common, Crypst abscesses uncommon, Goblet cells present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Ulcerative Collitis

A

Rectum always involved, Continuous, mucosa is inflamed, superficial, no granulomas, stictures uncommon, Crypt abscesses common, goblet cells depressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Symptoms for IBD

A

diarrhoea with blood in UC, steatorrhoea in CD, abdominal pain, malaise, lethargy, anorexia, weight loss, aphthous ulcers, tenesmus, urgency, N&V in CD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Tenesmus

A

Continuous inclination to open the bowels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Canker sore or Apthous ulcers

A

Small lesions that develop in your mouth or on gums. Unlike cold sores, they are not found on the lips and not contagious.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Proctitis

A

UC affecting the colon only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Pancolitis

A

UC affecting the whole colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Erythema Nodosum

A

Swollen fat under the skin causing red bumps and patches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Pyoderma gangrenosum

A

Large painful ulcers on the skin mainly legs. Autoimmune disease associated with UC and CD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Differentials for IBD

A

IBS, Infective colitis, Coeliac Disease, Diverticulitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Investigations for IBD

A
  • Bloods: FBC, b12, folate, ESR, CRP, blood culture
  • Stools
  • Abdo X-ray
  • Barium enema
  • Colonoscopy
  • Rectal biopsy
  • MRI
  • Staging
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Crohn’s Disease Activity Index (CDAI)

A

Tool used to quantify the symptoms of patients with Crohn’s disease. Helps to identify response or remission of disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Trulove and Witts’ Severity Index

A

Measures the severity of UC. Classified as mild, moderate or severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Treatment of Crohns

A
  1. Stop Smoking
  2. Glucocorticoids- Prednisolone
  3. Infliximab
  4. Surgery- panproctocolectomy and end-ileostomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Treatment of UC

A
  1. Aminosalicylate - mesalazine
  2. Azathioprine for moderate to severe
  3. Surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Complications of IBD

A

Strictures, fistulae, perforation, haemorrhage, colorectal cancer, toxic megacolon, anaemia, osteoporosis due to steroid therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Irritable bowel Syndrome and the different types

A

A functional bowel disorder.

  • IBS-D (Diarrhoea predominated)
  • IBS-C (Constipation)
  • IBS-A (Alternating stool pattern)
  • IBS- PI (Post-infective)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

How common is IBS

A
  • Affects 1 in 5 people
  • Most common functional gastrointestinal disorder (FGID)
  • Females 2x more likely than men
  • Teens to 40s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Cause of IBS

A

Unknown. Result of the disruption in communication between the brain and gut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Risk Factors for IBS

A

Depression, hypochondriac, being female

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Symptoms for IBS

A

Pain and cramping, diarrhoea, constipation, changes in bowel movements, bloating, tenesmus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Differentials for IBS

A

IBD, Coeliac Disease, Gastroenteritis, Colorectal carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Manning Criteria

A

Helps in diagnosis of IBS. Minimum of 2.

  1. Relief of abdominal pain with defecation
  2. Bloating or abdominal distention
  3. Looser stool with the onset of abdominal pain
  4. Feeling of incomplete evacuation of stool
  5. More frequent bowel movements with the onset of pain
  6. Passage of mucus from the rectum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Rome II Criteria

A

Used to diagnose functional bowel disorder. For IBS, at least 12 weeks preceding the abdominal discomfort with 2 of the 3 features:

  1. Relieved with defecation
  2. Change in frequency of stool
  3. Change in appearance of stool
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Treating IBS

A
  1. Avoid food that trigger symptoms
  2. Adjust fibre in diet
  3. Exercise regularly
  4. Reduce stress levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Antidiarrhoeal drugs for bowel frequency

A

Loperamide, codeine, co-phenotrope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Smooth muscle relaxants for pain

A

Mebeverine, hydrochloride, dicycloverine, hydrochloride, peppermint oil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Infective Gastroenteritis

A

Infection of the stomach and GI tract due to bacterial or viral infection, causing vomiting and diarrhoea.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Risk factor for Infective Gastroenteritis

A

Young children and older Aldults
Travellers to developing countries
Homosexual men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Causes of Infective Gastroenteritis

A
  • Viral causes common in children
  • Bacterial causes common in adults
  • Parasitic: protozoa esp giardia lambia, entamoeba histolytica, cryptosporidium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Mechanisms of Infective Gastroenteritis

A
  • Mucosal adherence
  • Mucosal invasion where bacteria penetrates lining
  • Toxin Production: Enterotoxins and cytotoxins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Organisms that cause Infective Gastroenteritis

A

Bacillus cereus, Staph. aureus, C. perfringens, C. botulinum, C. diff, Norovirus, Salmonella spp., E.coli, Shigella Sonnei, Campylobacter, Cryptosporidium, V. Cholera, Rotavirus, ETEC

92
Q

Risk factors for Infective Gastroenteritis

A

Poor personal hygiene, lack of sanitation, immunocompromised, achlorydia, uncooked food, insufficient reheating

93
Q

Symptoms of Infective Gastroenteritis

A

Diarrhoea, Vomiting, Abdominal pain, fever, fatigue, headache, muscle pain

94
Q

Differentials for Infective gastroenteritis

A

IBD, IBS, Coeliac Disease, Colorectal Cancer, UTI, Chest infections, Malaria

95
Q

Investigations for Infective Gastroenteritis

A

Stool Culture
Urea and Electrolytes
Clostridium difficile toxin
Blood Culture

96
Q

Treatment for Infective gastroenteritis

A
  1. Oral Rehydration Solution
  2. Antibiotics
  3. Antiemetics and Antidiarrhoeals
97
Q

Antiemetics

A

Drug to treat nausea and vomiting. Used to treat motion sickness and the side effects of opiods

98
Q

Antiemetics

A

Prochlorperazine

99
Q

Antidiarrhoeals

A

Codeine, Loperamide

100
Q

Antibiotic for Shigella, Campylobacter and Salmonella

A

Ciprofloxacin????

101
Q

Antibiotic for Cholera

A

Tetracycline

102
Q

Complications of Infective Gastroenteritis

A

Dehydration, IBS, Haemolytic Uraemic Syndrome

103
Q

Glasgow-Blatchford Score

A

Helps identify patients for whom outpatient care is suitable

104
Q

Treating suspected variceal bleeding

A

Give a splachnic vasoconstrictor such as terlipressin or octreotide intravenously with abx such as quinolone, cephalosporin or piperacillin-tazobactam.

105
Q

Acute Pancreatitis

A

Acute inflammation of the pancrease releasing exocrine enzymes that cause autodigestion of the organ.

106
Q

Where is acute pancreatitis most common

A

Scandinavia and USA

107
Q

Causes of pancreatitis

A

I GET SMASHED

Idiopathic, Gallstones, Ethanol, Trauma, Steroids, Mumps, Autoimmune, Scorpion Stings, Hyperlipidaemia, ERCP, Drugs

108
Q

Symptoms of Acute pancreatitis

A

Epigastric pain, radiates to back,jaundice, shock, ileus, rigid abdomen, tenderness, Cullen’s sign or Grey Turner’s, tachycardia, fever,

109
Q

Ileus

A

A painful obstruction of the ileum

110
Q

Differentials for pancreatitis

A

`AAA

111
Q

Investigations for pancreatitis

A

Bloods: Raised Serum amylase and urinary amylase, Serum Lipase, CRP

Chest Xray, Abdominal Ultrasound, Contrast-enhanced spiral CT, MRCP, ERCP

112
Q

What criteria is used for pancreatitis within 48 hours?

A

Modified Glasgow criteria for pancreatitis caused by gallstones and alcohol.

113
Q

What criteria is used to test for alcohol-induced pancreatitis after 48hrs.

A

Ranson’s Criteria

114
Q

Glasgow criteria Score for pancreatitis (PANCREAS)

A

A score > 3 =Acute Severe Pancreatitis. A score < 3 = Acute Mild Pancreatitis

PaO2 < 8kPa
Age > 55yo
Neutrophils
Calcium < 2mmol/l
Renal Function: Urea > 16mmol
Enzymes: AST/ALT > 200iu/L
Albumin <32g/l
Sugar: glucose >10mmol/L
115
Q

APACHE II Score

A

Acute Physiologic Assessment and Chronic Health Evaluation. Used to predict ICU mortality
Sensitive even within first 24hrs of presentation

116
Q

Management of patients with Acute Pancreatitis (VACCINES)

A 
Vital Signs monitoring
Analgesia/ Abx
Catheter- Calcium gluconate
Cimetidine (H2 receptor)
IV access and fluids
NBM or Nutrition
Empty gastric contents
Surgery if required
117
Q

Complications of Pancreatitis (PAIN)

A

Peripancreatic fluid collections
Abscesses
Infection
Necrosis

118
Q

Chronic pancreatitis

A

Long-standing inflammation leading to irreversible damage

119
Q

Who does chronic pancreatitis affect

A

Male:female 4:1

Median age 51 y

120
Q

Causes of chronic pancreatitis

A
  • Obstruction of bicarbonate excretion leading to activation of pancreatic enzymes causing tissue necrosis and fibrosis
  • Alcohol causes proteins to precipitate in the ductular structure leading to dilatation and fibrosis
  • Tropical chronic pancreatitis
  • Hereditary chronic pancreatitis
  • Autoimmune chronic pancreatitis
  • Cystic fibrosis
  • Tumours
121
Q

Symptoms of chronic pancreatitis

A

Upper abdominal pain, weight loss, Diarrhoea, anorexia, bloating, Steatorrhoea, jaundice

122
Q

Differential for chronic pancreatitis

A

Pancreatic malignancy

123
Q

Investigations for chronic pancreatitis

A

if known alcohol abuse: Serum amylase and lipase, faecal elastase, transabdo USS. contrast-enhanced spiral CT

124
Q

Management of chronic pancreatitis

A 
Alcohol abstinence
Low fat diet due to inability to digest
Give Creon
Give fat-soluble ADEK
Analgesia
Diabetes
Surgery for unremitting pain, narcotic abuse, or decreased weight
125
Q

Complications of chronic pancreatitis

A 
Pancreatic pseudocyst
Diabetes
Biliary obstruction 
Local arterial aneurysm
Pancreatic carcinoma 
Intra/retroperitoneal cyst rupture
126
Q

Kwashiorkor

A

Type of malnutrition involving swelling. Adequate energy but insufficient protein intake. Oedema and hepatomegaly.

127
Q

Marasmus

A

Type of malnutrition involving thinness and wasting. Inadequate energy and protein intake.

128
Q

Iron deficiency

A

Leads to microcytic anaemia, due to poor diet or elevated needs

129
Q

Iodine deficiency

A

Leads to goitre/hypothyroidism

130
Q

Vitamin A deficiency

A

fat-soluble vitamin, xerophthalmia (dryness of the conjunctiva), cause of blindness

131
Q

Zinc deficiency

A

leads to acrodermatitis or Gianotti-Crosti syndrome causing itchy red blisters

132
Q

Vitamin C deficiency

A

leads to scurvy, anemia, spontaneous bleeding, pain in the limbs, anorexia, cachexia, gingivitis, halitosis

133
Q

Vitamin D deficiency

A

leads to osteoporosis and osteomalacia, fat-soluble vitamin

134
Q

Vitamin E deficiency

A

Leads to neurological deficit and haemolysis, fat soluble vitamin

135
Q

Vitamin K deficiency

A

Leeds to bleeding disorders, fat-soluble vitamin

136
Q

Vitamin B1/ Thiamine deficiency

A

causes Beri-beri, heart failure with oedema

137
Q

Wet Beri-beri

A

Affects cardiovascular system, causing SOB, increased heart rate and swelling

138
Q

Dry Beri-beri

A

Affects nervous system causing difficulty walking , numbness in hands and feet, confusion, pain and vomiting

139
Q

Coeliac Disease

A

Inflammatory response in the small intestines caused by gluten preventing absorption . Gluten is found in wheat, barley and rye.

140
Q

Signs and Symptoms of Coeliac Disease

A

Diarrhoea, abdominal pain, bloating and flatulence, constipation, fatigue, weight loss, dermatitis herpetiformis (itchy rash), ataxia

141
Q

Diagnosing Coeliac Disease

A

Blood test, antibody testing followed by a biopsy

142
Q

Gallstones

A

A crystalline mass formed by g the gallbladder made from bile pigments, cholesterol and calcium salts.

143
Q

Cholelithiasis

A

The formation of gall stones

144
Q

Who does gall stones affect

A

‘Fair, fat, fertile, female and forty’

145
Q

2 types of gallstones

A

Cholesterol gallstones: 80% cholesterol by weight, light yellow, dark green or brown

Pigment Stones: small and dark, made of bilirubin and calcium salts,Black pigment stones common in haemolytic conditions, brown pigment stones common in biliary infection

146
Q

Risk factors for gallstones

A

Increasing age, femaile, family history, obesity, weight loss, diabetes, oral contraception, smoking, parity

147
Q

Signs and Symptoms for cholecystitis and cholangitis

A

Epigadtric/ RUQ pain, Pain radiates to back , jaundice, reffered to right shoulder pain, nausea and vomiting, jaundice, feer due to peritonitis

148
Q

Murphy’s Sign

A

Patient supine, ask pt to breathe in, place fingers in RUQ, inflamed gallbladder impinges on fingers causing pain on patient - Positive Murphy’s sign

149
Q

Investigations for gallstones

A 
Bloods: raised CRP
Liver Function Tests
Ultrasound 
Abdominal X-ray
MRCP 
ERCP
150
Q

MRCP

A

Magnetic Resonance Cholangiopancreatography. An MRI that produces images of the hepatobiliary and pancreatic systems using radiowaves.

151
Q

ERCP

A

Endoscopic Retrograde Cholanio-Pancreatography is a procedure that examines the pancreatic and bile ducts. Tube placed through mouth and through to bile ducts. Can cause stone extraction, stent insertion or biopsy.

152
Q

Complications for Gallstones

A

Obstructive jaundice, cholangitis, gallstone ileus, pancreatitis, empyema, pancreatitis, Mirizzi’s syndrome

153
Q

Mirizzi’s Syndrome

A

Common hepatic duct obstruction caused by extrinsic compression a stone in the cystic duct or infundibulum of gallbladder, presenting with jaundice.

154
Q

Antibiotics for cholangitis

A

Cefuroxime and metronidazxole

155
Q

Acute Hepatitis

A

Inflammation of the liver caused by infection, medications, toxins and autoimmune disorders.

156
Q

Hepatitis A

A
  • RNA Virus
  • Most common acute viral hepatitis
  • Faecal-oral spread or shellfish
  • Humans are only reservoir
  • Picornavirus
157
Q

Hepatitis B

A
  • DNA Virus
  • Hepadnavirus
  • Reverse transcriptase activity
  • Transmission via infectious blood
158
Q

Hepatitis C

A
  • RNA Virus
  • Flavivirus
  • Transmission via infectious blood
159
Q

Hepatitis D

A
  • Incomplete RNA virus, requires HepB virus for activation
160
Q

Hepatitis E

A
  • RNA Virus

- Spread via faecal-oral route

161
Q

Non-viral Infections that cause Hepatitis

A

Toxoplasma Gondii
Leptospira icterohaemorrhagiae
Coxiella burnetii (Q fever)

162
Q

Viral Infections that cause Hepatitis

A

Viral A, B (D), C, E
Epstein- Barr Virus
Cytomegalovirus
Yellow Fever Virus

163
Q

Drugs that cause Hepatitis

A

Paracetamol

164
Q

Poisons that cause Hepatitis

A

Amanita Phalloides (mushrooms)
Aflatoxin
Carbon Tetrachloride

165
Q

Other causes of Hepatitis

A

Pregnancy, circulatory insufficiency, Wilson’s Disease

166
Q

Risk Factors for Hepatitis

A

IVDU, alcohol abuse, poor hygiene, contaminated water, travel, bleeding disorders, MSM, Pregnancy and breastfeeding, needlestick injury

167
Q

Symptoms of Hepatitis

A

Flu-like symptoms: feer, malaise, anorexia, nausea, RUQ pain, arthralgia, jaundice, dark urine, pale stools, hepatosplenomegaly, adenopathy

168
Q

Differentials for Hepatitis

A

Biliary colic, pancreatitis, cholecystitis

169
Q

Investigations for Hepatitis A

A
  • LFTs: increased AST/ALT, and bilirubin
  • FBC: prolonged PT
  • Antibodies
170
Q

Hepatitis A treatment

A
  • Mainly supportive
  • Avoid alcohol
  • Immunisation
171
Q

Hepatitis B treatment

A
  • Avoid sex, alcohol

- Immunisation

172
Q

Hepatitis C treatment

A
  • Weekly Peginterferon injection

- Daily ribavirin

173
Q

Hepatitis D treatment

A
  • Peginterferon alpha

- Liver transplantation

174
Q

Hepatitis E treatment

A
  • People will usually get better without treatment

- Acetaminophen/Paracetamol against vomiting should not be given

175
Q

Antiviral drugs for Hepatitis

A

Ribavirin, Boceprevir, Tolaprevir, Entecavir, Tenofovir, Lamivudine, Adefovir, Telbivudine

176
Q

Complications of Hepatitis

A

Chronic hepatitis, Cirrhosis, Chronic liver disease, hepatocellular carcinoma

177
Q

Acute appendicitis

A

Sudden inflammation of the appendix and is a surgical emergency

178
Q

Who does acute appendicitis affect

A

Mainly 10-20yo

179
Q

Causes of Acute appendicitis

A

Lumen of appendix becomes obstructed with faecolith and gut organisms invade appendix wall. The appendix becomes filled with mucous and swells. Pressure increases in the lumen, vessels become occluded causing ischaemia. Bacteria can leak out forming pus.

180
Q

Symptoms of Acute appendicitis

A

Abdominal pain, loss of appetite, Nausea and vomiting, swollen belly, fever,

181
Q

Signs of Acute Appendicitis

A

General abdominal tenderness,

182
Q

McBurney’s Sign

A

Deep tenderness at McBurney’s point signifies acute appendicitis, tachycardia, furred tongue, coughing hurts, shallow breaths

183
Q

Mcburney’s point

A

Fount one-third of the distance from the anterior superior iliac spine to the umbilicus

184
Q

Aaron’s sign

A

Referred pain felt in the epigastrium upon continuous firm pressure over McBurney’s point.

185
Q

Psoas sign/ Cope sign

A

Pain on extending hip if retrocaecal appendix

186
Q

Rosving’s sign

A

When palpation of the left lower quadrant increases the pain felt in the right lower quadrant

187
Q

Alvarado score

A

Scoring system used to diagnose appendicitis.

  • Abdo pain migrating to right iliac fossa
  • Anorexia
  • N or V
  • Tenderness in right iliac fossa
  • Rebound tenderness
  • Fever of 37.3
  • Leukocytosis > 10,000
  • Neutrophilia > 70%
188
Q

Investigations for appendicitis

A
  • Bloods: Increased WCC, ESR, CRP
  • USS
  • CT
189
Q

Treating appendicitis

A

Appendicectomy and antibiotics

190
Q

Complications of appendicitis

A

Perforation, appendix abcess, appendix mass (when an inflamed appendix becomes covered with omentum)

191
Q

Small and large bowel obstruction

A

A mechanical or functional obstruction of the intestines preventing the normal transit of the products of digestion.

192
Q

Causes of a bowel obstruction

A

Adhesions, constipation, tumours, hernias, volvulus, diverticular stricture, foreign body, gallstone ileus, Crohn’s stricture, instussusception, TB

193
Q

Paralytic ileus

A

Obstruction of the intestine due to paralysis of the intestinal muscles

194
Q

Causes of an ileus

A

abdo surgery, pancreatitis, spinal injury, hypokalaemia, hyponatraemia, uraemia

195
Q

Ogilvie’s Syndrome

A

aka Acute colonic pseudo-obstruction (ACPO) is a massive colonic distention in the absence of mechanical obstruction

196
Q

Symptoms of a bowel obstruction

A

Nausea, vomiting, anorexia, colic, constipation, no flatus, abdominal distention

197
Q

Signs of a bowel obstruction

A

Distention, tenderness, resonant to percussion, active tinkiling bowel sounds, absent sounds

198
Q

Differentials for bowel obstruction

A

Gastroenteritis- diarrhoea, flatus

Gut perforation

199
Q

Investigations for bowel obstruction

A

Abdo x-ray, water-soluble (gastrografin) enema, CT, colonoscopy

200
Q

Treatment for bowel obstruction

A

Small bowel obstruction can be treated with fluids, analgesia, correction of electrolyte imbalance

Large bowel obstruction or strangulation require stenting or surgery

Flexible sigmoidoscopy for sigmoid volvulus

201
Q

Complications for bowel obstruction

A

Perforation and bowel ischameia can lead o peritonitis and septicaemia

Flu and electrolyte imbalance can lead to AKI

202
Q

Hernias

A

The protrusion of a viscus through a defect of the wall of its containing cavity into an abnormal position

203
Q

4 classifications of hernias

A

Irreducible, Incarceration, Obstructed, Strangulated

204
Q

Irreducible hernia

A

part of a bowel that cannot be pushed back into the right place

205
Q

Incarcerated hernia

A

Contents of hernia sac are stuck inside by adhesions

206
Q

Obstructed hernia

A

when GI contents cannot pass though

207
Q

Strangulate hernia

A

If ischaemia occurs and is a surgical emergency

208
Q

Most common hernia

A

Inguinal hernia

209
Q

Who is commonly affected by inguinal hernias

A

Mainly males

210
Q

Who is commonly affected by femoral hernias

A

Female, pregnant, increasing age

211
Q

Indirect inguinal hernias

A

Passes though the deep inguinal ring and through the superficial inguinal ring. Can strangulate

212
Q

Direct inguinal hernias

A

hernia pushes directly forward through the posterior wall of the inguinal canal into a defect. Rarely strangulate.

213
Q

Contents of inguinal canal

A

Round ligament, spermatic cord and ilioinguinal nerve

214
Q

Borders of the inguinal canal

A
  • Anterior wall: aponeurosis of the external oblique
  • Posterior wall: transversalis fascia.
  • Roof: transversalis fascia, internal oblique, and transversus abdominis.
  • Floor: inguinal ligament
215
Q

Borders of the femoral canal

A
  • Anteriorly: inguinal ligament
  • Medially: lacunar ligament.
  • Laterally: femoral vein
  • Posteriorly: Pectineus
216
Q

Risk factors for hernias

A
  • Increased intra-abdominal pressure​

- Weakness of the abdominal muscles: Chronic cough, Constipation​, Heavy lifting​, Advanced age​, Obesity

217
Q

Risk factors for hernias

A

Increased intra-abdominal pressure​, Weakness of the abdominal muscles: Chronic cough, Constipation​, Heavy lifting​, Advanced age​ Obesity

218
Q

Borders of the femoral triangle

A
  • Superiorly: inguinal ligament
  • Medially: adductor longus muscle
  • Laterally: sartorious muscle
219
Q

Symptoms of hernia

A

Pain particularly when coughing or stooping​, change in bowel habit, constipation​, burning sensation in the groin​, scrotal swelling

220
Q

Differentials for hernia

A

Inguinal hernia, femoral canal lipoma or lymph node, saphena varix, femoral artery aneurysm, athletic pubalgia, hydrocele, varicocoele, undescended testes

221
Q

Saphena varix

A

Dilatation at the top of the long saphenous vein due to valvular incompetence. Saphena varix will disappear when lying flat, have palpable thrill when coughing, and varicose veins can be found elsewhere.

222
Q

Athletic Pubalgia

A

Condition of the pubic joint affecting athletes following a small tear in rectus sheath through which impingement of abdominal wall musculature can occur

223
Q

Investigations or hernia

A

Abdominal USS

224
Q

Management of inguinal hernias

A
  • Lichtenstein repair: mesh inserted to reinforce abdominal wall
  • Laparoscopic repair for recurrences or bilateral hernias
225
Q

Management of femoral hernias

A
  • All femoral hernias should be repaired due to risk of strangulation.
  • Herniotomy = ligation and excision of the sac
  • Herniorrhapy = repair of hernia defecit
226
Q

Charcot’s Triad

A

Signs of cholangitis: RUQ pain, fever and jaundice

227
Q

Renold’s Triad

A

Signs suggesting the diagnosis obstructive ascending cholangitis: right upper quadrant pain, jaundice, and fever with shock (low blood pressure, tachycardia) and an altered mental status.

Y3 Core Conditions (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions