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Inflammation > Abdominal Conditions > Flashcards

Abdominal Conditions Flashcards

1
Q

Name 3 upper abdominal inflammatory conditions.

A

Gall stone disease (cholecystitis, cholangitis). Pancreatitis. Peptic ulcer disease. Gastro-oesophageal reflux disease (GORD). Oesophagitis.

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2
Q

Name 3 lower abdominal inflammatory conditions.

A

Appendicitis. Diverticular disease. Inflammatory bowel disease. Clostridioides (clostridium) difficile colitis. Radiation proctitis.

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3
Q

What 5F’s summarise gall stone disease?

A

Fat. Fair. Female. Fertile. Forty.

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4
Q

Name 3 complications of gall stone disease.

A

Biliary colic (sudden pain due to gallstone blocking cystic duct). Acute cholecystitis (infection). Obstructive jaundice. Ascending jaundice. Pancreatitis. Gallstone ileus.

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5
Q

What are the 3 types of Acute cholecystitis.

A

Empyema (pus) of the gallbladder. Gangrene (loss of blood supply) of the gallbladder. Perforation (holes) of the gallbladder.

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6
Q

When there is an interference of the blood supply for the gall bladder, it results in necrosis of the gall bladder known as…

A

Gangrene of the gallbladder.

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7
Q

Why is there pain in gall stone disease?

A

Stone obstructs the cystic duct.

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8
Q

What does the cystic duct do?

A

It transfers bile between the gallbladder and common and hepatic bile ducts.

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9
Q

Why does pain subside when a patient with gallstone disease lies down?

A

Gallstone falls back down cystic duct.

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10
Q

What’s the difference between cholangitis and cholecystitis?

A

Ascending cholangitis is inflammation of the bile duct, usually caused by bacteria ascending from its junction with the duodenum . Cholecystitis is inflammation of the gallbladder.

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11
Q

What is gallstone ileus?

A

When the gallstone enters the small bowel via the cholecysto-duodenal fistula - causes bowel obstruction.

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12
Q

How do gall stones enter the small bowel?

A

Using the cholecysto-duodenal fistula.

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13
Q

Give 2 treatments for gall stone disease.

A

Ultrasound scan. Magnetic resonance cholangiopancreatography (MRCP). ERCP - endoscope used to examine a patients pancreatic and bile ducts.

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14
Q

What surgical procedure is used in gall bladder disease?

A

Laparascopic cholecystectomy (removal of gall bladder).

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15
Q

Give 3 causes of acute pancreatitis.

A

Gallstones. Idiopathic. Ethanol. Trauma. Steroids. Mumps. Infection.

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16
Q

Give 2 symptoms of acute pancreatitis.

A

Abdominal pain. Loss of appetite. Palpable, tender mass

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17
Q

How is acute pancreatitis diagnosed?

A

CT scan - visualisation of inflammation, necrosis, abscess, pancreatic pseudocysts. Ultrasound - Gallstones. Lab results - elevated serum amylase, lipase, bilirubin

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18
Q

Give 2 complications of acute pancreatitis.

A

Acute peripancreatic fluid collection. Pancreatic pseudocyst. Local complication of necrotizing pancreatitis. Severe manifestations e.g. Acute respiratory distress syndrome (ARDS).

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19
Q

What is peptic ulcer disease?

A

It refers to both gastric and duodenal ulcers. ↑ acid secretion, ↓ protective mechanisms → mucosal damage → ulceration.

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20
Q

Give 2 causal factors for peptic ulcer disease.

A

H. pylori infection (most common) -↑ gastric acid secretion, ↓ duodenal HCO3 secretion. NSAID - particularly low dose aspirin corticosteroids. Physiologic stress e.g. Cushing’s ulcer (intracranial hypertension), Curling ulcer (severe burns). Psychological stress. Hyperchlorydia. Smoking. Chronic obstructive pulmonary disease (COPD). Hypergastrinemia (Zollinger-Ellison syndrome).

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21
Q

What bacteria is responsible for peptic ulcer disease?

A

Helicobacter pylori. Spiral ram-negative infection.

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22
Q

What are proton-pump inhibitors?

A

Proton-pump inhibitors are a group of drugs whose main action is a pronounced and long-lasting reduction of stomach acid production.

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23
Q

Name 2 things used to treat peptic ulcers.

A

Surgery - for bleeding and complications. Proton-pump inhibitors e.g. metronidazole, meprazole, esomeprazole - reduce stomach acid production. Antibiotics e.g. clarithromycin, amoxicillin.

24
Q

Name 2 things used to diagnose peptic ulcers.

A

Abdominal CT scan. Barium abdominal radiography. Endoscopy.

25
Q

Give 2 complications of peptic ulcer disease.

A

Upper GI bleed. Repeated ulcers. Peptic ulcer perforation. Pyloric stenosis.

26
Q

What is gastro-oesophageal reflux disease (GORD)?

A

Prolonged content of gastric contents with lower oesophageal mucosa - stomach acid is able to pass back up oesophagus.

27
Q

Give 2 causes fo gastro-oesophageal reflux disease (GORD).

A

Smoking. Pregnancy. Large meals. Surgical treatment of achalasia (lower oesophageal sphincter fails to open during swallowing).

28
Q

Give 3 symptoms of gastro-oesophageal reflux disease (GORD).

A

Dyspepsia - burning feeling from stomach/lower chest. Acid brash - acid gets in your throat. Water brash - excessive salivation. Odynophagia - painful swallowing. Chest pain. Chronic cough.

29
Q

What happens in Barret’s oesophagus?

A

Normal tissue lining the oesophagus – the tube that carries food from the mouth to the stomach – changes to tissue that resembles the lining of the intestine.

30
Q

Give 2 differential diagnoses of dyspepsia (indigestion).

A

Oesophagitis. Infection. Peptic ulcer. Gastrointestinal malignancy.

31
Q

What are 2 investigations for gastro-oesophageal reflux disease (GORD).

A

Full blood count - exclude anaemia. Endoscopy - assess for oesophagitis. Barium swallow.

32
Q

What is a barium swallow?

A

It’s a test that may be used to determine the cause of painful swallowing, difficulty with swallowing, abdominal pain, bloodstained vomit, or unexplained weight loss. Barium sulfate is a metallic compound that shows up on X-rays and is used to help see abnormalities in the oesophagus and stomach.

33
Q

Name 2 ways that gastro-oesophageal reflux disease (GORD) can be managed.

A

Lifestyle - encourage weight loss. Drugs - antacids to relieve symptoms. Surgery e.g. nissen fundoplication (fundus of stomach wrapped around oesophagus to prevent reflux).

34
Q

Give 2 ways how appendicitis is prevented.

A

Central abdominal pain that migrates to right iliac fossa. Pain worse on movement, coughing. Nausea, vomiting and diarrhoea.

35
Q

Give 2 things you would find on examination for an appendicitis patient.

A

Guarding. Rebound tenderness (pain upon removal of pressure). Percussion tenderness.

36
Q

Give 2 causes of appendicitis.

A

Obstruction of lumen (e.g. foreign bodies, malignancy) blocks escape of mucosal secretions. Increased pressure causes engorgement (appendix swells with fluid) and inactivity.

37
Q

Give 3 ways to investigate appendicitis.

A

Urine dipstick. Pregnancy test. CT scan with contrast.

38
Q

How is appendicitis managed?

A

Laparoscopic appendicectomy - appendix removed through incision in the right lower abdominal wall.

39
Q

What is diverticular disease?

A

Sac-like protrusion of mucosa through the muscular colonic wall.

40
Q

Give 2 ways how diverticular disease.

A

Bloated. Constipation, diarrhoea. Tummy pain. Nausea.

41
Q

Give 2 complications of diverticular disease.

A

Development of a fistula (abnormal channel). Development of an abscess (pus caused by a bacterial infection). Intestinal obstruction (mechanical impairment causes blockage of bowel). Dysuria (pain on urination).

42
Q

How is diverticular disease treated?

A

Hartmann’s procedure - surgical resection (cutting out) of rectosigmoid colon.

43
Q

What are the two types of inflammatory bowel disease?

A

Crohn’s disease. Ulcerative colitis.

44
Q

What is the difference between Crohn’s disease and Ulcerative colitis?

A

Crohn’s disease - occurs anywhere between mouth and anus. Ulcerative colitis - limited to the inner lining of the colon.

45
Q

Give 2 ways of how ulcerative colitis is presented.

A

Diarrhoea. Blood in stools. Cramping. Weight loss.

46
Q

Give 2 ways of how Crohn’s disease is presented.

A

Diarrhoea. Weight loss. Increase in the frequency and urgency. Cramping and abdominal pain. Malaise (feeding of discomfort).

47
Q

Name 2 ways of how inflammatory bowel disease is diagnosed.

A

Faecal calprotectin (protein biomarkers in faeces - determine inflammation). Stool culture. Bloods - FBC (anaemia) and C-reactive protein (rise).

48
Q

Name 2 ways inflammatory bowel disease is treated.

A

Immunosuppressants e.g. adalimumab, infliximab. Surgery.

49
Q

What surgery is carried out to treat inflammatory bowel disease?

A

Colectomy - surgical removal of part of the colon.

50
Q

Give 3 differentials of inflammatory bowel disease.

A

Diverticulitis (type of disease affecting the digestive tract). Irritable bowel syndrome. Laxative use. Colorectal carcinoma.

51
Q

What is Clostridiodes (Clostridium) difficile colitis?

A

Symptomatic infection due to spore forming bacteria.

52
Q

Name 3 symptoms associated with Clostridiodes (Clostridium) difficile colitis.

A

Diarrhoea. Fever. Loss of appetite. Feeling sick. Colonic perforation. Abdominal compartment syndrome - organ dysfunction by intrabdominal hypertension.

53
Q

What is procedure is used to treat Clostridiodes (Clostridium) difficile colitis?

A

Hartmann’s procedure - total abdominal colectomy with end ileostomy.

54
Q

What is Radiation Proctitis?

A

Inflammation and damage to the lower parts of the colon after exposure to the x-rays.

55
Q

Name 2 acute symptoms of Radiation Proctitis.

A

Diarrhoea. Mucus discharge. Urgency.

56
Q

Name 2 chronic symptoms of Radiation Proctitis.

A

Bleeding more severe. Patients have obstructed defection - constipation, rectal bleeding, urgency, faecal incontinence.

Inflammation (36 decks)

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