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GI > Acute Conditions > Flashcards

Acute Conditions Flashcards

1
Q

What defines an upper GI bleed? What are the symptoms? (5)

A

Bleeding proximal to the ligament of Treitz

  1. Nausea
  2. Haematemesis
  3. Coffee ground vomit
  4. Melaena
  5. Anaemia
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2
Q

What are the commonest causes of upper GI bleeds? (5)

A
  1. Peptic ulcers
  2. Oesophagitis
  3. Mallory-Weiss tears
  4. Gastroduodenal erosions
  5. Ruptured varices
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3
Q

What Ix are done for someone with a suspect upper GI bleed? (2)

A
  1. Group and save/cross match

2. Endoscopy (to diagnose and treat)

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4
Q

What are the RFs for upper GI bleeds? (4)

A
  1. NSAIDs (PUD)
  2. Alcoholism (cirrhosis = varices)
  3. Chronic liver disease (cirrhosis = varices)
  4. H. pylori
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5
Q

What is the management for someone with an upper GI bleed? (2)

A

If in shock:

  1. Crystalloid fluid + RBCs and FFP.
  2. Emergency endoscopic surgery
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6
Q

What is acute pancreatitis?

A

Inflammation and subsequent auto-digestion of the pancreas

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7
Q

What are the signs/symptoms of acute pancreatitis? (4)

A
  1. Severe stabbing pain radiating to the back (worse w movement)
  2. N+V
  3. Raised serum amylase + lipase
  4. Abd. bruising (Grey-Turner’s + Cullens)
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8
Q

What are Grey-Turner’s and Cullen’s signs?

A 
GT= bruising on the flanks 
C = para-umbilical bruising
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9
Q

What Ix are done for someone with suspected pancreatitis?

A

Serum lipase and amylase (3X normal)

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10
Q

What is the management for someone with acute pancreatitis? (3)

A
  1. Fluids (prevent pancreatic necrosis)
  2. Analgesia
  3. Anti-emetics
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11
Q

What are the signs/symptoms of a bowel obstruction? (7)

A
  1. Abd. pain (colicky)
  2. Distension
  3. Hyper-resonant on percussion
  4. Complete or partial constipation
  5. Tinkling sounds on auscultation
  6. Vomiting bile (small bowel obstruction)
  7. Weight loss and blood in stool (large bowel obstruction - malignancy)
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12
Q

What are the causes of a small bowel obstruction? (4)

A
  1. Previous surgery (adhesions)
  2. Hernia incarceration (can’t be put back)
  3. Crohn’s (inflammation = scar tissue = stricture)
  4. Appendicitis
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13
Q

What are the causes of a large bowel obstruction? (4)

A
  1. Colorectal malignancy
  2. Colonic volvulus
  3. Benign stricture (from UC)
  4. Severe constipation
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14
Q

What Ix are done for someone with a suspected bowel obstruction? (3)

A
  1. AbXR
  2. CXR
  3. CT abd. + pelvis
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15
Q

What is the management for someone with a bowel obstruction? (3)

A
  1. Fluids + NG tube to suck out gastric gastric contents to give the bowel a rest.
  2. Analgesia
  3. Laproscopic surgery
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16
Q

What are the signs/symptoms of peritonitis? (6)

A
  1. Severe pain (worse w movement)
  2. Rigidity/guarding
  3. Distension
  4. Fever
  5. WL
  6. Rebound tenderness
17
Q

What are the causes of peritonitis? (4)

A
  1. Perforated viscus
  2. Pranceatitis
  3. PU perforation
  4. Ruptured appendix
18
Q

What Ix are done for someone with suspected peritonitis? (3)

A
  1. AbXR (dilated bowel loops, pneumoperitoneum)
  2. FBC (raised CRP + WCC)
  3. CT
19
Q

What is the management for someone with peritonitis? (3)

A
  1. Treat underlying cause
  2. IV fluids
  3. ABx (met, gent, coamox)
20
Q

What are the complications of peritonitis? (3)

A
  1. Sepsis
  2. Shock
  3. Peritoneal abscess
21
Q

What is a perforated viscus?

A

A perforation somewhere in the GI tract (upper has more sudden onset)

22
Q

What are the symptoms of a perforated viscus? (5)

A
  1. Severe pain at the site of perforation
  2. N+V
  3. Haematemesis/melaena
  4. Fever/chills
  5. Rebound tenderness
23
Q

What Ix are done for someone with suspected perforated viscus? (3)

A
  1. AXR (pneumoperitoneum)
  2. CT abd. + pelvis
  3. FBC (raised WCC + CRP)
24
Q

What is the management for someone with a perforated viscus? (2)

A
  1. IV fluids + NG tube to rest bowel

2. Laproscopic surgery to close perforation + clean peritoneum

25
Q

What would be seen on an AbXR for someone w a small bowel obstruction? (2)

A
  1. Dilated intestinal loops with visible circular folds

2. Absence of gas in rectum

26
Q

What would be seen on an AbXR for someone w a large bowel obstruction?

A
  1. Gaseous distension of large bowel

2. Kidney bean shape seen in volvulus

27
Q

Which area of the large bowel is most susceptible to perforation?

A

Caecum

28
Q

Which organs cause epigastric pain?

A

Foregut (stomach, pancreas, liver, biliary tree, 1st 2/3 duodenum)

29
Q

Which organs cause periumbilical pain?

A

Midgut (last 1/3 duodenum, jejunum, ileum and 2/3 transverse colon)

30
Q

Which organs cause hypogastric pain?

A

Hindgut (last 1/3 transverse colon to rectum)

GI (3 decks)

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