alimentary disease Flashcards

signs and symptoms: recall and explain common signs and symptoms of gastrointestinal and liver diseases

1
Q

define sign

A

externally visible and detectable to someone other than the patient

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2
Q

define symptom

A

internally experienced by patient and impossible to detect by others

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3
Q

signs of general GI disease

A

malaise, rapid weight loss (unintentional and uncontrollable), anorexia (eating disorder), anaemia

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4
Q

define malaise

A

non-specific; generally unwell from indeterminable cause

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5
Q

define anaemia and common causes

A

reduced ability to carry oxygen due to low [Hb]; fewer normal sized erythrocytes or normal number smaller erythrocytes

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6
Q

hepatobiliary disorders

A

right-upper quadrant pain, biliary colic, jaundice, dark urine, pale stool, ascites

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7
Q

why right-upper quadrant pain

A

where most of liver and gall bladder located

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8
Q

what does right-upper quadrant pain suggest

A

hepatobiliary disease

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9
Q

define biliary colic and cause

A

colicky (severe windy) pain caused by gall bladder contraction against downstream obstruction

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10
Q

in biliary colic what could the obstruction be

A

gall stones, impingement of common bile duct (e.g. by tumour)

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11
Q

define jaundice and cause

A

hallmark symptom of liver failure caused by increase in circulating bilirubin

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12
Q

signs of jaundice

A

yellowing of skin, sclera and mucous membranes

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13
Q

why is circulating bilirubin increased in jaundice

A

hepatobiliary system unable to process amount of bilirubin in blood for pre-hepatic, hepatic or post-hepatic reasons

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14
Q

what causes dark urine

A

elevated conjugated bilirubin in urine, associated with liver disease

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15
Q

why does stool become pale in liver disease

A

bilirubin doesn’t male it to gut so stercobilin concentration, which causes pigmentation of faeces, will decrease

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16
Q

define ascites

A

generalised oedema of >30mL in abdominal cavity

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17
Q

what causes ascites

A

cancer, malnutrition, liver failure

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18
Q

disorders of upper GI tract

A

haemoptysis, melaena, nausea, vomiting, haematemesis, dysphagia, odynophagia, heartburn, acid regurgitation, belching, chest pain, epigastric pain

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19
Q

define haemoptysis

A

coughing up blood (GI or respiratory disease)

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20
Q

define malaena and cause

A

black tarry stool due to upper GI bleeding, with pigment altered by gut flora, digestive enzymes and secretions

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21
Q

define nausea

A

queeziness with/without inclincation to vomit

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22
Q

define vomiting (emesis)

A

voluntary/involuntary rapid ejection of stomach contents

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23
Q

define haematemesis

A

vomitting blood

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24
Q

define dysphagia

A

difficulty in swallowing food, fluid

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25
Q

define odynophagia

A

pain during swallowing food, fluid

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26
Q

define heartburn and common cause

A

central burning sensation, acid regurgitation

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27
Q

define acid regurgitation

A

process of stomach acid entering oesophagus

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28
Q

define belching

A

voluntarily/involuntarily excess air in stomach escaping through mouth

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29
Q

define chest pain

A

perception of discomfort in central chest pain

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30
Q

causes of chest pain

A

referred pain, or not; includes heartburn

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31
Q

define epigastric pain

A

discomfort in central upper abdomen

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32
Q

mid-GI tract disorders

A

abdominal pain, steatorrhoea, diarrhoea, abdominal distension

33
Q

define abdominal pain

A

pain experienced superficial to abdominal cavity

34
Q

what can abdominal pain be sub-categorised into

A

4 quadrants/9 regions

35
Q

define steatorrhoea

A

sloppy, oily faeces caused by excess fats in stool

36
Q

in steatorrhoea, what causes excess fats in stool

A

digestive failure due to reduced lipase activity or reduced bile activity

37
Q

define diarrhoea

A

very watery faeces and frequent defecation

38
Q

define abdominal distension

A

general presentation of large abdomen

39
Q

causes of abdominal distenstion

A

harmful excess gas in colon, ascites, abdominal tumour

40
Q

lower-GI tract disorders

A

abdominal pain, rectal bleeding, constipation, diarrhoea, incontinence, flatulence

41
Q

cause of rectal bleeding

A

hasn’t been in GI system long enough to lose oxygen and have Hb broken down

42
Q

define constipation

A

irregular passing of stools regularly, or inability to completely empty bowel

43
Q

in constipation, why is stool firmer and dryer

A

reduced gut motility allowing for water reabsoprtion and dehydration of faeces

44
Q

define incontinence

A

loss of voluntary control over excretion of waste (bladder, rectum)

45
Q

causes of incontinence

A

neural damage to anal sphincters, mechanical damage to sphincters, associated diarrhoea too watery to retain

46
Q

characteristics of flatulence

A

loudness, frequency or severity of smell

47
Q

whole body disorders caused by GI disorders

A

cachexia, obesity, lymphadenopathy, jaundice

48
Q

define cachexia and demographic prevalence

A

muscle wasting, often moe common in older adults preceding decline in physical functioning

49
Q

define obesity

A

overt sign of nutritional imbalance

50
Q

cause of obesity

A

extended period of positive eating balance leading to storage in subcutaneous white adipose tissue

51
Q

define lymphadenopathy

A

palpable enlargement of lymphoid tissue (uni/bilateral)

52
Q

hand disorders caused by GI disorders

A

koilonychia, leuconychia, nail clubbing, Dupytren’s contracture, tachycardia, tremor

53
Q

define koilonychia

A

spooning of nails of fingers (concave in centre)

54
Q

cause of koilonychia

A

iron-deficient anaemia

55
Q

define leuconychia

A

partial/complete whitening of nails

56
Q

cause of leuconychia

A

dietary nutrient deficiency

57
Q

define nail clubbing

A

nails of fingers take an enlarged, concave appearance

58
Q

causes of nail clubbing

A

malabsorption, Crohn’s, cirrhosis

59
Q

assessing nail clubbing

A

assess angle of nail bed with distal phalange; <160, >180

60
Q

define Dupytren’s contracture

A

one or more fingers into bent position (usually ring, little finger)

61
Q

cause of Dupytren’s contracture

A

thickened cords of skin develop in layer of tissue under skin of palm

62
Q

in Dupytren’s contracture, what are thickened cords of skin associated with

A

persistent uncontrolled diabetes, excess alcohol consumption

63
Q

define tremor

A

inability to keep hand completely still

64
Q

abdominal signs of GI disorder

A

palpable organ enlargement, abdominal tenderness, distension

65
Q

cause and presentation of hepatomegaly

A

hepatitis, palpated in upper right quadrant

66
Q

causes of abdominal tenderness

A

local obstruction, infection

67
Q

anus and rectum signs of GI disorder

A

haemorrhoids, fistula, fissure, proctitis

68
Q

define haemorrhoids (piles)

A

swollen superficial blood vessels prone to bleeding (can feel itchy)

69
Q

2 types of haemorrhoid and name painful one

A

internal, external; external is painful

70
Q

define fistula

A

generic term for alternative pathway; any pathway from anus/rectum to outside environment not directly through entire anal canal

71
Q

define fissure

A

tear or ulceration of mucosal lining of peri-anal tissue; prone to infection

72
Q

define proctitis

A

inflammation of inside of rectum

73
Q

2 methods to detect proctitis

A

digital rectal exam, sigmoidoscopy

74
Q

define subjectivity

A

differences in perception or location of pain between individuals

75
Q

factor influencing interpretability

A

referred pain

76
Q

9 regions of regional abdominal pain

A

right hypochronriac pain, epigastric pain, left hypochondriac pain, right lumbar (flank) pain, umbillical pain, left lumbar (flank) pain, right iliac (inguinal) pain, hypogastric (suprapubic) pain, left iliac (inguinal) pain

77
Q

3 key factors to determining problem

A

history, examination, investigations

78
Q

investigating and reporting pain: SOCRATES

A

Site, Onset, Character, Radiation, Associated symptoms, Timing, Exacerbating/relieving symptoms, Severity