alimentary disease

Question 1

define sign

Answer 1

externally visible and detectable to someone other than the patient

Question 2

define symptom

Answer 2

internally experienced by patient and impossible to detect by others

Question 3

signs of general GI disease

Answer 3

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

Question 4

define malaise

Answer 4

non-specific; generally unwell from indeterminable cause

Question 5

define anaemia and common causes

Answer 5

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

Question 6

hepatobiliary disorders

Answer 6

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

Question 7

why right-upper quadrant pain

Answer 7

where most of liver and gall bladder located

Question 8

what does right-upper quadrant pain suggest

Answer 8

hepatobiliary disease

Question 9

define biliary colic and cause

Answer 9

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

Question 10

in biliary colic what could the obstruction be

Answer 10

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

Question 11

define jaundice and cause

Answer 11

hallmark symptom of liver failure caused by increase in circulating bilirubin

Question 12

signs of jaundice

Answer 12

yellowing of skin, sclera and mucous membranes

Question 13

why is circulating bilirubin increased in jaundice

Answer 13

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

Question 14

what causes dark urine

Answer 14

elevated conjugated bilirubin in urine, associated with liver disease

Question 15

why does stool become pale in liver disease

Answer 15

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

Question 16

define ascites

Answer 16

generalised oedema of >30mL in abdominal cavity

Question 17

what causes ascites

Answer 17

cancer, malnutrition, liver failure

Question 18

disorders of upper GI tract

Answer 18

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

Question 19

define haemoptysis

Answer 19

coughing up blood (GI or respiratory disease)

Question 20

define malaena and cause

Answer 20

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

Question 21

define nausea

Answer 21

queeziness with/without inclincation to vomit

Question 22

define vomiting (emesis)

Answer 22

voluntary/involuntary rapid ejection of stomach contents

Question 23

define haematemesis

Answer 23

vomitting blood

Question 24

define dysphagia

Answer 24

difficulty in swallowing food, fluid

Question 25

define odynophagia

Answer 25

pain during swallowing food, fluid

Question 26

define heartburn and common cause

Answer 26

central burning sensation, acid regurgitation

Question 27

define acid regurgitation

Answer 27

process of stomach acid entering oesophagus

Question 28

define belching

Answer 28

voluntarily/involuntarily excess air in stomach escaping through mouth

Question 29

define chest pain

Answer 29

perception of discomfort in central chest pain

Question 30

causes of chest pain

Answer 30

referred pain, or not; includes heartburn

Question 31

define epigastric pain

Answer 31

discomfort in central upper abdomen

Question 32

mid-GI tract disorders

Answer 32

abdominal pain, steatorrhoea, diarrhoea, abdominal distension

Question 33

define abdominal pain

Answer 33

pain experienced superficial to abdominal cavity

Question 34

what can abdominal pain be sub-categorised into

Answer 34

4 quadrants/9 regions

Question 35

define steatorrhoea

Answer 35

sloppy, oily faeces caused by excess fats in stool

Question 36

in steatorrhoea, what causes excess fats in stool

Answer 36

digestive failure due to reduced lipase activity or reduced bile activity

Question 37

define diarrhoea

Answer 37

very watery faeces and frequent defecation

Question 38

define abdominal distension

Answer 38

general presentation of large abdomen

Question 39

causes of abdominal distenstion

Answer 39

harmful excess gas in colon, ascites, abdominal tumour

Question 40

lower-GI tract disorders

Answer 40

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

Question 41

cause of rectal bleeding

Answer 41

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

Question 42

define constipation

Answer 42

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

Question 43

in constipation, why is stool firmer and dryer

Answer 43

reduced gut motility allowing for water reabsoprtion and dehydration of faeces

Question 44

define incontinence

Answer 44

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

Question 45

causes of incontinence

Answer 45

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

Question 46

characteristics of flatulence

Answer 46

loudness, frequency or severity of smell

Question 47

whole body disorders caused by GI disorders

Answer 47

cachexia, obesity, lymphadenopathy, jaundice

Question 48

define cachexia and demographic prevalence

Answer 48

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

Question 49

define obesity

Answer 49

overt sign of nutritional imbalance

Question 50

cause of obesity

Answer 50

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

Question 51

define lymphadenopathy

Answer 51

palpable enlargement of lymphoid tissue (uni/bilateral)

Question 52

hand disorders caused by GI disorders

Answer 52

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

Question 53

define koilonychia

Answer 53

spooning of nails of fingers (concave in centre)

Question 54

cause of koilonychia

Answer 54

iron-deficient anaemia

Question 55

define leuconychia

Answer 55

partial/complete whitening of nails

Question 56

cause of leuconychia

Answer 56

dietary nutrient deficiency

Question 57

define nail clubbing

Answer 57

nails of fingers take an enlarged, concave appearance

Question 58

causes of nail clubbing

Answer 58

malabsorption, Crohn's, cirrhosis

Question 59

assessing nail clubbing

Answer 59

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

Question 60

define Dupytren's contracture

Answer 60

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

Question 61

cause of Dupytren's contracture

Answer 61

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

Question 62

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

Answer 62

persistent uncontrolled diabetes, excess alcohol consumption

Question 63

define tremor

Answer 63

inability to keep hand completely still

Question 64

abdominal signs of GI disorder

Answer 64

palpable organ enlargement, abdominal tenderness, distension

Question 65

cause and presentation of hepatomegaly

Answer 65

hepatitis, palpated in upper right quadrant

Question 66

causes of abdominal tenderness

Answer 66

local obstruction, infection

Question 67

anus and rectum signs of GI disorder

Answer 67

haemorrhoids, fistula, fissure, proctitis

Question 68

define haemorrhoids (piles)

Answer 68

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

Question 69

2 types of haemorrhoid and name painful one

Answer 69

internal, external; external is painful

Question 70

define fistula

Answer 70

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

Question 71

define fissure

Answer 71

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

Question 72

define proctitis

Answer 72

inflammation of inside of rectum

Question 73

2 methods to detect proctitis

Answer 73

digital rectal exam, sigmoidoscopy

Question 74

define subjectivity

Answer 74

differences in perception or location of pain between individuals

Question 75

factor influencing interpretability

Answer 75

referred pain

Question 76

9 regions of regional abdominal pain

Answer 76

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

Question 77

3 key factors to determining problem

Answer 77

history, examination, investigations

Question 78

investigating and reporting pain: SOCRATES

Answer 78

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