Brainscape's Knowledge GenomeTM

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


See full index

Y1 LSS Alimentary System > Alimentary disease > Flashcards

Alimentary disease Flashcards

Economics; Signs and symptoms; Abdominal pain; Obesity; Jaundice; Alcohol; Gastrointestinal cancer; Clinical nutrition; Malnutrition

1
Q

What are the features of jaundice?

A

Yellow discolouration of sclerae and skin

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

What causes jaundice?

A

Raised bilirubin ( serum bilirubin >40μmol/L)

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

What are the 3 major categories of jaundice?

A

Haemolytic
Congenital
Cholestatic

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

What causes prehepatic jaundice?

A

Haemolysis

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

What causes hepatic jaundice?

A 
Viral hepatitis
Drugs
Alcoholic hepatitis
Cirrhosis
Pregnancy
Reccurent ideopathic cholestasis
Congenital disorders
Infiltrations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes post-hepatic jaundice?

A 
Common duct stones
Carcinoma in:
-bile duct
-Head of pancreas
-Ampulla
Biliary stricture
Sclerosing cholangitis
Pancreatitis
Pseudocyst
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is haemolytic jaundice?

A

Haemolytic anemias cause increased breakdown of RBC→increased production of bilirubin→jaundice
Unconjugated bilirubin ∴ not water soluble and doesn’t pass into urine
Increased serum urobilinogen
Otherwise normal liver biochemistry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is hyperbilirubinaemia?

A

Impaired conjugation of bilirubin with glucuronic acid or impaired bilirubin handling by the liver
Raised bilirubin but normal biochemistry otherwise

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

What is the most common congenital hyperbilirubinaemia?

A

Gilbert’s syndrome
-autosomal recessive
-mutation in gene coding for UDP-glucuronyl transferase = decreased enzyme activity = decreased conjugation of bilirubin
asymptomatic, slightly raised serum bilirubin
Must be triggered to lead to jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What triggers Gilbert’s syndrome to lead to jaundice?

A

Dehydration
fasting
viral illness

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

How is Gilbert’s syndrome diagnosed?

A

Raised unconjugated hyperbilirubin
Otherwise normal liver biochemistry
Normal full blood count, smear and reticulocyte count (excludes haemolysis)
Absence of signs of liver disease

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

What causes cholestatic jaundice?

A

Failure of bile secretion by the liver OR bile duct obstruction
Divided into hepatic and post hepatic cholestasis:
-Hepatic - hepatocellular swelling or abnormalities at cellular level of bile excretion
-Post-hepatic - obstruction of bile flow at any point distal to bile canaliculi

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

What characterises cholestatic jaundice?

A

Conjugated bilirubin
Pale stool
Dark urine
Abnormal liver biochemistry

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

What are healthy eating reccommendations in the UK based on?

A

Dietary reference values
series of estimates for different population subgroups for the essential macros and micros to prevent nutritional deficiencies

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

What are the healthy eating guidelines in the UK?

A

Eat at least 5 portions of fruit and veg a day
Base meals on starchy carbohydrates, wholegrain versions where possible
Have dairy or dairy alternatives - lower fat and lower sugar alternatives
Eat some beans, pulses, fish, eggs, meat and other proteins (2 portions of fish per week, one oily)
Choose unsaturated oils and spreads and eat in small amounts
6-8 cups of fluid daily

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

How is nutritional status evaluated?

A

National diet and nutrition survey
Look at what factors influence dietary choices
NHS apps
Nutrition screening

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

What are the two strategies use when patients are not able to eat for themselves?

A

Enteral feeding - delivery of nutritious fluid past upper GI tract and into stomach/small intestine
Paraneteral feeding - Bypasses GI tract all together via delivery of nutrients into the blood

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

What type of patient normally receives enteral nutrition?

A

Patient with upper GI problem e.g. dysphagia/trauma

Cannot chew/swallow food normally

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

What are complications associated with enteral nutrition?

A

V low risk of
Nausea
Vomition
Aspiration

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

What are technical requirements of enteral nutrition?

A

Basic training to administer and maintain

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

What are the effects of enteral nutrition on the GI tract?

A

No effect

Maintains internal structure and function of GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the cost of enteral compared to parenteral nutrition?

A

Parenteral expensive and 5x more expensive than enteral

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

What type of patient receives parenteral nutrition?

A

Dysfunctional GI tract that is unable to digest, absorb or excrete appropriately
Can take more than 12 hours to administer so has serious consequences on quality of life

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

What are complications of parenteral nutrition?

A

High risk of
Blood clots
infection
liver failure

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

What are technical requirements of parenteral nutrition?

A

Requires specialist training and support throughout feeding period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the effect of parenteral nutrition on the GI tract?

A

Atrophy of GI structures due to underuse

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

What is short bowel syndrome and why is it sometimes necessary?

A

Characterised by significant removal of bowel, leaving patient with less than 100cm of functional intestinal tract
Sometimes needed due to problems such as Crohn’s, cancer, isachemia, ulcerative colitis, irradiation

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

What does short bowel syndrome result in?

A

Dehydration, malnutrition, malabsorption of nutrients

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

What are the consequences of short bowel syndrome?

A

reduction in absorptive sfa
loss of tissue interrupts control of gut function via hormones and the enteric NS
Loss of large intestine tissue is associated with increased risk of infection

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

What are the 3 main aims for management of short bowel syndrome?

A

Provide adequate nutrition for patients
ensure adequate water and electrolytes to maintain homeostasis
correction and prevention of acid base imbalance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What can reduce reliance on parenteral nutrition?

A

Anastamosis of the small intestine to the colon

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

How is alcohol metabolised?

A

Three separate pathways

1) ethanol → acetaldehyde in peroxisomes via H2O2
2) Ethanol → acetaldehyde in microsomes using NADPH, H+ and O2 = NADP+ and H2O
3) Ethanol → acetaldehyde in cytosol by ADH, reversible reduction of NAD+

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

What factors affect the metabolism of alcohol?

A

Diet, gender, body habitus, racial and genetic influences
appreciation of these factors can lead to greater understanding of why some individuals are more susceptible to effects of alcohol

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

What are the physical effects of alcohol?

A 
Effects large number of end organs
CNA
CVS
GIT
GUT
LMS
Endocrine and reproduction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are the psychological effects of alcohol?

A

Alcohol is a drug of addiction
Frequently used in conjunction with other recreational drugs of abuse
Used as a bad coping mechanism for a number of psychological conditions

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

What is obesity?

A

High accumulation of body fat or adipose tissue in relation to lean body mass
Individuals usually at high clinical risk because of excess body fat

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

What are the main causes of obesity?

A

Occurs when energy intake exceeds energy expenditure for a long period of time
- as a result of increased availability of labour saving devices
- less physical activity, more sedentary lifestyle
Small genetic contribution but only explains 5% obesity

38
Q

What are the major components of daily energy expenditure in humans?

A

Resting Metabolic Rate - sum of sleeping metabolic rate and energy cost of arousal - 50-70% EE
Thermic effect of food - 5-15% EE
Physical activity - spontaneous and also voluntary - 20-40% EE
Basal metabolic rate - correlates with body weight ∴ total EE is higher in obese persons

39
Q

How is BMI calculated?

A

Weight in kg/ Height² in m

40
Q

What are the main complications associated with obesity?

A

Cost of treating obesity very high and still increasing

Chronic and severe medical problems

41
Q

What are the health risks of obesity?

A 
Isachemic heart disease - hypertension, coronary thrombosis, congestive heart failure, angina, myocardial infarction
T2D
Cancers - due to effect on hormones
Gallstones
Osteoarthritis
Mental health
Stroke
Sleep apnoea
Gout 
Infertility
42
Q

What is the difference between android and gynoid obesity?

A

Android - fat is more around middle
Gynoid - fat more around hips and buttocks
Android associated with worse health complications and higher risk of complications

43
Q

What are the NICE recommendations regarding clinical management of obesity?

A 
Diet
Exercise
Behavioural therapy
Drug treatment
Surgery if BMI>40
44
Q

What is the main difference between signs and symptoms?

A

Signs are externally visible and detectable to someone other than the patient
Symptoms internally experienced by patients and impossible to detect by others

45
Q

What are the signs and symptoms of general GI tract disease?

A

Unintentional and uncontrollable rapid weight loss due to reduced energy intake and increased bowel motility
Anaemia - reduced ability to carry O2
Malaise - generally feeling unwell
Anorexia

46
Q

What are the signs and symptoms of upper GI tract disease?

A 
Belching
Acid regurgitation
Heartburn 
Epigastric pain 
Chest pain
Dysphagia - difficulty swallowing 
Odynophagia - pain when swallowing 
Vomiting - may be haematemesis
Melaena - black tarry stool
Haemoptysis - coughing up blood
47
Q

What are general signs over the whole body of GI tract disease?

A

Cachexia - muscle wasting
Obesity
Jaundice
Lymphadenopathy - disease of lymph nodes

48
Q

What are signs and symptoms of hepatobiliary disease?

A

Right upper quadrant pain esp when palpated
Biliary colic - sudden pain caused by gallbladder contraction against downstream obstruction
Jaundice - increase in bilirubin not processable by hepatobiliary system
Dark urine - XS bilirubin
Pale stool - lack of bilirubin in gut
Ascites - oedema in abdominal cavity

49
Q

What are signs and symptoms of mid GI tract disease?

A

Abdominal pain superficial to abdominal cavity
Steatorrhoea - sloppy, oily faeces due to XS fats in stool
Diarrhoea - watery poo
Abdominal distension

50
Q

What are the signs and symptoms of lower GI tract disease?

A 
Abdominal pain 
Flatulence
Incontinence
Diarrhoea
Constipation
Red rectal bleeding
51
Q

What are signs on the hands of GI tract disease?

A 
Koilonychia - spoon nails
Tremours
Leuconychia - whitening of nails
Nail clubbing
Dupytrens contracture
Tachycardia
52
Q

What are signs in the anus and rectum of GI tract disease?

A

Haemorrhoids
Fistula
Fissure
Proctitis

53
Q

What two things should be considered when describing and interpreting descriptions of abdominal pain?

A

Subjectivity
-location and severity of pain may be perceived differently between different people
Interpretability
-Pain may not always be where it is perceived

54
Q

What are typical causes of right hypochondriac area pain?

A 
Gall stones
Gall bladder infection
Pulled muscle
Hepatitis
Kidney stone
Pneumonia
55
Q

What are the regions of the abdomen?

A

Right hypochondriac epigastric left hypochondriac
right lumbar/flank umbilical left lumbar/flank
right iliac/inguinal hypogastric/suprapubic left iliac/inguinal

56
Q

What are typical causes of epigastric area pain?

A 
acid reflux
heartburn 
heart attack
gastritis
stomach ulcer
duodenal ulcer
pancreatitis
epigastric hernia
57
Q

What are typical causes of left hypochondriac area pain?

A 
Pneumonia
Spleen infection
Splenomegaly
Hepatitis
Kidney stone
Constipation
Trapped wind
58
Q

What are typical causes of right lumbar/flank area pain?

A 
Kidney stone
kidney infection
trapped wind
constipation
pulled muscle
appendicitis
59
Q

What are typical causes of umbilical area pain?

A 
Stomach ulcer
Bowel obstruction
Constipation
Worms
Crohns
Food poisoning
trapped wind
umbilical hernia
60
Q

What are typical causes of left lumbar/flank pain?

A 
Constipation
Trapped wind
Diverticulitis
IBS
Kidney stone
Kidney infection
Crohns
Ulcerative colitis
61
Q

What are typical causes of right iliac/inguinal area pain?

A 
Appendicitis
Urine infection
Constipation
Ectopic pregnancy
Menstrual pain
Pelvic infection
Endometriosis
Ovarian cyst
Trapped wind
Hernia
62
Q

What are typical causes of hypogastric/suprapubic area pain?

A 
Trapped wind
Constipation
Blaster infection
Urinary retention
Menstrual cramps
Endometriosis
Pelvic infection
Fibroids
Miscarriage
63
Q

What are typical causes of left iliac/inguinal area pain?

A 
IBS 
Crohns
Ulcerative colitis
Diverticulitis
Constipation
Trapped wind
Menstrual pain
Endometriosis
Pelvic infection
Ovarian cysts
Ectopic pregnancy
hernia
64
Q

What is the diagnostic approach for abdominal pain?

A

History of problem and family history
Examination - visual, auditory, smell and tactile inputs
Investigations - confirm or exclude diagnoses

65
Q

How is pain investigated and reported?

A 
SOCRATES
Site - specific area or diffuse
Onset - when and how
Character of pain
Radiation of pain elsewhere
Associated symptoms
Timing of pain - any changes over time
Exacerbating/relieving factors 
Severity - 1-10 pain
66
Q

What is cancer?

A

Disease called by uncontrollable divison of abnormal cells in a part of the body

67
Q

How do primary cancers arise?

A

Directly from cells in an organ

68
Q

How do secondary cancers arise?

A

Spread from another organ, directly or by other means e.g. blood or lymph

69
Q

What locations does the branch term gastrointestinal cancer include?

A 
Oesophageal
Stomach
BIliary system
Pancreatic
Colorectal- small and large intestine, colon, anus
70
Q

What are the two types of oesophageal cancer?

A

Adenocarcinoma

Squamous cell carcinoma

71
Q

What is oesophageal adenocarcinoma?

A

Occurs in the columnar epithelium that lines the lower 1/3 of the oesophagus
Related to acid reflux - repetitive damage to the epithelium
Associated with obesity, tobacco smoking and alcohol consumption

72
Q

What are the stages of development of an adenocarcinoma?

A 
Normal epithelium
Hyperplasia - abnormal proliferation of epithelial cells
Development of adenomatous polyps
Development of adenocarcinoma
Metastasis
73
Q

Where does squamous cell carinoma occur?

A

In the squamous epithelium that lines the upper 2/3 of the oesophagus

74
Q

What are the main causes of squamous cell carcinoma?

A

Tobacco smoking and chewing
Alcohol consumption
Ingestion of caustic substances

75
Q

How does alcohol increase the risk of squamous cell carcinoma ?

A

Acetaldehyde metabolite in alcohol damages epithelial cells

76
Q

Why is alcohol related squamous cell carcinoma more common in the Asian population?

A

Mutations in acetaldehyde dehydrogenase enzyme that leads to a build up of acetaldehyde which increases the risk of cancer

77
Q

What are the stages of development of squamous cell carcinoma?

A

Normal epithelium
Metaplasia - development of abnormal squamous cell
Dysplasia - proliferation of abnormal cells
Severe dysplasia - almost all cells abnormal
Development of squamous cell carcinoma
Metastasis

78
Q

What are symptoms of oesophageal cancer and when do they appear?

A

Appear after >50% of circumference of oesophagus is cancerous, due to tumour narrowing tube
Difficulty and pain when swallowing
Weight loss - lack of nutrition
Pain in breast bone and stomach or a feeling of reflux
Later stages = nausea, vomiting, regurgitation of food, vomiting blood due to trauma to the tumour

79
Q

How are oesophageal cancers investigated?

A

Endoscopy - oesophagogastroduodenoscopy - camera and biopsy
CT scan - check for metastasis
Endoscopic ultrasound to determine level of invasion

80
Q

What is the available treatment for oesophageal cancers?

A

Surgery
-Remove tumour from oesophageal wall
-Oesophagectomy - removal of part of the oesophagus
Chemotherapy and radiotherapy

81
Q

Where does colorectal cancer occur?

A

colon or rectum

82
Q

What are the main causes of colorectal cancer?

A 
Old age
lifestyle factors including:
-diet
-alcohol
-obesity
-tobacco smoking 
-lack of physical activity
83
Q

What is the UK screening program for colorectal cancer?

A

faecal sample every two years tested for the presence of blood
Offered for those over 60 years old

84
Q

What are risk factors for colon cancer?

A 
Family history
IBS
Specific inherited conditions
-familial adenomatous polyposis
-hereditary non-polposis colon cancer
-Lynch syndrome
Uncontrolled ulerative colitis
Age
Previous polyps
85
Q

What are the symptoms of colorectal cancer?

A 
Worsening constipation
Blood in stool
Loss of appetite
Loss of weight
Nausea and  vomiting
Rectal bleeding
Anemia
86
Q

How is colorectal cancer investigated?

A 
Abdominal radiography
Plain CT
Barium enema
Colonoscopy
CT virtual colonoscopy
87
Q

What is the available treatment for colorectal cancer?

A

Surgery
-removal of the tumour via colonoscopy or laparotomy
-Removal of large parts of the colon = colostomy
Chemotherapy and radiotherapy

88
Q

What is refeeding syndrome?

A

Metabolic disturbances occuring as a result of reinstitution of nutrition to patients who are starved or severely malnourished
usually when starved for 5 days or more

89
Q

What is the mechanism of refeeding syndrome?

A

Insulin falls and cortisol/glucagon increased to cause protein catabolism and gluconeogenesis
Feeding leads to insulin secretion, causing an uptake of phosphorus, magnesium, potassium and glucose
This causes all their levels to drop rapidly - hypophosphatemia/kalemia/magnesaemia and sodium retention

90
Q

What are the consequences of refeeding syndrome?

A 
Arrhythmias 
Respiratory distress/depression
Weakness
Paralysis
Confusion
91
Q

How can refeeding syndrom be managed?

A

Daily biochemistry
Vitamin supplementation
Slow reintroduction of nutrition support

Y1 LSS Alimentary System (7 decks)

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