Brainscape's Knowledge GenomeTM

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


See full index

GI > All GI > Flashcards

All GI Flashcards

1
Q

N+V anorexia myalgia lethargy RUQ pain

Questions may point to risk factors such as foreign travel or intravenous drug use.

A

Viral hepatitis

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

The liver only usually causes pain if stretched.

In severe cases cirrhosis may occur.

One common way this can occur is as a consequence of …?

A

Congestive hepatomegaly

One common way this can occur is as a consequence of congestive heart failure.

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

RUQ pain, intermittent, begins abruptly –> subsides gradually.

Attacks AFTER eating.

Nausea is common.

Female, Forties, Fat and Fair although this is obviously a generalisation.

A

Biliary colic

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

Pain similar to biliary colic i.e.
(RUQ pain, fever intermittent, begins abruptly –> subsides gradually.

Attacks AFTER eating.

Nausea is common.

BUT more severe and persistent. The pain may radiate to the back or right shoulder.

A

Acute cholecystitis

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

Charcot Triad of:
fever (rigors are common)
RUQ pain
jaundice

A

Ascending cholangitis -

infection of the bile ducts commonly secondary to gallstones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Bowel obstruction secondary to an impacted gallstone.

Hx of RUQ pain colicky

X-ray = multiple dilated loops, air in biliary tree!!!

Abdominal pain, distension and vomiting are seen.

A

Gallstone ileus

It may develop if a fistula forms between a gangrenous gallbladder and the duodenum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Persistent biliary colic symptoms (i.e. RUQ pain, intermittent, begins abruptly –> subsides gradually. Attacks AFTER eating. Nausea is common.)

Assoc with anorexia, jaundice and WL.

A palpable mass in the right upper quadrant (What sign?)

periumbilical lymphadenopathy (Which node?)

left supraclavicular adenopathy (Which node?) may be seen

High bili, HIGH ALP

A

Cholangiocarcinoma

A palpable mass in the right upper quadrant (Courvoisier sign),

periumbilical lymphadenopathy (Sister Mary Joseph nodes)

left supraclavicular adenopathy (Virchow node) may be seen

Flukes clonorchis, primary sclerosing, nitrosamines

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

Usually due to alcohol or gallstones

Severe epigastric pain

Vomiting is common

Examination may reveal tenderness, ileus and low-grade fever

Periumbilical discolouration (Which sign?) and flank discolouration (Which sign?)

A

Periumbilical discolouration (Cullen’s sign) and flank discolouration (Grey-Turner’s sign)

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

Painless jaundice #classic

Anorexia and weight loss are common

A

Pancreatic cancer

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

Malaise, anorexia and weight loss, mild RUQ pain

RIGHT lobe mass Fluid filled

Poor defined boundaries Anchovy paste @ aspiration

A

Amoebic liver abscess

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

history of NSAID use or alcohol excess.

Which ulcers: more common?

Epigastric pain BETTER by eating

Epigastric pain WORSE by eating

Features of upper gastrointestinal haemorrhage may be seen (haematemesis, melena etc)

A

Duodenal ulcers: more common than gastric ulcers,

epigastric pain relieved by eating = duodenal

pain worsened by eating = gastric

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

Pain initial in the central abdomen before localising to the right iliac fossa (RIF).

Anorexia, Tachycardia, low-grade pyrexia, tenderness in RIF

Which sign = more pain in RIF than LIF when palpating LIF?

A

Appendicitis

Rovsing

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

Colicky pain typically in the LLQ

Diarrhoea, sometimes bloody.

Fever, raised inflammatory markers and white cells sudden onset profuse dark red rectal bleeding.

She was previously well.

How are the PR bleeds managed here?!?

A

Acute diverticulitis

Diverticula bleeds often settle SPONTANEOUSLY!!!

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

History of malignancy (intraluminal obstruction)/previous operations (adhesions)Vomiting.

Not opened bowels recently

CENTRAL pain

constipation
sounds TINKLING!!!!
tumour tender
absent of flatus
n+v
distended

Ix??

A

Bowel obstuction

  1. AXR
  2. CT CONFIRM!!!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Loin pain radiating to the groin

severe but intermittent.

Patient’s are characteristically restless.

Visible or non-visible haematuria may be present

A

Renal colic

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

Loin pain + Fever and rigors are common

as is vomiting

A

Acute pyelonephritis

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

Suprapubic pain common in men, who often have a history of benign prostatic hyperplasia

A

Urine retention

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

RIF/LIF pain and a history of amenorrhoea for the past 6-9 weeks.

Vaginal bleeding may be present

A

Ectopic

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

Central abdominal pain radiating to the back:

catastrophic (e.g. Sudden collapse) or
sub-acute (persistent severe central abdominal pain with developing shock)

Patients may be shocked (hypotension, tachycardic)

Patients may have a history of cardiovascular disease

A

Rupt AAA

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

Central abdominal pain

History of atrial fibrillation or other cardiovascular disease

Diarrhoea, rectal bleeding may be seen

A metabolic acidosis is often seen (due to ‘dying’ tissue)

A

Mesenteric ischaemia

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

Projectile, non-bilious vomiting, olive mass @ RUQ, HYPO-nat/kal/chlor ALKalosis

A

Pyloric stenosis USS/test feed

PyloroMyoTomy

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

Drawing knees up; COLICKY, D+V, sausage mass, red currant poo; telescoping bowel USS - target mass

A

IntuSuscepTionReduction + Air inflation

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

FHx, Abdo distensin, Meconium delay, constipated from birth

A

Hirchsprung’s gangilionic dx @ Rectal biopsy

Rectal washouts -> anorectal pull-through anastomosis

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

PREMATURE, abdo distension, bloody pooX-ray - pneumatosis + intestinalis + free air #footballSx

A

NEC

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

Scaphoid (sucked in) abdo +
BILIOUS vomiting;

High cecum @midline;

assoc with diaphragmatic hernia/omphalocele/duod atresia

A

Malrotation

Upper GI contrast + USS to confirm

Laparotomy

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

itchy perianal area, particularly PM

Sellotape perianal area, microscopy to see eggs

A

Threadworm

For kid AND family=
>6m = mebendazole+hygiene for 2w

<6m=hygiene measures for 6w #rigorous (handwash, nails, shower, linen, nightwear)

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

Umbilical discharge of small bowel content

Can get persistence of part of the duct (Meckel’s diverticulum).

A

Persistent vitello-intestinal duct

Contrast study to confirm

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

Central abdo pain and URTI

A

Mesenteric adenitis

AB’s conservative mx

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

chronic diarrhoea = see undigested food in POO

A

Toddler’s

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

Jaundice > 14d; high biliruin

A

Biliary atresia

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

choking + cyanotic spells; TracheoOesophagFistula + polyhydramnios; vacterl assocV -

Vertebral anomalies
A - Anorectal malformations
C - Cardiovascular anomalies
T - Tracheoesophageal fistula
E - Esophageal atresia
R - Renal (Kidney) and/or radial anomalies
L - Limb defects
A

Oesophageal atresia

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

Bouts of crying, pull legs up, worse in PM (i.e. distress during spasm)

A

infantile colic

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

crying, which stops abruptly, child draws chin into his chest, throws his arms out, relaxes and starts crying again (distress between spasms)

A

infantile spasm - do EEG

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

Red lesions around umbilicus, bleed on contact, purulent discharge

chemical cautery + top silver nitrate to treat

A

Umbilical granuloma

35
Q

umbilical infection = s.aureus; risk of portal bacteraemia, thrombosis tx with topical and systemic AB’s

A

Omphalitis

36
Q

Premature neonate, spontaneously close 1-3yrs

A

Umbilical hernia

37
Q

Linea alba defect, close to umbilicus; more defined compared to umbilical hernias

A

Paraumbilical hernia

38
Q

Pee from umbilicus

A

Persistent urachus

39
Q

Asymptomatic rectal bleed; Rule of 2

RIF pain
Bleeding and ulcer due to ectopic gastric epithelium

A

Meckel diverticulum

40
Q

Viral gastroenteritis -> 4-5 loose stools/day

Remove lactose few months

A

Transient lactose intolerance

41
Q

abdo pain, bloating, constipation, N+V; NO blood

Which one? (chagas, old, neuroPsych dx); LBObst=large dilated loops + COFFEE bean sign #air-fluidlevel;

Which one? (all ages, preggers) small bowel obstTx?????

A

Volvulus

sigmoid (chagas, old, neuroPsych dx); Sigmoid=LBObst=large dilated loops + COFFEE bean sign #air-fluidlevel;

Caecal (all ages, preggers) Caecal=small bowel obst

Sig: rigid sigmoidoscopy + rectal tube insert
Cecal: right hemicolect
If obstruction cstand then…. LAPARATOMY!!!

42
Q

Lump in Inguinal groin area
Reducible disappears when laying flat scrotum fine

Black kid symmetrical bulge under umbilicus

A

Congenital inguinal hernia – paediatric surgery ASAP incarceration risk
<6w - surg <2d
<6m - surg <2w
<6y - surg <2m

Infanta umbilical hernia resolve <5yrs

43
Q

Female midcycle pain

Two weeks after last menstrual period

Suprapubic pain

Resolve after about 1–2 days

Normal FEC normal dipsticks

A

Mittelschmerz

44
Q

Sudden epigastric pain

Before = upper abdo pain,

Now generalised abdominal pain

CXR show free air under the diaphragm

A

Perforated peptic ulcer

45
Q

Explain:

Rovsing
Murphy sign

Colin sign - periumbilical bruise

Grey-turner - flank bruise

A

Rovsing - press RLQ hurt in LLQ

Murphy sign - press RUQ -> breath in -> stops breathing in -> repeat on LUQ

Colin sign - periumbilical bruise = pancreatitis

Grey-turner - flank bruise = pancreatitis

Guarding, rovsing, obturator IRot, Psoas,
Extra sx etc
Child vague
Retrocecal/colic = RFlankPain,
Psoas positive Preg - RUQ insead of RLQ
Subcolic/pelvic = suprapubic/freq inc, vag/anal pain, diarrhoea tenesmus

46
Q

26-year-old female with a history of constipation, episodic abdominal pain and bloating.

A

Irritable bowel syndrome

47
Q

Dukes colorectal

Mucosa, wall, nodes, mets

A

mucosa, bowel wall, LN met, distant

Dukes’ A
Tumour confined to the mucosa 95%

Dukes’ B
Tumour invading bowel wall 80%

Dukes’ C
Lymph node metastases 65%

Dukes’ D
Distant metastases

48
Q

Kid has Down’s syndrome
PROJECTILE vomiting
Bilious vomiting poss/not poss

Soft non-distended abdomen

Double bubble sign on x-ray

A

Duodenal atresia

49
Q

Child left testicle present in scrotum

Right testicle absent

Sometimes palpable when bathe child

A

Crypto organism undescended testicle

Orchidopexy = 6+m

Orchidectomy = 2+ yr

50
Q

RUQ and malaise/feverUSS = daughter/sand cysts

No epithelial lining

Grow <20cm

Thick walled + external laminated hilar membrane Internal enucleated
GERMINAL later
Echinococcus infection

A

Hyatid cysts

Mebendazole

51
Q

Fever RUQ jaundice

Cos of biliary sepsis > portal venous dx USS = fluid cavity; hyperechoic walls

A

Liver abscess

Ecoli adults

Staph kids

Amox/Cipro/Metra

52
Q

HYPERECHOIC USS liver
Ring of fibrous tissue
Red/purple vasc lesion

OCP use -> sharply demarcated
No fibrous capsule Mixed echoity

Congenital benign KIDS

A

Hemangioma

Liver cell adenoma

Hamartoma

53
Q

Usually history of antecedent vomiting. followed by the vomiting of a small amount of blood. There is usually little in the way of systemic disturbance or prior symptoms.

A

Mallory-Weiss Tear

54
Q

Often longstanding history of dyspepsia, patients are often OVERWEIGHT. What should NOT be associated with dysphagia or haematemesis.

A

Hiatus Hernia

Uncomplicated hiatus hernias should not be associated with dysphagia or haematemesis.

55
Q

Suspect in patients with severe chest pain without cardiac diagnosis AND signs suggestive of pneumonia without convincing history, where there is history of vomiting. Erect CXR shows infiltrate or effusion in 90% of cases

A

Oesopghageal rupture - Complete disruption of the oesophageal wall in absence of per-existing pathology. Left postero-lateral oesophageal is commonest site (2-3cm from OG junction).

56
Q

Progressive dysphagia + WLUsually little or NO history of previous GORD type symptoms.

A

Squamous cell carcinoma of the oesophagus

57
Q

Progressive dysphagia, may have previous symptoms of GORD or Barretts oesophagus.

A

Adenocarcinoma of the oesophagus

58
Q

Longer history of dysphagia, often not progressive. Usually symptoms of GORD. Often lack systemic features seen with malignancy

A

Peptic stricture

59
Q

May have dysphagia that is episodic and non progressive. Retrosternal pain may accompany the episodes.

A

Dysmotility disorder

60
Q

riad of:
dysphagia (secondary to oesophageal webs)
glossitis
iron-deficiency anaemia

Treatment includes iron supplementation and dilation of the webs

A

Plummer-Vinson syndrome

61
Q

Severe vomiting → painful mucousal lacerations at the gastroesophageal junction resulting in haematemesis. Common in alcoholics

A

Mallory-Weiss syndrome

62
Q

Severe vomiting → oesophageal rupture

A

Boerhaave syndrome

63
Q

Painful, bright red rectal bleeding post defecation Poss skin tag at 6/12 o clock midline position

Assoc with Crohns/UCBelow dentate line

A

Fissure in ano

Stool softeners, topical CCB dili/GTN, botulinum toxin, Sphincterotomy

64
Q

Painless, bright red rectal bleeding ppst defecation and bleeds onto the toilet paper and into the toilet pan

Constipation Hx poss!

A

Haemorroids

65
Q

May initially present with an abscess and thennnnnnnnnpersisting discharge onto the perineum, separate from the anus!!!!

How best visualised???

A

Fistula in ano

MRI!!!!!! For anal fistula!!!!

66
Q

Peri anal swelling and surrounding erythema

Ssevere pain in Ano-rectum + fever

A

Peri anal/ano-rectal abscess

Incision and drainage, leave the cavity open to heal by secondary intention

67
Q

frank haematemesis/altered blood MIXED with vomit. Usually prodromal features of dyspepsia and may have constitutional symptoms. Amount of bleeding variable but erosion of major vessel may produce considerable haemorrhage.

A

Gastric cancer

68
Q

Often NO prodromal features prior to haematemesis and malaena, but this AVM may produce quite considerable haemorrhage and may be difficult to detect endoscopically

A

Dieulafoy Lesion

69
Q

Usually haematemesis and epigastric discomfort. Usually there is an underlying cause such as recent NSAID usage. Large volume haemorrhage may occur with considerable haemodynamic compromise

A

Diffuse erosive gastritis

70
Q

Small low volume bleeds = more common so would tend to present as iron deficiency anaemia. Erosion into a significant vessel may produce considerable haemorrhage and haematemesis.

PAIN @ eating

A

Gastric ulcer

71
Q

Difficulty swallowing, dysphagia to both liquids and solids and sometimes chest pain

Usually caused by failure of distal oesphageal inhibitory neurones

Diagnosis is by pH and manometry studies together with contrast swallow and endoscopy

Treatment is with either botulinum toxin, pneumatic dilatation or cardiomyotomy

A

Achalasia WL Regurg Dysphagia

Manometry contrast swallow = dilated tapered oesophagus
Balloon Endo dilation – > cardio myotomy + PPI

72
Q

Symptoms include dysphagia, retrosternal discomfort and dyspepsia

May show ‘nutcracker oesophagus’ on barium swallow

A

Diffuse oesophageal spasm

Spectrum of oesophageal motility disorders

Caused by uncoordinated contractions of oesphageal muscles

73
Q

Tearing interscapular pain

Discrepancy in arterial blood pressures taken in both arms

May show mediastinal widening on chest x-ray

A

Dissection of thoracic aorta

74
Q

Symptoms of obstructed pooing

Assoc with childbirth and rectal intususception

Either int/ext

A

Rectal prolapse/intussusception

75
Q

Bright red rectal bleed Hx of IBS

Associated with chronic straining and constipation.

Histology shows mucosal thickening, lamina propria replaced with collagen and smooth muscle

Fibromuscular obliteration @ sigmoidoscopy

A

Solitary rectal ulcer syndrome

76
Q

Odynophagia

Poss dyspepsia Hx

A

Oesophagitis

77
Q

Duke’s colorectal classification

MWND

A

Mucosa, Bowel wall, LNmets, Distant

Dukes’ A
Tumour confined to the mucosa 95%

Dukes’ B
Tumour invading bowel wall 80%

Dukes’ C
Lymph node metastases 65%

Dukes’ D
Distant metastases

78
Q

Rectal Bleeding +altered bowel habit, malaise, history of fissures (especially anterior) and abscesses

Perineal inspection may show fissures or fistulae.

Proctoscopy = indurated mucosa and possibly strictures.

Skip lesions may be noted at colonoscopy.poss surg @ RIGHT SIDE

A

Crohns disease

79
Q

Bright red bleeding often mixed with stool

Diarrhoea, WL, NOCTURNAL incontinence,passage of mucous

PRProctitis is the most marked finding.

Peri anal disease is = ABsent.

Colonoscopy will show continuous mucosal lesion.

A

Ulcerative colitis

80
Q

sudden onset profuse dark red rectal bleeding.She was previously well.

A

Diverticular bleed

81
Q

Hernia seen in older patients

(the aponeurotic layer between the rectus abdominis muscle medially and the semilunar line laterally)

A

Spigelian hernia

A hernia through the spigelian fascia (the aponeurotic layer between the rectus abdominis muscle medially and the semilunar line laterally)

82
Q

Hernia in females and typical presents with bowel obstruction

A

Obturator hernia - A hernia which passes through the obturator foramen. More common in females and typical presents with bowel obstruction

83
Q

hernia can present with strangulation WITHOUT symptoms of obstruction

A

Richter hernia - A rare type of hernia where only the antimesenteric border of the bowel herniates through the fascial defect

Richter’s hernia can present with strangulation without symptoms of obstruction

GI (22 decks)

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