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Gastroenterology > Altered Bowel Habit and Abdominal Pain > Flashcards

Altered Bowel Habit and Abdominal Pain Flashcards

1
Q

What is altered bowel habit?

A

change in frequency/consistency of your bowel movements

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2
Q

What are some chronic conditions causing altered bowel habit?

A 
coeliac disease
chron's disease
diverticulosis
IBS
thyroid disorders
IBD
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3
Q

What is the scoring system for UC?

A

truelove and witts criteria

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4
Q

What is the gene mutation for increased risk of Chron’s disease?

A

NOD2/CARD15 gene

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5
Q

Symptoms of IBD?

A 
diarrhoea
blood/mucous in stools
anaemia
malaise
weight loss
mass +/- RIF
colicky abdominal pain
cramps
local peritonitis
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6
Q

Treatments for IBD?

A

aminosalicylates - 5 ASA (sulfasalazine/mesalazine)
corticosteroids
immunomodulators (azathioprine/methotrexate/anti-TNF infliximab)

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7
Q

What is seen in a biopsy of UC?

A 
inflammatory infiltrate
goblet cell depletion
glandular distortion
mucosal ulcers
crypt abscesses
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8
Q

What are the symptoms UC?

A 
episodic or chronic diarrhoea
increased bowel frequency
urgency
tenesmus
fever/malaise/anorexia/weight loss
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9
Q

What are signs of UC?

A 
clubbing
oral ulcers
episcleritis/iritis/conjuctivitis
large joint arthritis
sclerosing cholangitis
ankylosing spondlitis
osteomalacia
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10
Q

What is the treatment for mild UC?

A

steroids

5-ASA

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11
Q

What is the treatment for moderate UC and how is it classified?

A

4-6 motions/day but otherwise well

prednisolone 40mg for 7 days then reducing with steroid enemas

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12
Q

What is the treatment for severe UC and how is it classified?

A 
>6 motions/day and unwell
admit to hospital
NBM and IV fluids
IV hydrocortisone
after improvement - prednisolone with 5-ASA
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13
Q

On day 3 of severe UC flare up if CRP >45 or >6 stools what should be done?

A

colectomy

rescue therapy with ciclosporin or infliximab

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14
Q

What are the indications for surgery in UC?

A

perforation
massive haemorrhage
toxic dilatation
failed medical therapy

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15
Q

What is the type of surgery in UC?

A

proctocolectomy and terminal ileostomy

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16
Q

What are the side effects of 5-ASAs?

A 
rash
haemolysis
increased temperature
hepatitis
pancreatitis
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17
Q

How is Chron’s disease characterised?

A

transmural granulomatous inflammation

18
Q

What does the histology of Chron’s look like?

A 
granulomas containing multinucleate giant cells
transmural inflammation
neutrophil infiltrates
skip lesions
wall thickening
19
Q

What are the symptoms of Chron’s?

A 
abdominal pain
diarrhoea
urgency
weight loss
fever
malaise
20
Q

Additional features in Chron’s?

A 
skin tags
fissure
fistula
anal disease
adhesions
strictures
perforation
21
Q

What are extra-intestinal signs of Chron’s?

A

same as UC

renal stones

22
Q

What are complications of Chron’s?

A 
small bowel obstruction
toxic dilatation
abscess formation
fistulae
rectal haemorrhage
B12 deficiency
iron deficient anaemia
venous thromboembolism
23
Q

What is the treatment for mild flare ups of Chron’s

A

oral prednisolone

24
Q

What is the treatment for severe flareups of Chron’s?

A

IV hydrocortisone
admission to hospital
NBM
IV fluids

25
Q

What 2 types of cancers are found in the oesophagus and where are they found?

A

squamous in mid-thoracic portion

adeno in lower oesophagus

26
Q

What is the treatment for oesophageal cancer?

A

oesophageal stenting
radical radiotherapy
chemotherapy
surgery

27
Q

Where is gastric cancer common?

A

adenocarcinoma in the pyloric region

28
Q

What are the risk factors for gastric cancers?

A 
japanese
hypo/achlorhydria
male
high salt and nitrates
gastric polyps
29
Q

How does gastric cancer present?

A 
dyspepsia
epigastric pain
anorexia
weight loss
early satiety
iron deficiency anaemia
haematemesis and melena
30
Q

What is the commonest colorectal cancer and where is it found?

A

adenocarcinoma

rectum and sigmoid colon

31
Q

What are the risk factors for colorectal cancer?

A 
male
family history
IBD especially UC
low fibre diet
high fat and red meat diet
obesity
32
Q

What are the clinical signs of right sided colon cancer?

A

iron deficiency anaemia
abdominal pain
abdominal mass

33
Q

What are the clinical signs of left sided colon cancer?

A

blood per rectum
altered bowel habit
abdominal mass

34
Q

What are the clinical signs of rectal cancer?

A

blood per rectum
tenesmus
obstruction

35
Q

What does treatment of colorectal cancer depend on?

A

Duke’s classification

36
Q

How does pancreatic cancer present?

A

abdominal pain radiating through to back
weight loss
obstructive jaundice

37
Q

What is usually maintained in pancreatic cancer?

A

endocrine and exocrine function

38
Q

What is released from exocrine cancer cells?

A

CA19-9

39
Q

Where are metastases of hepatobiliary cancer usually from?

A

stomach
colon
breast
lung

40
Q

What suggests the diagnosis of hepatobiliary cancer?

A

raised alpha fetoprotein

41
Q

What is the treatment for hepatocellular carcinoma?

A

transplant
chemo/ethanol injection
resection

42
Q

What are teh predisposing factors for cholangiocarcinoma?

A

primary sclerosing cholangitis
liver fluke infection
choledochal cyst
Caroli’s disease

Gastroenterology (5 decks)

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