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GI > Core Conditions > Flashcards

Core Conditions Flashcards

1
Q

What is the main sign of a peptic ulcer?

A

Epigastric pain worse after meals/when lying flat

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2
Q

What are the red flags for a suspected peptic ulcer requiring an immediate endoscopy? (6)

A

ALARMS:

  1. Anaemia
  2. Loss of weight
  3. Anorexia
  4. Recent onset
  5. Melaena/haematemesis
  6. Swallowing difficulty
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3
Q

What is the pathophysiology of peptic ulcer formation?

A

Decreased prostaglandin release which control acid release and increase mucous production

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4
Q

What Ix are done for someone with a suspected peptic ulcer? (2)

A
  1. Carbon 13 urea breath test for H. pylori

2. Upper GI endoscopy (if worried about perforation or malignancy)

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5
Q

What are the main RFs for peptic ulcer formation? (5)

A
  1. H pylori
  2. NSAIDs
  3. Adrenaline/NA
  4. Smoking
  5. Alcohol
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6
Q

What is the management for someone with a peptic ulcer? (6)

A
  1. Lifestyle: decrease smoking/alcohol
  2. H. pylori eradication
  3. Acid secretion control (PPI = omeprazole or H2 receptor antagonist = ranitidine)
  4. Neutralise acids
  5. Mucosal protection (misoprostol)
  6. Surgery
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7
Q

What are the signs of iron deficiency anaemia? (4)

A
  1. Koilonychia
  2. Atrophic glossitis
  3. Angular stomatitis
  4. Conjunctival pallor
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8
Q

What Ix are done for someone with suspected iron deficiency anaemia? (3)

A
  1. Blood film
  2. Serum ferritin (reduced)
  3. Total Iron Binding Capacity (raised)
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9
Q

What is seen on a blood film w Iron deficiency anaemia? (2)

A

Microcytic + hypochromic anaemia

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10
Q

What is the management for iron deficiency anaemia? (2)

A
  1. Treat underlying cause

2. Oral ferrous sulphate after iron returns to normal

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11
Q

What is diverticular disease? And what are the symptoms?

A

Herniation of the mucosa and submucosa through the muscular layer of the colon wall

Asymptomatic

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12
Q

What is diverticulitis?

A

Infection of the diverticula

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13
Q

What are the presentations of diverticulitis? (3)

A
  1. Recurrent dull lower left quadrant pain
  2. Change in bowel habit
  3. Bleeding
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14
Q

What Ix are done for someone w suspected diverticular disease? (3)

A
  1. FBC (leucocytosis)
  2. CXR (exclusion)
  3. CT Abd. (confirmation of diverticula)
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15
Q

What are the main RFs for diverticular disease? (2)

A
  1. Age

2. Low fibre diet

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16
Q

What is the treatment for diverticular disease? (4)

A

None if asymptomatic

  1. Analgesia
  2. Fibre supplement
  3. Abx if diverticulitis
  4. Surgery
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17
Q

What are the symptoms of colorectal polyps?

A

Asymptomatic

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18
Q

What are the RFs for colorectal polyps? (5)

A
  1. Age
  2. FHx and genetics
  3. Hx of polyps
  4. Acromegaly
  5. IBS
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19
Q

What are the causes of colorectal polyps? (3)

A
  1. Familial adenomatous polyposis (100% risk of colon cancer)
    2, Hereditary non-polyposis colorectal cancer
  2. Peutz-Jeghers syndrome (benign harmatomatous polyp)
20
Q

What Ix are done for someone w suspected colorectal polyps? (4)

A
  1. Colonoscopy
  2. Flex sigmoidoscopy
  3. Double contrast barium enema
  4. Narrow band imaging (determine whether polyp is neo/non-neoplastic)
21
Q

What is the management for someone with colorectal polyps? (2)

A
  1. Edoscopic polypectomy (best)

2. Prophylactic colectomy for those with FAP

22
Q

What is cholecystitis? What are the symptoms/signs? (3)

A

Inflammation of the bile duct due to the passing of a stone

  1. RUQ pain
  2. Fever
  3. Murphy’s sign
23
Q

What is ascending cholangitis? What are the symptoms/signs? (3)

A

Inflammation of the biliary tree due to INFECTION

Charcot’s triad (can lead to sepsis):

  1. RUQ pain
  2. Fever
  3. Jaundice
24
Q

Where can the pain of biliary colic radiate to?

A

The shoulder

25
Q

How do gallstones form?

A

Bile supersaturating with cholesterol

26
Q

What Ix are done for someone w gall stone disease? (4)

A
  1. FBC (raised CRP/WCC suggests cholecystitis or cholangitis)
  2. LFTs (raised ALP + ALT)
  3. Abd. US
  4. ABG (for sepsis w cholangitis)
27
Q

What are the RFs for gall stone disease?

A

5Fs: Fat, forty, female, fair, fertile

28
Q

What is the management for someone with gallstone disease? (4)

A
  1. Cut out high fat diet (biliary colic)
  2. Analgesia + ABx (if cystitis or angitis
  3. Endoscopic lithotripsy
  4. Cholecystectomy
29
Q

What is a hiatus hernia? What are the symptoms? (4)

A

Protrusion of intra-abd. contents through an enlarged oesophageal hiatus of the diaphragm

  1. GORD
  2. Dull retrosternal pain
  3. Dysphagia
  4. Bowel sounds heard in chest
30
Q

What is a paraumbilical hernia? What are the signs/symptoms? (3)

A

Protrusion of the peritoneum through a weakness in the anterior abd. wall fascia

  1. Pain/hesitation in lifting or coughing
  2. Hardening = gut strangulation
  3. Thrill felt when patient coughs
31
Q

What is an inguinal hernia? What are the symptoms? (2)

A

Protrusion of abd. contents through a weakened inguinal ring or inguinal floor

  1. Groin/scrotal discomfort
  2. Thrill felt when patient coughs
32
Q

What Ix are done for a suspected hiatus hernia? (4)

A
  1. CXR
  2. Upper GI contrast
  3. Oesophago-gastro-duodenoscopy (OGD)
  4. CT/MRI
33
Q

What causes paraumbilical hernias? How is it managed?

A

Repetitive bouts of raised intra abd. pressure

Surgery

34
Q

How are hiatus hernias managed? (3)

A
  1. PPIs
  2. Weight Loss
  3. Dietary changes
35
Q

What is diverticulosis?

A

The asymptomatic presence of diverticula

36
Q

What are the common bacterial causes of gastroenteritis? (4)

A
  1. Campylobacter
  2. Shigella
  3. Salmonella
  4. E. coli
37
Q

What are the common viral causes of gastroenteritis?(4)

A
  1. Norovirus
  2. Rotavirus
  3. Adenovirus
  4. Astrovirus
38
Q

What are the parasitic causes of gastroenteritis? (2)

A
  1. Protozoa

2. Helminths

39
Q

What is the MAIN symptom of enteric infections? What are the signs of this? (5)

A

Dehydration:

  1. Tachycardia
  2. Weak pulse
  3. Sunken eyes
  4. Deep breathing
  5. Low urine output
40
Q

What is the symptom of a type 1 enteric infection?

A

Non-inflammatory watery diarrhoea

41
Q

What is the symptom of a type 2 enteric infection?

A

Inflammatory dysentery (blood, mucus + leukocytes in stool)

42
Q

What is the symptom of a type 3 enteric infection?

A

Penetrating enteric fever (where you get systemic infection)

43
Q

What Ix are done for enteric infections? (2)

A
  1. Stool culture

2. Urea + creatinine (test for dehydration - can cause AKI)

44
Q

What is the management for enteric infections? (2)

A
  1. Re-hydration

2. Infection control (isolation)

45
Q

Where in the digestive tract does Crohn’s commonly affect and so how do these patients present?

A

Terminal ileum

B12 deficiency (absorbed in the terminal ileum)

GI (3 decks)

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