disease definitions

Question 1

define the acute abdomen

Answer 1

A combination of symptoms and signs, including abdominal pain, which results in a patient being referred for an urgent general surgical opinion.

Question 2

what is the pathophysiology of the acute abdomen?

Answer 2

Peritonitis
Intestinal obstruction
Abdominal pain

Question 3

what are some of the aetiologies of the acute abdomen?

Answer 3

non-specific pain, acute appendicitis, acute cholecystitis/colic pain, petic ulcer perforation, etc.

Question 4

what are the major liver diseases?

Answer 4

alcohol-related liver disease, non-alcoholic fatty liver disease (NAFLD), viral hepatitis, autoimmune liver diseases

Question 5

what are the different hepatitis viruses?

Answer 5

A, B, C, D and E

Question 6

non-alcoholic fatty liver disease is a term encompassing which three entities?

Answer 6

Simple steatosis
Non-alcoholic steatohepatitis (NASH)
Fibrosis and cirrhosis

Question 7

what is the progression of NAFLD?

Answer 7

normal liver -> steatosis -> NASH -> fibrosis and cirrhosis (not all cases progress the entire way)

Question 8

what are the three main autoimmune liver diseases?

Answer 8

Autoimmune hepatitis
Primary biliary cholangitis (PBC)
Primary sclerosing cholangitis (PSC)

Question 9

define jaundice

Answer 9

Yellowing of the skin, sclerae, and other tissues caused by excess circulating bilirubin - can be classified as pre-hepatic, hepatic, or post-hepatic

Question 10

define Choledocholithiasis

Answer 10

the presence of gallstone(s) in the common bile duct

Question 11

what is cholangitis (ascending cholangitis)?

Answer 11

an infection of the bile duct, usually caused by bacteria ascending from its junction with the duodenum. It tends to occur if the bile duct is already partially obstructed by gallstones.

Question 12

what is the definition of chronic liver disease and its causes?

Answer 12

Liver disease that persists beyond 6 months:
Chronic hepatitis
Chronic cholestasis
Fibrosis and Cirrhosis
Others e.g. steatosis
Liver tumours

Question 13

what is the clinical presentation of cirrhosis?

Answer 13

Compensated chronic liver disease,
Decompensated chronic liver disease (ascites, variceal bleeding, hepatic encephalopathy)
Hepatocellular carcinoma

Question 14

what are varices and where do they occur?

Answer 14

an abnormally dilated vessel with a tortuous course, due to portral hypertension. occur at porto-systemic anastomoses:
Skin – Caput medusa
Oesophageal & Gastric
Rectal
Posterior abdominal wall
Stomal

Question 15

what is hepatic encephalopathy and what are its precipitants?

Answer 15

confusion due to liver disease. can be precipitated by: GI bleed, infection, constipation, dehydration (electrolyte disturbance), medication esp. sedation

Question 16

what is the most common type of liver cancer?

Answer 16

hepatocellular carcinoma

Question 17

what is steatosis?

Answer 17

fatty liver (can be a result of alcohol abuse or not)

Question 18

what is steatohepatitis?

Answer 18

fatty liver with inflammation (can be a result of alcohol abuse or not); neutrophil infiltration and can result in fibrosis and cirrhosis due to a build-up of scar tissue

Question 19

what is achalasia?

Answer 19

a hypomotility disorder; functional loss of myenteric plexus ganglion cells in distal oesophagus and LOS; results in the failure of the LOS to relax

Question 20

what is gastro-oesophageal reflux disease (GORD)?

Answer 20

pathological acid (and bile) exposure in lower oesophagus due to abnormal function of LOS ? and/or the presence of a hiatus hernia ?

Question 21

define barrett’s oesophagus

Answer 21

Intestinal metaplasia related to prolonged acid exposure in distal oesophagus; is a precursor to dysplasia/ adenocarcinoma

Question 22

where in the oesophagus is squamous cell carcinoma most likely to occur?

Answer 22

in the proximal and middle third of oesophagus

Question 23

where in the oesophagus is adenocarcinoma most likely to occur?

Answer 23

Occurs in distal oesophagus; is associated with Barrett’s oesophagus (progresses through dysplasia to cancer)