Diseases Flashcards
What is dyspepsia?
Indigestion Is a syndrome consisting of: -Epigastric pain/burning -Postprandial fullness -Early satiety
What can H. pylori cause?
Reversible gastric cancer
Peptic ulcers
What treatment is given for a duodenal ulcer?
PPI (proton pump inhibitor) - Omeprazole
What is the treatment for a H. pylori infection?
PPI + amoxicillin + clarithromycin
What is blood in the stools called?
Melaena
What is the most important thing in an upper GI bleed?
Resuscitation
What colour of IV access should be used in management of any emergency situation?
Grey
What are the 2 major causes of upper GI haemorrhage?
Bleeding peptic ulcer
Variceal bleeding
What is the best treatment for a bleeding peptic ulcer?
Endoscopic treatment: -injection of adrenaline -clips -heater probe coagulation Acid suppression - (PPI -> omeprazole)
Which disease increases risk of varaceal bleeding?
Liver cirrhosis
What is the best treatment for a bleeding oesophageal varice?
Coagulation therapy - Vit K
Broad spectrum antibiotics - in case of sepsis
Variceal banding
Terlipressin
What are the 3 causes of small bowel obstruction?
Within the lumen,
Within the wall,
Outside the wall
What are the signs of small bowel obstruction?
Absolute constipation, Vomiting, Burping, Colicky pain, Abdominal distension
What investigation should be done for small bowel obstruction?
AXR (abdominal X-ray)
What is the treatment for small bowel obstruction?
‘Drip and suck’
Resuscitate with fluids and suck for up to 72 hours
What is the risk with mesenteric ischaemia (dead gut)?
Infarction which can be fatal to patients
How is mesenteric ischaemia diagnosed?
Pain out of proportion to clinical findings,
Acidosis on ABGs
How is mesenteric ischaemia (dead gut) treated?
Emergency surgery - if black and infarcted nothing can be done and will die slowly, if young and fit enough can remove parts of the small bowel
What is gastroenteritis?
Infective diarrhoea
What is the treatment for gastroenteritis?
No antibiotics, just supportive management
What increases risk of gastroenteritis?
Acid suppression (PPI), immunosuppression
What is dystentry?
Inflammation of the intestine associated with blood and mucous
What is the symptom of diarrhoea associated with cholera?
Rice-water diarrhoea
What causes rapid development of gastroenteritis?
Preformed toxins
What does shiga toxin/shiga-like toxin cause?
Inhibit protein synthesis and cause cell death
What organism produces shiga-like toxin?
E. coli 0157/STEC/VTEC
Why do you not give antibiotics immediately in gastroenteritis?
In case it causes HUS (haematuria and renal failure)
What is the criteria for diagnosis of IBS?
Rome IV: Abdominal pain >1day/week for at least 3 months + 2 of: -related to defecation -change in stool frequency (bowel habit) -change in stool appearance
Must be for > 3 months
What other disease is associated with primary sclerosing cholangitis?
Ulcerative colitis
What is the first line treatment in UC?
Mesalazine
What is the maintenance therapy in Crohns?
Azathioprine
What is koilonychia a sign of?
Iron deficiency anaemia
What are the signs and first line investigation of acute pancreatitis?
Signs: severe epigastric pain, radiation to back, nausea
Investigation: Serum amylase
What is the protocol following acute hepatitis diagnosis?
Supportive management,
Immunise contacts,
Notify public health,
Monitor for encephalopathy
Who is at increased risk of HepA?
Areas of poor hygiene/overcrowding,
PWID,
Male/male sex
What are the signs of coeliac disease and what is the diagnosis based upon?
Distended abdomen, failure to thrive, diarrhoea
Diagnosis = biopsy
Which antibody is tested for in coeliac disease?
Anti-TTG antibody
What sign indicates that a gastric ulcer is not the diagnosis in peptic ulcer disease?
Pain not exacerbated by eating
What are the signs of ischaemic bowel on biopsy?
Necrosis, ulceration + granulation
