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Year 1 - Gastrointestinal (DP) > Diseases Of The Upper GI Tract > Flashcards

Diseases Of The Upper GI Tract Flashcards

0
Q

What ducts form the common bile duct?

A

Cystic duct

Common hepatic duct

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1
Q

What do the right hepatic and left hepatic duct combine to form?

A

Common hepatic duct

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2
Q

Where do the common bile duct and pancreatic duct meet?

A

Ampulla of vater

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3
Q

Through what do the common bile duct and pancreatic duct empty their contents?

A

Major duodenal papilla - has the sphincter of Oddi

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4
Q

What is ERCP and what does it do?

A

Endoscopic Retrograde Cholangiopancreatography

Studies biliary tree and pancreas

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5
Q

What can cause posthepatic jaundice and how?

A

Gallstones
Pancreas head carcinoma
Bile flows back to liver - overspill into blood - increased blood bilirubin

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6
Q

What are the 4(/5) parts of the pancreas?

A

Head (with Uncinate process)
Neck
Body
Tail

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7
Q

What is the role of the pancreas?

A

Exocrine
- Acinar cells - Secrete pancreatic enzymes into pancreatic duct
Endocrine
- Islets of Langerhans - Secrete insulin and glucagon into blood

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8
Q

What is the blood supply to the pancreas?

A

Pancreatic branches of the splenic artery
Sup. pancreaticoduodenal artery (from gastroduodenal a.)
Inf. pancreaticoduodenal artery (from sup. mesenteric a.)

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9
Q

What are the four parts of the duodenum?

A
  1. Superior - intraperitoneal
  2. Descending
  3. Horizontal
  4. Ascending
    (The rest are retroperitoneal)
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10
Q

What is the name of the folds in the jejunum?

A

Plicae circularis

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11
Q

When fat is absorbed into enterocytes where does it go?

A 
Into chylomicrons
Into lacteals (special lymph vessels)
Drains into venous system at left venous angle
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12
Q

What lesions can be present in the mouth?

A

Ulcer
Lump
White patch
Red patch

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13
Q

What is Sjögren’s syndrome?

A

Salivary gland disease - dry mouth

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14
Q

What haematological disorders have oral signs?

A

Deficiencies of

  • Vitamin B12
  • Folate
  • Iron
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15
Q

What oral signs are present in iron deficiency?

A 
Recurrent ulceration
Oral dysaesthesia
Oral candida
Angular chelitis
Smooth tongue
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16
Q

Hairy leukoplakia, Kaposi’s sarcoma and candidosis are oral manifestations of what?

A

HIV/AIDS

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17
Q

How does the Oesophagus appear in reflux disease?

A

Red

Ulcerated

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18
Q

Barrett’s oesophagus is a metaplasia of what cells to what?

A

Simple squamous to columnar epithelium

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19
Q

How does Barrett’s oesophagus appear?

A

Red
Velvety
Shifted z line

20
Q

A 21 year old man presents with dysphagia. He has asthma and has a family history of allergy. He has no symptoms or signs of reflux disease. On endoscopy his Oesophagus appears corrugated. What is the likely diagnosis and treatment?

A

Eosinophilic oesophagitis

Steroids/Chromoglycate/Montelukast

21
Q

A 62 year old man presents with dysphagia. He has smoked for 45 years and drinks 40 units of alcohol a week. He has noticed unplanned weight loss over the past number of weeks. He has some lymphadenopathy in his neck. What is the likely diagnosis?

A

Squamous cell carcinoma

22
Q

In what areas of the mouth is squamous cell carcinoma most likely?

A

Non-keratinised

23
Q

Where is a peptic ulcer more common, stomach or duodenum?

A

Duodenum

24
Q

On endoscopy, a lesion appears clear cut and almost like it has been ‘punched out’. Is it more likely to be cancer or an ulcer?

A

Ulcer

25
Q

What type of gastric cancer is linked to H. pylori infection?

A

Adenocarcinoma

26
Q

What are common presentations of oesophageal cancer?

A 
Dysphagia
Odynophagia
Haematemesis
Dysphonia
Weight loss
27
Q

Alarm features of upper GI disease

A 
>55 years
Dysphagia
GI blood loss
Persistent vomiting
Unexplained weight loss
Upper abdo mass
Anaemia (iron deficient)
28
Q

What are the two types of gastric adenocarcinoma and how can they be distinguished?

A 
Intestinal
- Irregular gland tubules
- Intestinal metaplasia
Diffuse
- Secrete mucus
- Poorly differentiated
- Signet ring cells
29
Q

Typical clinical presentations of gastric cancer

A 
Dyspepsia
Upper GI bleed
Weight loss
Abdo mass
Jaundice
30
Q

In what type of lesion is a total gastrectomy performed?

A

Proximal

31
Q

Treatment options for Variceal bleeding

A

Injection scleropathy - Ethanolamine
Banding
Histocryl glue

32
Q

Treatments for arterial bleeding in the GI tract

A

Injection therapy - Adrenaline
Heater probe
Clips

33
Q

What surgery is available for sufferers of GORD?

A

Nissen fundoplication

34
Q

What is gastroparesis and what are its symptoms?

A

Delayed gastric emptying

  • Feeling full
  • Nausea
  • Vomiting
  • Weight loss
  • Upper abdo pain
35
Q

What is achalasia?

A

LOS in spasm
Lack of oesophageal peristalsis
(Treatment is balloon dilation or injection of Botox)

36
Q

What are the Rome III criteria for dyspepsia?

A

Epigastric pain
Postprandial fullness
Early satiety

37
Q

How do we test f or H. pylori infection?

A

Urease breath test
- C13 labelled urea eaten
- If C13 CO2 exhaled then H. pylori present
Faecal antigen test also possible

38
Q

Treatment for H. pylori infection

A

Omeprazole 20mg twice daily AND
Clarithromycin 500mg twice daily AND
Amoxicillin 1g twice daily

39
Q

What are the four types of tongue papillae?

A

Filiform (no taste buds)
Fungiform
Foliate
Circumvalate

40
Q

What classes of anti-emetic drugs exist and give examples?

A 
5-HT3 receptor antagonists
- Ondansetron
- Palonosetron
Muscarinic ACh receptor antagonists
- Hyosine
- Scopolamine
Histamine H1 receptor antagonists
- Cyclizine
- Cinnarizine
Dopamine receptor antagonists
- Domperidone
- Metoclopramide
41
Q

When are 5-HT3 receptor antagonists used?

A

Suppress chemotherapy and radiation-induced emetics and postoperative vomiting

42
Q

What drugs are used for the prophylaxis and treatment of motion sickness?

A

Muscarinic acetylcholine receptor antagonists

Histamine H1 receptor antagonists

43
Q

What are the side effects of hyosine?

A

Blurred vision
Urinary retention
Dry mouth
Central sedation

44
Q

If vomiting has been induced by irritants, what drugs can be used?

A

Histamine H1 receptor antagonists

45
Q

When are dopamine receptor antagonists used?

A

Drug induced emesis

GI disorders

46
Q

What is nabilone?

A

Cannaboid (CB1) receptor agonist

47
Q

Give an example of NK1 receptor antagonist and when it is used?

A

Aprepitant

Acute phase of highly emetogenic chemotherapy

Year 1 - Gastrointestinal (DP) (8 decks)

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