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Block 32- GI/surgery > Dyspepsia > Flashcards

Dyspepsia Flashcards

1
Q

lining of oesophagus

A

stratified squamous

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2
Q

upper 1/3 oesophagus layers=

A

outer longitudinal layer and inner circular layer muscle layers

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3
Q

lower 2/3 oesophagus layers =

A

both smooth muscle

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4
Q

activity of lower oesophageal sphincter

A

high resting tone assisted by the diaphragm

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5
Q

benign oesophageal sphincter=

A

narrowing of the oesophagus

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6
Q

what is the most common cause of benign oesophageal sphincters

A

gastroesophageal reflux disease

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7
Q

other causes of benign oesophageal sphincters

A

oesophagitis
GORD
achalasia
hiatus hernia

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8
Q

symptoms of benign oesophageal sphincter

A 
dysphagia
food regurgitation 
dyspepsia
heartburn
frequent burping
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9
Q

treatment for benign oesophageal stricture=

A

treat the underlying cause

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10
Q

symptoms of pharyngeal pouch

A

cough
regurgitation
halitosis (bad breath)
dysphagia

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11
Q

pharyngeal pouch also called

A

zenker’s diverticulum

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12
Q

where is a pharyngeal pouch

A

immediately above the upper stricture

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13
Q

in a pharyngeal pouch where does the wall herniate through

A

the point of least resistance= killian’s triangle

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14
Q

is a pharyngeal pouch a real diverticulum

A

no its a pseudodiverticulum not all layers of the wall herniate

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15
Q

investigations for pharyngeal pouch (2)

A

barium swallow

contrast CT

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16
Q

achalasia=

A

lower oesophageal motility disorder -hypertensive non-relaxed oesophageal sphincter

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17
Q

symptoms of achalasia (4)

A
  • dysphagia
  • regurgitation
  • unintentional weight loss
  • coughing when lying down
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18
Q

1st line treatment of achalasia

A

endoscopic balloon dilation

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19
Q

alternative treatment of achalasia (4)

A
  • cardiomyotomy
  • verapamil / nitrates
  • botulinum toxin injection
  • gastrostomy
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20
Q

what causes GORD

A

failure of the lower oesophageal sphincter

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21
Q

what angle in the oesophagus becomes larger in GORD

A

angle of his

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22
Q

risk factors for GORD (4)

A

obesity
pregnancy
smoking
hiatus hernia

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23
Q

complications of GORD (4)

A

oesophagitis
oesophageal strictures
barretts oesophagus

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24
Q

symptoms of GORD (4)

A

heartburn
acid regurgitation
indigestion
dysphagia

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25
first method treatment of GORD
8 weeks PPI trial
26
what happens if no GORD symptom improvement after PPI
OGD
27
investigations for GORD (5)
- OGD - ambulatory pH monitoring - oesophageal manometry - barium swallow - capsule endoscopy
28
treatment lifestyles changes in GORD
-weight loss -head-of-bed elevation -avoidance of late-night eating avoiding specific foods
29
what is functional dyspepsia
gut hypersensitivity and motility disturbances
30
other word for functional dyspepsia
non-ulcer dyspepsia
31
what is normally the cause of functional dyspepsia
H.pylori iinfection causing non-erosive reflux disease
32
clinical presentation of functional dyspepsia
bloating abdominal pain nausea and vomiting heartburn and indigestion
33
treatment of functional dyspepsia
dietary modifications PPIs H2 antagonist
34
investigations for peptic ulcer
H.pylori breath test OGD FBC stool haem test
35
active bleeding ulcer management
- resuscitation - endoscopy dual therapy - mechanical clips/ cauterization - PPIs
36
red flag symptoms with upper abdo pain
- haematemesis - unintentional weight loss - nausea and vomiting - dysphagia - >55 years - family history
37
cholelithiasis=
gallstones
38
what can gallstones be made from (3)
cholesterol bilirubin mixed substances from bile
39
presentation of cholelithiasis (5)
- colicky pain in RUQ - N&V - indigestion - bloating - heartburn
40
when do symptoms and complications occur in cholelithiasis
when stones tranverse and obstructs cystic duct
41
what can chronic obstruction of the biliary duct result in
cholecystitis
42
what can happen if a calculi becomes blocked at the ampulla of vater
acute biliary pancreatitis
43
investigations of cholelithiasis (4)
FBC LFTs Serum lipase/ amylase abdominal ultrasound
44
what is cholecystitis
acute inflammation of the gallbladder walls
45
acalculous cholecystitis =
inflammation of the gallbladder without evidence of gallstones
46
symptoms of cholecystitis
RUQ abdo pain positive murphy sign palpable abdominal mass
47
choledocholithiasis=
gallstones in bile ducts
48
what can gallstones in bile ducts cause (3)
- biliary colic /obstruction - acute pancreatitis - acute cholangitis
49
cholangitis=
bile duct infection and inflammation
50
which causes jaundice ascending cholangitis or acute cholecystitis
ascending cholangitis
51
ascending cholangitis =
obstruction of common bile duct causing bacterial infection
52
as the obstruction & infection in ascending cholangitis advances what happens in the bile duct
pressure increases forcing extravasation of bacteria into blood stream
53
symptoms of ascending cholangitis
``` fever leukocytosis obstructive jaundice RUQ colicky pain pruitus ```
54
primary sclerosing chongitis-= (PSC)
skin lesions of inflammation along the biliary tree
55
where is inflammation most common in PSC
larger bile ducts higher up
56
what does the inflammation in PSC cause
progressive fibrosis forming strictures
57
what can PSC lead to in the liver
cirrhosis
58
consequence of PSC in biliary tree
bile duct stones
59
risk factors for PSC
male gender | IBD
60
symptoms of PSC (7)
``` abdominal pain pruitus jaundice fatigue fever weight loss steatorrhea ```
61
primary biliary cholangitis =(PBC)
interlobular duct damage by autoimmune granulomatous formation
62
consequence of PBC
cholestasis fibrosis cirrhosis portal hypertension
63
cholestasis=
stoppage of bile flow
64
symptoms of primary biliary cholangitis (6)
``` pruitus fatigue dry eyes dry mouth hepatomegaly syncope ```
65
risk of PBC
female | other autoimmune disease
66
I GET SMASHED acute pancreatitis
``` idiopathic gallstones ethanol Trauma Scorpion/ spider Malignancy/mumps Autoimmune Steroids Hyperlipidaemia/ hypercalcaemia/ hyperparathyroidism/ hypothermia ERCP Drugs ```
67
main cause of acute pancreatitis
excessive alcohol abuse
68
what is the pancreas is alcohol a direct toxic insult to
acinar cells
69
symptoms of acute pancreatitis (5)
- N&V - anorexia - epigastric abdominal pain - tachycardia - grey-turners sign
70
what is grey-turners sign
bilateral flank blue discolouration
71
treatment for acute pancreatitis (6)
``` resuscitation opioid pain relief nil by mouth initially insulin ondansetron ERCP ```
72
chronic pancreatitis caused by
continual insults on the acinar cells
73
what can cause chronic pancreatitis (7)
``` alcohol biliary tract disease hypercalcaemia hyperlipidaemia haemochromatosis cystic fibrosis idiopathic ```
74
symptoms of chronic pancreatitis (5)
- epigastric pain radiates to back - steatorrhea - obstructive jaundice - weight loss - N&V
75
symptoms of gastric carcinoma (7)
``` dyspepsia weight loss anorexia N&V dysphagia epigastric mass/pain virchows node ```
76
risk factors for gastric cancer (5)
``` H.pylori pernicious anaemia male 50-70 family history ```
77
investigations for gastric cancer
OGD + biopsies endoscopic ultrasound CT/MRI

Block 32- GI/surgery (9 decks)

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