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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
Q

first method treatment of GORD

A

8 weeks PPI trial

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26
Q

what happens if no GORD symptom improvement after PPI

A

OGD

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27
Q

investigations for GORD (5)

A
  • OGD
  • ambulatory pH monitoring
  • oesophageal manometry
  • barium swallow
  • capsule endoscopy
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28
Q

treatment lifestyles changes in GORD

A

-weight loss
-head-of-bed elevation
-avoidance of late-night eating
avoiding specific foods

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29
Q

what is functional dyspepsia

A

gut hypersensitivity and motility disturbances

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30
Q

other word for functional dyspepsia

A

non-ulcer dyspepsia

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31
Q

what is normally the cause of functional dyspepsia

A

H.pylori iinfection causing non-erosive reflux disease

32
Q

clinical presentation of functional dyspepsia

A

bloating
abdominal pain
nausea and vomiting
heartburn and indigestion

33
Q

treatment of functional dyspepsia

A

dietary modifications
PPIs
H2 antagonist

34
Q

investigations for peptic ulcer

A

H.pylori breath test
OGD
FBC
stool haem test

35
Q

active bleeding ulcer management

A
  • resuscitation
  • endoscopy dual therapy
  • mechanical clips/ cauterization
  • PPIs
36
Q

red flag symptoms with upper abdo pain

A
  • haematemesis
  • unintentional weight loss
  • nausea and vomiting
  • dysphagia
  • > 55 years
  • family history
37
Q

cholelithiasis=

A

gallstones

38
Q

what can gallstones be made from (3)

A

cholesterol
bilirubin
mixed substances from bile

39
Q

presentation of cholelithiasis (5)

A
  • colicky pain in RUQ
  • N&V
  • indigestion
  • bloating
  • heartburn
40
Q

when do symptoms and complications occur in cholelithiasis

A

when stones tranverse and obstructs cystic duct

41
Q

what can chronic obstruction of the biliary duct result in

A

cholecystitis

42
Q

what can happen if a calculi becomes blocked at the ampulla of vater

A

acute biliary pancreatitis

43
Q

investigations of cholelithiasis (4)

A

FBC
LFTs
Serum lipase/ amylase
abdominal ultrasound

44
Q

what is cholecystitis

A

acute inflammation of the gallbladder walls

45
Q

acalculous cholecystitis =

A

inflammation of the gallbladder without evidence of gallstones

46
Q

symptoms of cholecystitis

A

RUQ abdo pain
positive murphy sign
palpable abdominal mass

47
Q

choledocholithiasis=

A

gallstones in bile ducts

48
Q

what can gallstones in bile ducts cause (3)

A
  • biliary colic /obstruction
  • acute pancreatitis
  • acute cholangitis
49
Q

cholangitis=

A

bile duct infection and inflammation

50
Q

which causes jaundice ascending cholangitis or acute cholecystitis

A

ascending cholangitis

51
Q

ascending cholangitis =

A

obstruction of common bile duct causing bacterial infection

52
Q

as the obstruction & infection in ascending cholangitis advances what happens in the bile duct

A

pressure increases forcing extravasation of bacteria into blood stream

53
Q

symptoms of ascending cholangitis

A 
fever 
leukocytosis 
obstructive jaundice 
RUQ colicky pain 
pruitus
54
Q

primary sclerosing chongitis-= (PSC)

A

skin lesions of inflammation along the biliary tree

55
Q

where is inflammation most common in PSC

A

larger bile ducts higher up

56
Q

what does the inflammation in PSC cause

A

progressive fibrosis forming strictures

57
Q

what can PSC lead to in the liver

A

cirrhosis

58
Q

consequence of PSC in biliary tree

A

bile duct stones

59
Q

risk factors for PSC

A

male gender

IBD

60
Q

symptoms of PSC (7)

A 
abdominal pain 
pruitus
jaundice 
fatigue 
fever 
weight loss
steatorrhea
61
Q

primary biliary cholangitis =(PBC)

A

interlobular duct damage by autoimmune granulomatous formation

62
Q

consequence of PBC

A

cholestasis
fibrosis
cirrhosis
portal hypertension

63
Q

cholestasis=

A

stoppage of bile flow

64
Q

symptoms of primary biliary cholangitis (6)

A 
pruitus 
fatigue
dry eyes 
dry mouth 
hepatomegaly 
syncope
65
Q

risk of PBC

A

female

other autoimmune disease

66
Q

I GET SMASHED acute pancreatitis

A 
idiopathic 
gallstones
ethanol
Trauma 
Scorpion/ spider 
Malignancy/mumps 
Autoimmune 
Steroids 
Hyperlipidaemia/ hypercalcaemia/ hyperparathyroidism/ hypothermia 
ERCP 
Drugs
67
Q

main cause of acute pancreatitis

A

excessive alcohol abuse

68
Q

what is the pancreas is alcohol a direct toxic insult to

A

acinar cells

69
Q

symptoms of acute pancreatitis (5)

A
  • N&V
  • anorexia
  • epigastric abdominal pain
  • tachycardia
  • grey-turners sign
70
Q

what is grey-turners sign

A

bilateral flank blue discolouration

71
Q

treatment for acute pancreatitis (6)

A 
resuscitation 
opioid pain relief
nil by mouth initially 
insulin 
ondansetron 
ERCP
72
Q

chronic pancreatitis caused by

A

continual insults on the acinar cells

73
Q

what can cause chronic pancreatitis (7)

A 
alcohol 
biliary tract disease
hypercalcaemia 
hyperlipidaemia 
haemochromatosis 
cystic fibrosis 
idiopathic
74
Q

symptoms of chronic pancreatitis (5)

A
  • epigastric pain radiates to back
  • steatorrhea
  • obstructive jaundice
  • weight loss
  • N&V
75
Q

symptoms of gastric carcinoma (7)

A 
dyspepsia 
weight loss 
anorexia 
N&V
dysphagia 
epigastric mass/pain 
virchows node
76
Q

risk factors for gastric cancer (5)

A 
H.pylori 
pernicious anaemia 
male 
50-70 
family history
77
Q

investigations for gastric cancer

A

OGD + biopsies
endoscopic ultrasound
CT/MRI

Block 32- GI/surgery (9 decks)

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