Formative Questions Flashcards
What is the pain called that is associated with gallstones?
Comes on an hour after eating?
Biliary colic pain
Why does the pain associated with gallstones typically come on about an hour after food?
This is usually the time it takes food in the form of chyme to reach the duodenum
Acidic Chyme detected by the I cells in the duodenum, they produce Cholecystokinin
Cholecystokinin stimulates the contraction of the gall bladder
This squeezing against the blockage/gallstone leads to further inflammation and pain
Why may a patient who has had gallstones in future present with worse abdominal pain that lasts for longer and a fever?
The gallstone gets lodged in the cystic duct leading to cholecystitis
This means the walls of the gallbladder are inflamed meaning a secondary infection can occur
What are some potential complications of a gallstone lodging in the proximal Common Bile Duct?
Post-hepatic jaundice
Cholangitis
What is cholangitis?
Inflammation of biliary system
What are some potential complications of a gallstone lodging in the distal Common Bile Duct?
Post-hepatic jaundice
Acute pancreatitis
What causes the liver enlargement with chronic alcohol abuse?
What are the 2 mechanisms that lead to this?
Fatty liver disease
NADH is a by product of alcohol metabolism which inhibits lipid breakdown
Ethanol inhibits the formation and secretion of lipoproteins
Why can chronic alcohol misuse lead to malnutrition and vitamin deficiencies?
Alcohol abuse can lead to pancreatitis which would lead to decreased production of digestive enzymes
Areas of the GI tract likely damaged decreasing its absorption ability
What leads to the development of oesophageal Varices in a person with chronic alcohol abuse?
Cirrhosis occurs
This leads to portal hypertension
This leads to a back pressure building up on the veins draining through the liver which includes the oesophageal veins
So there’s increased pressure in these portosystemic anaostomoses leading to their distension
What are 2 other locations of Porto-systemic anastomoses other than the oesophagus?
Umbilicus
Anorectal
What features can be seen during a colonoscopy with Chrons disease?
Skip like lesions
Cobblestone appearance
Strictures
What is the difference between strictures and adhesions?
Strictures = issues in line
Adhesions = where the peritoneum of different structures stick together
What histological finding is pathognomonic of Chrons?
Epithelioid granulomas
What are some Perianal pathologies that might by present in Chrons disease?
Haemorrhoids
Anal fissures
Opening of fistula
Perianal abcesses
Skin tags
Why is RLQ pain common with Chrons disease?
The terminal ileum is the most common place for chrons to affect and the terminal ileum is in the RLQ
