Gastric / Abdo Related

Question 1

What is Crohn’s disease
Pathophysiology + Common symptoms

Answer 1

ulcers and inflammation from anywhere from mouth to anus - affecting any thickness of the bowel
- normally patchy areas + often affects small intestine

D and v with right lower abdomen pain

Rlq pain, bloody diarrhoea, due to ulcer affecting full lining,

Question 2

What is sickle cell disease
Pathophysiology + Common symptoms

Answer 2

Abnormal shaping of red blood cells
Causing reduction of oxygen pickup
Clotting and problems of blood cells going through vessels

Prehospital treatment equals pain relief

Question 3

What is adrenal crisis ( Addison crisis)
Pathophysiology
Common symptoms
Treatment plan

Answer 3

Damage to the adrenal glands
Causing a reduction in aldosterone (allowed raas - K+ out with na+ and water in) and
cortisone ( break down of protein and fatts into glucose )

Fatigue + hyperkalemia + hypotension + D&V + abdo leg back pain + patchy hyperpigmentation

Hydrocortisone + fluids + glucose (if indicated)

Question 4

What is diverticulitis
Pathophysiology + Common symptoms

Answer 4

1) out pouches from the bowel - muscle layer normally weak whereby blood gets in - gets weaker over time ( can get infected with poo and cause problems )

2) pain in left lower quadrant ? Temp and abnormal bowel movement

3) fluid , pain relief, convay if diaheria or fever

Question 5

What is constipation
Pathophysiology + Common symptoms

Answer 5

Reduced poo movement - dehydration = due to intake ( large intestine causes further water suck up = rocks )
Swollen abdomen - rigid and non tender
Irregular bowel activity
Excess wind
Small pellets of poo
Any overflow

Question 6

What is an appendicitis
1)Pathophysiology
2)Common symptoms
3) signs
4) treatment

Answer 6

1) inflammation or infection of the appendix due to blockage (poo). Mucus production naturally + bacteria = swelling which compress blood supply = rupture

2) nausea and vomiting, middle pain which end up in the lower right quadrant, fever,

3) rosvings sign( left to right) + McBurney sign ( rebound tenderness)
Obturators sign ( bend knee to 90 degrees internal rotation)
Blumbergs sign ( deep press and release increase pain on release)
Cough or jump causes pain

4) anti sickness, pain relief and convay

Question 7

What is hepatitis
Pathophysiology + Common symptoms

Answer 7

Normally a viral infection that affects the liver or maybe through excess alcohol usage leading to cirrhosis ( scaring of the liver )

2) fatigue, weight loss, pain, jaundice, palpable mass ( hemotomegaly)

Question 8

What is kidney stones
Pathophysiology + Common symptoms + treatment plan

Answer 8

1) higher solute to solvent ratio= solute filters out becomes crystals = increase crystals = harder = stones
2) flank pain, UTI symptoms
3) pain relief, anti- emetics, antibiotics ( high chance of infection) convey

Question 9

What is a UTI( urine tract infection)
1)Pathophysiology
2)Common symptoms
3) treatment ✅

Answer 9

1) bacteria infection of urinary tract reither upp ( phylopheritis- kidney or ureta) or lower ( cystitis - bladder or urethra )

2) dark or strong smelling pee, pain/ stinging/ burning when peeing, blood in urine - Murphy punch

3) antibiotics - hospital /GP

Question 10

What is acute cholecystitis
Sign and symptoms - duration
Diagnostic tool ( prehospitally + how 2conduct)

Answer 10

1) infection o inflammation of gallbladder due to blockage due to gallstones blocking cystine duct due to big stone = high cholesterol or reduced motility ( 6hour plus pain )

2) RUQ pain, pyrexia , shoulder tip pain
3) Murphy’s sign - push in ask them to breath

Question 11

What is acute pancreatitis
1) pathophysiology
2) command symptoms
3) treatment plan

Answer 11

1) autodigestion of the pancreas due to premature enzymes activation (PEA).
Alcohol- causes excess release of (PEA) and reduce fluid and bicarb = sludgy pancreatic juice = blockage ( GALLSTONES have similar effects) @ cell increase juice = increase pressure = squashed membrane = release of lysosomes ( go to PEA ) = activation
= Pancreas destruction = inflammation and blood, leaky vessel

2) epigastric/ LUQ pain, upper back pain, hypotension, Cullen/ grey turner signs, painful palable mass, nausea, dehydration

3) fluids, pain relief convay to hospital

Question 12

What are the signs of upper GI bleeding

Answer 12

Hematasis - vomit blood
- coffee grounds ( digested )

Question 13

What is the signs for lower GI bleed

Answer 13

Melena ( pooy blood)

Question 14

What is general IBS alongside the symptoms ( irratible bowel syndrome) + name the condition under the umbrella of IBS

Answer 14

1)abnormal bowel movement or disturbance with often pain without any detectable bowel abnormality

2)abdo pain relived by going to the toilet, poo has changed in texture or frequency + bloating.

3) Crohn’s + ulcerative colitis

Question 15

What is gastroenteritis + pathophysiology
2) signs and symptoms
3) treatment plan

Answer 15

Commonly stomach flu causes d and v caused by the noravirus and rotavirus in kids

D and v, loss of appetite and fever
Get better after a few days

Fluid in dehydration, analgesia , anti emetic only after 3 days

Question 16

What is ulcerative colitis
Comman symptoms

Answer 16

Inflammation due to ulcers - affecting large bowel, with LLQ pain, that’s continuous left to right, affect 1/2 bowel thickness, with red bloody diarrhoea

• -ulcers in the large intestine and colon which is continuous
• left sides pain with bloody diarrhoea
• it’s under the cover - inner most intestine are affected

Question 17

What is peritonitis
2) signs and symptoms
3) treatment

Answer 17

Inflammation of the peritoneum due to infection
1) primary spontaneous = bacteria entering
2) secondary = perforation ( appendix, cholecystitis, diverticulitis, )

Signs = reduced bowel sounds due to edema, pain on movement ( even breathing), blumberg positive, fever tachycardia or tachypnea = sepsis

3) convay, pain relief, antiemetic, ? alert if septic

Question 18

What is a AAA typical symptoms
Pathophysiology
Symptoms

Answer 18

Abdominal aortic aneurysm ( there is a dilation of the decending aorta = increased elasticity or epithelial cell lossage.

Risk factor = age (60+), male, cardiovascular disease, marfin syndrome.

PT normally asymptomatic with a pulsating abdominal mass

Question 19

What is biliary colic
1) pathophysiology
2) treatment plan

Answer 19

It’s the same as acute cholecystitis but less than 6 hours pain normally gallstones goes backwards, no inflammation as no time to build up
No fever

2) treat as acute cholisistitis - as you can’t stay for 6 hours ( pain relief, anitemtics, convay)

Question 20

What is cholangitis

Answer 20

Gallstone blockage of command bile duct causes no bile flow = backwards flow to liver into blood causing Jaundice all other symptoms of acute cholecystitis but ** increased risk of infection**

Reynold pentard
Charlots triad

Question 21

What is chronic pancreatitis
1) pathophysiology
2) command symptoms
3) treatment

Answer 21

1) same as acute pancreatitis but body tries to rebuild = fibrous tissue + alcohol ( calcium fixation )= decrease diameter of ducts. This causes decrease pancreatic juice outage + damage to acner cells = decreased enzymes = undigested food

2) smelly greasy( white) poo, weight loss, new onset diabetes, and same symptoms as acute = epigastric /LUQ / UPPER back pain, nausea vomiting, fever, hypotension

3) pain relief, fluids if required, convay/ ( ? Cardiac / )

Question 22

What are the causes of bowel obstruction they are 4

Answer 22

1) function issue - nerve issue = low mortillity

2) extramural ( outside bowel cavity ) = adhesions, hernias volvulus, diverticuli

3) mural ( chrons, intrassusserptions- bowel into bowel like telescope)

4) intraluminal ( forgein body, fecal impaction)

Question 23

What is bowel obstruction
1) simple pathophysiology
2) signs and symptoms
3) treatment

Answer 23

1) extramural, intramural, intraluminal

2) distension, no flatus, hyper/hypo/ no bowel sounds, abdo pain cramping, fecal vomiting

3) pain relief, fluids, convay

Question 24

What is Chronic ischemic bowel disease
1) pathophysiology
2) command symptom
3) treatment plan

Answer 24

Also known as bowel angina
1) atherocrosis of the arterys leading to bowel ( mesierial/ celecia artery)

2) pain that starts 30 minutes after eating lasting 1-2 hours, cramping pain, weight loss.

3) pain relief, ?convay

Question 25

What is acute ischemic bowel
1) pathophysiology
2) common symptoms + risk factor
3) treatment plan

Answer 25

1) a sudden blockage of ones or more arterys leaving to the intestine, due to a clot or thrombus.

2) sudden severe abdominal pain, ending up in LLQ, with no known cause. Late sign is peritonitis AF is a key risk factor

3) pain relief, alert 🚨🚨

Question 26

What is a peptic ulcer/ gastitis
1) pathophysiology
2) signs and symptoms
3) treatment plan

Answer 26

1) stomach has a natural mucus lining stop it becoming ingested by hydrochloride acid- prolonged NSAID usage - prostaglandin= less blood, bacteria, stress ( alcohol, spice) increases acid production. This erodes the lining causing gastris leading to inflammation thus ulcers ( duodenal / stomach).

2) epigastric burning pain, vomiting, heamptosis leading to shock in extreme cases . Ulcer = stomach if eating makes it worse and eating makes it feel better it’s duodenal.

3) pain relief through decreasing acidity so convay

Question 27

What are the signs and symptoms of a ruptured AAA( Abdominal Aeotic Aneurism)

2) treatment plan

Answer 27

1) severe tearing abdominal pain, lower back pain, pulsating mass, Hypovolemic Shock ( tachycardia, -tachypnea, -cool periphery, -increased CBR, -Lower limb mottling, - no femoral, pedal pulse, Significant difference in Bilateral BP.

2) 15L O2.
- defib pads,
- Bilateral Cannulation. - TXA if under 3 hours
-fluids ( maintaining permissive hypotension,( radial or 90mmgh systolic))
Pre- Alert 🚨🚨🚨🚨🚨🚨🚨🚨🚨

Question 28

1) What is pelvic inflammatory disease
2) signs and symptoms
3) treatment plan

Answer 28

1) bacterial infection of mucosa/ epithelial tissue of uterus, flopian tube, overlies - clamedia or ghornarea, causes scar tissue and adhesions

2) abdo pain ( lower), fever, vaginal discharge ( abnormal = green yellow or smelly)

3) antibiotics, pain relief ( convay/ gp)

Question 29

What is a hernia
Pathophysiology,
Test for hernia
Comman symptoms

Answer 29

A part of bowel that protrudes out of the muscle lining of the abdomen.
Named based upon where they are

2 tests = coughing makes them visible + Lying down makes them disappear

2) abdo pain / distension, / constipation,/ vomiting

Question 30

What is CKD/ AKI
pathophysiology
Comman problems
Condition associated to consider

Answer 30

Decreased kidney function ( 3 months +=CKD, LESS = AKI)
- Causes = hypertension, diabetes, obstruction
2) hyperkalemia, hypocalcemia, high urea, reduce RBC production

3) arrithmas, brittle bones, anemia

Question 31

What is clostridium difficile CDIFF

1) pathophysiology - transfers via ….
2) comman symptoms
3) treatment = what should I do

Answer 31

1) anaerobic gutt bacteria = HIGHLY CONTAGIOUS transmitted via spores in feces

2) normally asymptomatic But PT takes antibiotics or omprozole = bacteria range drop = cdiff highly
Abdo pain + D&V —– Fever tachycardia, hypotension, dehydration

3) antibiotics or poo swap, PT should stay isolated till 24 hours after last diarrhea
Wash hands = stop contamination

Question 32

If you have a patient with renal colic pain who is over 50yrs old
What should you suspect and aim to rule out

Answer 32

AAA

Question 33

In a patient who is a child has abdo pain
You aim to VNR, when parents mention ot has vomited, what must you check in terms of character of the vomit before VNRing

Answer 33

Any child with Bile based vomit ( green) should be conveyed

Question 34

What is alcoholic pancreatitis
1) risk factor - what can it cause
2) symptom
3) treatment plan

Answer 34

1)Any intake of alcohol for chronic users can cause severe inflammation of the pancreas due to normal pathophysiology

2)Any abdo pian or nausea

3) pain relief, antimetics Convay

Question 35

Mallory Weiss
1) pathophysiology
2) command symptom

Answer 35

1) tears to the mucosa @ oesophagus @ cardiac spincter due to prolonged vomiting/ retching/ alcohol usage

2) epigastric pain, vomiting, bloody vomit, and Malèna

Question 36

What is alcoholic ketoacidosis
1) pathophysiology
2) symptoms
3) treatment plan **

Answer 36

1) malnutrition = decreased glucose +decreased hormone production
- alcohol affect liver = incomplete breakdown = affect cell = mitochondria
- illness or PT stop eating drinking = significant glucose drops
Fat stores activated = keystones

Vomiting/ dehydration = further acidosis

2) abdo pain + vomiting + (keystones despite normal glucose readings)

3) convay + fluids + Pre-Alert