Gastro Flashcards
Where do you see a retrocardiac air-fluid level on CXR?
Hiatus hernia
How does infection with entamoeba histolytica present?
Parasitic infection
Faeco-oral transmission
Bloody diarrhoea initially
Then abdo pain and intermittent fevers
Occasionally amoebic liver abscess
What is Rovsing’s sign?
Palpation of the LLQ reproduces pain in the RLQ - seen in acute appendicitis
What is a perianal haematoma?
Rupture of a blood vessel beneath the anal skin
Red/purplish pea-sized lump at the anal margin
Painful, resolves over a few days
Which type of obstruction are most linked to incarcerated hernias?
Malignancy?
Hernia = SBO
Malignancy = LBO
Give three causes of pneumoperitoneum
Perforated viscus (e.g. ulcer)
Infection of the peritoneal cavity with gas-producing organisms
Introduction of air through female genital tract
Air under diaphragm on CXR
How does primary biliary cirrhosis present?
Middle-aged woman
Fatigue, pruritus, steatorrhoea, & jaundice
Xanthelasma, skin hyperpigmentation, hepato/splenomegaly
What is primary biliary cirrhosis?
Autoimmune disease of the liver with destruction of the bile canaliculi
How do we dx primary biliary cirrhosis?
Antimitochondrial antibodies
What is Courvoisier’s law?
In the presence of a palpable gallbladder, painless jaundice is unlikely to be caused by gallstones
(Think panc ca)
When can we dx Gilbert’s syndrome?
If increased bilirubin is <3x the upper limit of normal, and 1-3/12 later it hasn’t increased
Give two atypical sx of GORD
Coughing and wheezing (aspiration of gastric contents into tracheobronchial tree), hoarseness (irritation of vocal cords) and reflux (most common cause of non-cardiac chest pain)
What causes pre-hepatic portal htn?
Portal vein thrombosis
Which part of the bowel is the commonest site for a colorectal carcinoma?
Rectum
How do we investigate ? perforated peptic ulcer first line?
CXR - pneumoperitoneum (free air under diaphragm)
Then CT
