GASTRO Flashcards
Oesophageal cancer
Description and clinical features
squamous or adenocarcinoma. Poor prognosis. Local spread more than mets. Characterised by progressive dysphagia
Oesophageal ulcer
(description + CFs)
rare but often fatal. Side effect of slow release potassium tablets (hence use soluble instead). Characterised by sudden pain.
Oesophageal stricture
(description + CFs)
characterised by dysphagia
Oseophageal candidiasis
(description + CFs)
thrush, common in immunosuppression but can happen to anyone. Causes painful dysphagia and may have oral thrush
Oesophageal dysmotility
(description + CFs)
is a functional problem. Symptoms include dysphagia and pain.
Oesophageal varices
(description + CFs)
dilated veins at the jn btw portal and systemic venous systems. Usually caused by portal HTN. There might be no symptoms/haematemesis/death.
Barrett’s oesophagus
(description + CFs)
normal distal squamous epithelial lining has been replaced by metaplastic columnar epithelium. Caused by GORD. No symptoms but increased risk of cancer.
Oesophageal perforation
(description + CFs)
Usually caused by surgical procedures. First symptom is pain and causes internal blood loss.
Hiatus hernia
(description + CFs)
A hiatus hernia describes the protrusion of an organ from the abdominal cavity into the thorax through the oesophageal hiatus, typically the stomach. Burning epigastric pain, which is made worse by lying flat.
Causes of Oesophageal Weakness
description and clinical features
could be muscular cause (muscular dystrophy) or neurological (guillain-barre syndrome, stroke, cancer) or injury
Gastritis
description and clinical features
caused by infection, acid, stress, H. pylori. There can be no symptoms but can also have pain, nausea and vomiting.
Gastric cancer
description and clinical features
carcinoma/adenocarcinoma. Some may be lymphomas.
Symptoms: loss of appetite, WL, dypepsia, nausea, vomiting
Common Bile duct inflammation
description and clinical features
cholangits, usually polymicrobial infection, often caused by obstruction (stone/cancer) or by ERCP.
Charcout’s triad: RUQ pain, fever and jaundice. Very unwell.
What is obstruction of common bile duct by a stone called
choledocholithiasis
What is cancer of the common bile duct called and what are the symptoms?
Cholangiocarcinoma
Jaundice, WL, anorexia, abdo pain
What type of cancer affects the ampulla of vater and symptoms
cholangiocarcinoma. Prognosis is a bit better than other periampullary cancers (other cholangiocarcinoma or pancrea ca)
Pancreatic cancer
description + symptoms
Mostly adenocarcinoma.
Symptoms: head of pancreas (painless, progressive, obstructive jaundice)
Body and tail of pancreas: non-specific pain and weight loss
Acute pancreatitis
description + symptoms
acute inflammation of the pancreas, releasing exocrine enzymes that cause autodigestion of the organ.
Acute vomiting, severe LUQ pain/radiation to back, upper abdo tenderness, sometimes guarding. Can cause shock.
Diagnosis: serum amylase 3x normal (but serum lipase more sensitive and specific)
Chronic pancreatitis
description + symptoms
causes permanent damage. Abdo pain and loss of pancreatic fn.
Severe epigastric pain radiating to back, N&V, decreased appetite, exocrine dysfn, malabsorption + WL, steatorrhea. Can lead to DM.
Coeliac disease
description + symptoms
Immune mediated gluten intolerance. Causes subtotal villous atrophy of small bowel and malabsorption
Often diagnosed after years of symptoms. Symptoms include abdo pain, WL, iron/B12/folate deficiency, IBS symptoms, diarrhea, mouth ulcers.
Small bowel obstruction
description + symptoms
could be caused by adhesions/intussuception. Abdo pain and bloating, vomiting. Increased bowel sends and then absent bowel sounds.
PROCHLORPERAZINE
CYCLIZINE
METACLOPRAMIDE
ORDANSENTRON
MACROGOL (MOVICOL)
DOCUSATE
GLYCERIN SUPPOSITORY
PHOSPHATE ENEMA
GAVISCON
RANITIDINE
LOPERAMIDE
HYOSCINE
MEBEVERINE
SULFASALAZINE/MESALAZINE
AZATHIOPRINE
