Gastro Flashcards
What investigation would you perform for suspected chronic pancreatitis?
Faecal elastase
What is the tumour marker for pancreatic cancer?
CA19-9
42 yr old woman presents with crampy RUQ pain after a big curry night out with the lasses. She also has nausea and has vomited 3 times. Diagnosis?
Biliary colic
What symptoms form Charcot’s triad referring to acute cholangitis ?
RUQ pain
Jaundice
Fever (w rigors)
What is Murphy’s sign and what does it indicate ?
Pressure below costal margin mid clavicular line. When asked to beathe in patient winces and stops breathing in. Sign of Acute cholecystitis
Bowel obstruction, which causes more frequent colicky pain, large or small?
Small bowel (cycle every 2-3mins)
Large bowel cycles every 10-15mins
If a patient reports dark urine and pale stools, what is the likely diagnosis?
Obstructive Jaundice
What causes Leuchonychia?
Hypoalbuminaemia as a result of chronic liver disease
What is the twisting of the bowel called?
Volvulus
What are the A->J of chronic liver disease?
Asterixis Bruising Clubbing Dupytrens Erythema (palmar) Fetor Hepatticus Gynaecomastia Hair Loss Icterus Jaundice Leuconychia
What are the possible causes of abdominal distention ?
Fat Foetus Faeces Flatus Fluid (ascites)
What are the 3 C’s (+I) of hepatomegaly?
Cancer, Cirrhosis, Cardiac (CCF, pericarditis) Infiltration (Amyloid, Sarcoid, Haemochromatosis)
What are the 5 categories of liver disease cause?
Alcohol Autoimmune Drugs Viruses Biliary Disease
What are the 4 causes of splenomegaly?
Portal Hypertension
Haematological
Infection
Inflammation
List 5 causes of epigastric pain
Gastric Ulcer GORD Pancreatitis AAA Gastritis MI?
List 5 causes of RUQ pain:
Hepatits Cholecystitis Cholangitis Gallstones Abcess
What might be the clues on examination that this patient has obstruction ?
Nausea, vomiting, constipation.
High pitched, tinkling bowel sounds.
? Previous surgery
?Tender, irreducible femoral hernia in the groin
What is Courvoisier’s sign ?
A palpable gallbladder in the presence of painless jaundice is unlikely to be gallstones. Cholangiocarcinoma
What is the most appropriate prophylactic medication for preventing vatical bleeds?
Propranolol - This is the correct answer. A non-cardioselective β blocker (NSBB) is used for primary and secondary prevention of bleeding in oesophageal varices. They act by causing splanchnic vasoconstriction, reducing portal blood flow.
What drugs would you give in acute GI bleed?
Antibiotics Terlipressin (to cause splanchnic vasoconstriction )
What is the most specific tumour marker for colorectal cancer?
CEA (Serum Carcinoembryonic antigen)
What are the most common causes of LBO and SBO respectively?
SBO - Adhesions and hernias
LBO - Carcinoman and volvulus
