Gastro/GI Flashcards
Cx of cirrhosis
CAVES
Coagulopathy Ascites Varices Encephalopathy SBP
Five F’s of abdominal distension
Fluid Flatus Feces Fetus Fat
PBC presentation (jaundice occurs late)
PPBBCCS
Pruritus Pigmentation of face Bones: osteoporosis, osteomalacia (reduced vit D) Big organs: HSM Cirrhosis and coagulopathy Cholesterol up Steatorrhoea
Raised ALP (= alkaline phosphatase)
ALKPHOS
Any fracture Liver damage K for Kancer Paget’s disease HyperPTH Osteomalacia Surgery
Causes of intrahepatic liver failure
3 C’s and 3 I’s
Chronic liver disease Carcinoma Congestive cardiac failure Immunological (PBC/PSC and AIH) Infiltrative (amyloid and myeloproliferative disorders) Infectious (HBV and HCV)
Signs of liver decompensation
3 A’s
Ascites
Asterixis
Altered mental state
Rule of 2s for Meckel’s diverticulum
2 inches 2 feet from the ileocaecal valve 2% of the population Presents in first 2 years of life 2 types of epithelial tissue
Hereditary haemocrhomatosis features
MEALS
Myocardial: dilated CM, Arrhyhtmias Endocrine: Pancreas DM, Pituitary, Parathyroid Arthritis Liver: CLD Skin: slate grey
Wilson’s disease
CLANK
Cornea - Kayser-Fleischer rings Liver disease Arhtiritis Neurological - Parkinsonism, psychos-s Kidney - Fanconi’s syndrome
Precipitants of portal hypertension
HEPATICS
Haemorrhage Electorlytes ( low K, Na) Poisons: diuretics, sedatives, anaethetics Alcohol Tumour: HCC Infection: SBP, pneumonia, UTI, HDV Constipation Sugar
Portal hypertension presentation
ACDCs
Asterixis, ataxia Confusion Dysarthria Constructional apraxia Seizure
Portal htn signs
SAVE
Splenomegaly
Ascites
Varices
Enphalopathy
Drug causes of gynaecomastia
Drug causes of gynaecomastia: SACKED
Spironolactone, alcohol, cimetidine, Ketoconazole Estrogen Digitalis
Signs of Cirrhosis
Signs of Cirrhosis: ABCDE
Asterixis, ascites Bruises Clubbing Dupuytren’s Erythema
Risk factors for pancreatic cancer
Risk factors for pancreatic cancer: SINED
Smoking Inflammation: chronic pancreatitis Nutrition: high fat diet EtOH DM
Acute Pancreatitis causes
Acute Pancreatitis causes: I GET SMASHED
Idiopathic Gallstones Ethanol Trauma Steroids Mumps Autoimmune Scorpion sting Hypercalcaemia ERCP DRUGS
Chronic pancreatitis causes
Chronic pancreatitis causes: AGITS
Alcohol
Genetic: CF, HH,
Immune: lymphoplasmacytic sclerosing pancreatitis
Triglycerides are raised
Structural: Pancreas divisum or obstruction by tumou
Presentations of Coeliac Disease
Presentations of Coeliac Disease: GLIAD
GI malabsorption: carbs, fat, protein, haematinics, vitamins Lymphoma and carcinoma Immune associations: IgA def., T1DM, PBC Anaemia Dermatological: dermatitis herpetiformis
Treatments of IBD
5-PC, 5-AI, CAMI
UC:
- 5-PC induction - 5-ASA, prednisolone, ciclosporin
- 5-AI maintenance - 5-ASA, Azathiprine, infliximab
CD:
- Corticosteroids, azathioprine, methotrexate, infliximab
Carcinoid Tumour
FIVE-HT
Flushing: paroxysmal, upper body and with or without wheals Intestinal: diarrhoea Valve fibrosis: TR and PS whEEze: bronchoconstriction Hepatic involvement: bypassed 1st pass metabolism Tryptophan deficiency: pellagra (3Ds) - Pellagra: - Diarrhoea - Dermatitis - Dementia
Haematemesis causes
Haematemesis: VINTAGE
Varices
Inflammation: oesophag-/gastr-itis or PUD (duodenal)
Neoplasia: oesophageal or gastric
Trauma: Mallory-Weiss tear (mucosal tear due to vomiting)
Boerhaave’s: full thickness tear 2cm proximal to LOS
Angiodysplasia and vascular anomalies: angiodysplasia, hereditary haemoragic telangectasia, Dieulafoy lesion (rupture of a large arteriole in stomach/bowel)
General bleeding: anticoagulants and chronic renal failure
Epistaxis
Rectal bleeding
DRIPPING arse
Diverticulae Rectal: haemorrhoids Infection: camply, shige, E. coli, C, diff, amoebiasis Polyps Inflammation: UC and Crohn's Neoplasia Gastric Upper Bleeding Angio: ischaemic colitis, HHT, angiodysplasia
Alcoholism screening tool
Alcoholism screening tool: CAGE
Felt you should Cut down?
People Annoyed you by criticising your drinking?
Guilty feeling about your drinking?
Eye opener needed?
Causes of liver failure
Causes of liver failure: VADAM Viral EtOH Drugs Autoimmune (PBC, PSC, AIH) Metabolic
Risk factors for cholecystitis
5 F’s
Fat Female Forty Fertile Fair
Glasgow score for acute pancreatitis
Glasgow score for acute pancreatitis: PANCREAS
PaO2 <6 Age >55 Neutrophils > 15 Calcium < 2 Urea > 16 Enzyme < 600 Albumin < 32 Sugar > 10
Release of enzymes in pancreatitis
Release of enzymes in pancreatitis: English Premier League
Elastases
Proteases
Lipases
Causes of Splenomegaly
Causes of Splenomegaly: MILD
Myeloproliferative - CML Infiltrative - Gaucher disease (deposition of glucocerebroside in cells of the macrophage-monocyte system) Lymphopriolferative - CLL Developing world - Malaria - Visceral Leishmaniasis
Causes of massive splenomegaly
Causes of massive splenomegaly: MMM
Malaria
CML
Myelofibrosis
and visceral leishmaniasis
Causes of constipation
Causes of constipation: OPENED IT
Obstruction Pain Anal fissure Proctalgia fugax Endocrine/electrolytes Hypothyroidism Reduced calcium, hypokalaemia, uraemia Neuro MS Myelopathy Cauda Equina Elderly Diet/dehydration IBS Toxins Opioids Anti-MAch
ALARM symptoms
ALARM symptoms
Anaemia Loss of wt. Anorexia Recent onset of progressive symptoms Melaena or haematemesis Swallowing difficulty
ABCD of alcoholism
Ascitic tap
B12 vitaimins
Chlordiazepoxide
Dietary requirements
Child-Pugh classification for grading of cirrhosis
Albumin Bilirubin Coagulopathy Distension (ascites) Encephalopathy
Causes for vomiting
ABCDEFGHI
AKI Brain (raised ICP) Cardiac (MI) DKA Ears Foreign substance Gravidity HyperCa2+/hyperNa Infection
Indications for splenectomy
HI RAT
Hyperslepnism/HS ITP Rupture AIHA Trauma
Differentials fo bilateral enlarged kidneys
Differentials fo bilateral enlarged kidneys: ABBA ADPKD Bilateral RCC (5%) Bilateral cysts (VHL) Amyloidosis
