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Y3 > Gastro II > Flashcards

Gastro II Flashcards

1
Q

Symptoms of barrett’s

A

Waterbrash, Nausea, abLOATING, belching, Burning pain when swallowing

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2
Q

High grade dysplasia/ pre-malignant barrets management

A

oesophageal resection, eradicative mucosectomy

endoscopic targeted mucosectomy, mucosal ablation by epithelial laser, radiofrequency HALO or photodynamic ablation PD

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3
Q

Low grade barretts

A

annual endoscopic surveillance,

no premalignant changes: surveillance endoscopy and biopsy performed, anti reflux measures–PPI

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4
Q

Biliary colic is

A

Pain due to obstruction of gallbladder or common bile duct, usually by a stone. Felt in Upper abdomen- in the midline or the right.

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5
Q

Aetiology of biliary colic

A

Due to contractions of the biliary tree

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6
Q

4F’s risk factors to which condition

A

Biliary colic

Forty, female, fat, fertile, fair

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7
Q

Symptoms of biliary colic

A

Nausea, pain in Right UQ/epigastric pain, Pain may radiate to right scapula, pain does not fluctuate and has a tendency to persist

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8
Q

When may biliary colic patients present with pain

A

After having a fatty meal

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9
Q

Imaging for biliary colic and look for

A

US– dilatation of CBD, gallbladder wall may be thickened

ERCP- Diagnostic and therapeutic for stones, stent for blocked bile duct
CT may be useful if other forms of imaging have been insufficient

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10
Q

Management of biliary colic

A 
Analgesics
IV
NBM
Surgical: laparoscopic cholecystectomy
ERCP- Diagnostic and therapeutic for stones, stent for blocked bile duct

Complications of surgery–injury to bile duct, fat intolerance- due to inability to secrete large amounts of bile into intestine due to absence of gall bladder
Post cholecystectomy syndrome- presence of abdominal symptoms e.g dyspepsia

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11
Q

Cholecystitis is

A

Inflammation of the gall bladder

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12
Q

Types of stones with cholecystitis

A

Mixed: Contains cholesterol, calcium bilirubinate, phosphate and protein - due to imbalance between bile salts, phopholipids, cholesterol. nucleation factors and gallbladder

Pure cholesterol stones

Pigment stones:black stones made of calcium bilirubinate – formed due to increased bilirubin

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13
Q

Risk factors of cholecystitis

A

Diabetes mellitus, Drugs (OCP, Octreotide) Family history

Pigment stone RF: Haemolytic disorders

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14
Q

Presenting symptoms of cholecystitis

A

Systemically unwell, fever, prolonged abdominal pain, pain may be referred to right shoulder

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15
Q

Signs of cholescystitis

A

Murphy’s sign
RUQ pain or epigastric tenderness
Tachycardia
Pyrexia

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16
Q

Bloods for cholecystitis

A

High WCC: in cholecystitis and cholangitis
LFT: High ALP and GGY in ascending cholangitis
Blood cultures, Amylase to exclude pancreatitis

17
Q

Imaging for cholecystitits

A

USS-shows gallstones
Increased thickness of gallbladder wall
Dilation of biliary tree

AXR-but only 10% are radio opaque

18
Q

Management for cholecystitis

A

Mild/Conservative: Low-fat diet

Medical:
NBM
IV fluids
Analgesia
ANTI EMETICS
ANTIBIOTICS-if infection is present, if symptoms persist despite this suspect a localised abscess or empyema

If obstruction is present-urgent biliary drainage by ERCP

Surgical:
laparoscopic cholecystectomy

19
Q

Complications of stones within the gallbladder

A

Biliary colic
Cholecystitis
Gallbladder empyema
Gallbladder cancer

20
Q

Complication of stones outside the gallbladder

A 
Obstructive jaundice
Pancreatitis
Ascending cholangitis
Cholecystoduodenal fistula
Gallstone ileus
Bouveret syndrome - Gallstones cause gastric outlet obstruction
Mirizzi syndrome
21
Q

Complications of Cholecystectomy

A 
Infection
Bleeding
Bile leak
Post cholecystectomy syndrome
Port-site hernia
22
Q

Decompensated cirrhosis

A

Ascites, Jaundice, Encephelopathy, GI bleed

23
Q

Decompensation precipitated by

A

infection, GI bleeding, constipation, high protein meal, electrolyte imbalances, tumour development or portal vein thormbosis

24
Q

Risk factor drugs for cirrhosis

A

Methotrexate hepatoxic drugs

25
Q

Inherited risk factors of cirrhosis

A 
Galactosaemia
a1 anti trypsin deficiency
Haemochromatosis
Cystic Fibrosis
Wilson's disease
26
Q

Vascular causes of risk factors

A

Budd chiari syndrome

Hepatic venous congestion

27
Q

Chronic Biliary disease

A

PBC, PSC, Biliary atresia

28
Q

Condition that causes cirrhosis

A

NASH- TOTAL PARENTAL NUTRITION, SHORT BOWEL SYNDROME,DIABETES, obesity, hyperlipidaemia– assoc with tamoxifen and amiodarone

Y3 (4 decks)

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