Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 3 Gastro > Gastro Presentations > Flashcards

Gastro Presentations Flashcards

1
Q

Abdominal distention

A 
Coeliac disease
IBS
Volvulus
Hepatocellular carcinoma
Portal hypertension
Ascites
Intestinal ischaemia
Intestinal obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Abdominal mass

A

Anal/PR

  • Colorectal cancer
  • Perianal abscess/fistulae

Epigastric/RUQ

  • Cholangiocarcinoma
  • Pancreatic cancer
  • Gastric cancer

Other

  • Appendicitis
  • Femoral hernias
  • Intestinal ischaemia
  • Intestinal obstrution
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Common differentials for acute abdomen

A 
Adhesions
Incarcerated/strangulated hernia
Cholecystitis
Perforated gastric ulcer
Appendicitis
Ectopic pregnancy
Pelvic inflammatory disease
Acute pancreatitis
Acute diverticulitis
Ulcerative colitis
Crohn's disease
Cholelithiasis
Gastrointestinal malignancy
Mallory-Weiss tear
Diabetic ketoacidosis
Opioid withdrawal
Hepatitis
Gastroenteritis
Infectious colitis
Sickle cell crisis
Endometriosis
Testicular torsion
Kidney stones
Pyelonephritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Common differentials for ascites

A 
Hepatitis C
Alcoholic liver disease
Congestive heart failure
Nephrotic syndrome
Pancreatitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does colonic bleeding typically present?

A

Bright red or dark red blood per rectum

Rarely meleaena

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does colonic bleeding rarely present as melaena?

A

Blood in the colon has a powerful laxative effect and is rarely retained long enough for transformation to occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How can you generally differentiate between right-sided bleeds and left sided?

A

Darker coloured - right-sided

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the presenting features of colitis?

A

Bleeding may be brisk in advanced cases, diarrhoea is commonly present. Abdominal x-ray may show featureless colon.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the presenting features of diverticular disease?

A

Acute diverticulitis often is not complicated by major bleeding and diverticular bleeds often occur sporadically.

75% all will cease spontaneously within 24-48 hours. Bleeding is often dark and of large volume.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the presenting features of colonic cancer?

A

Bleeding may be first sign of disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the presenting features of hemorrhoidal bleeding?

A

Typically bright red bleeding occurring post defecation.

Although patients may give graphic descriptions bleeding of sufficient volume to cause haemodynamic compromise is rare.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the indications for surgery for a lower GI bleed?

A

Patients > 60 years
Continued bleeding despite endoscopic intervention
Recurrent bleeding
Known cardiovascular disease with poor response to hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the surgical intervention for GI bleeds?

A

Selective mesenteric embolisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the clinical features of an upper GI bleed?

A

Haematemsis (most common)
Melena
Raised urea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the presenting features of oesophageal varicies?

A

Usually a large volume of fresh blood.
Swallowed blood may cause melena.
Often associated with haemodynamic compromise.
May stop spontaneously but re-bleeds are common until appropriately managed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the presenting features of oesophagitis?

A

Small volume of fresh blood, often streaking vomit. Malena rare.
Often ceases spontaneously.
Usually history of antecedent GORD type symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the presenting features of a Mallory-Weiss tear?

A

Typically brisk small to moderate volume of bright red blood following a bout of repeated vomiting. Malena rare. Usually ceases spontaneously.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the oesophageal causes of GI bleeds?

A

Oesophageal varicies
Oesophagitis
Cancer
Mallory Weiss Tear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the gastric causes of GI bleeds?

A

Gastric ulcer
Gastric cancer
Dieulafoy lesion
Diffuse erosive gastritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the presenting features of gastric ulcers?

A

Small low volume bleeds are more common so would tend to present as iron deficiency anaemia.

Erosion into a significant vessel may produce considerable haemorrhage and haematemesis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the presenting features of gastric cancer?

A

Frank haematemesis or altered blood mixed with vomit

Prodromal features of dyspepsia and may have constitutional symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is a dieulafoy lesion?

A

An arteriovenous malformation typically found in the stomach

Presents with haematemesis and melena

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the presenting features of diffuse erosive gastritis?

A

Usually haematemesis and epigastric discomfort. Usually there is an underlying cause such as recent NSAID usage.
Large volume haemorrhage may occur with considerable haemodynamic compromise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the duodenal causes of GI bleeds?

A

Duodenal Ulcer

Aorto-enteric fistula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Where are duodenal ulcers found? Why does this cause bleeding?

A

Posteriorly sited and may erode the gastroduodenal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the presenting features of duodenal ulcers?

A

haematemesis, melena and epigastric discomfort

pain occurs several hours after eating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is an aorto-enteric fistula?

A

In patients with previous abdominal aortic aneurysm surgery aorto-enteric fistulation remains a rare but important cause of major haemorrhage associated with high mortality.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How can you risk assess upper GI bleeding?

A

use the Blatchford score at first assessment, and

the full Rockall score after endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is taken into account in the Blatchford score?

A

Urea ‘protein’
Haemoglobin low
BP low
Pulse high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How are GI bleeds managed?

A

Wide-bore IV access
Platelet transfusion if actively bleeding
FFP if low fibrinogen or high PT/APTT

Endoscopy after resuscitation (within 24 hours)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How do you manage variceal bleeding?

A

Prophylactic Abs
Band ligation and injections of N-butyl-2-cyanoacrylate
Transjugular intrahepatic portosystemic shunts (TIPS)

32
Q

What can cause dark stool?

A

GI bleeding

Vitamin K deficiency

33
Q

What can cause pale stools?

A

Hepatitis

Obstructive jaundice

34
Q

What are the presenting features of PUD? Duodenal

A

Epigastric pain relieved by eating

35
Q

What are the presenting features of PUD? Gastric

A

Epigastric pain worsened by eating

36
Q

What are the presenting features of appendicitis?

A

Pain initial in the central abdomen before localising to the right iliac fossa
Anorexia is common
Tachycardia, low-grade pyrexia, tenderness in RIF
Rovsing’s sign: more pain in RIF than LIF when palpating LIF

37
Q

What are the presenting features of acute pancreatitis?

A

Usually due to alcohol or gallstones
Severe epigastric pain
Vomiting is common
Examination may reveal tenderness, ileus and low-grade fever
Periumbilical discolouration (Cullen’s sign

38
Q

What are the presenting features of biliary colic?

A

Pain in the RUQ radiating to the back and interscapular region

May be following a fatty meal

Obstructive jaundice may cause pale stools and dark urine

Female, forties, fat and fair

39
Q

What are the presenting features of acute cholecystitis?

A

History of gallstones symptoms
Continuous RUQ pain
Fever, raised inflammatory markers and white cells
Murphy’s sign positive (arrest of inspiration on palpation of the RUQ)

40
Q

What are the presenting features of diverticulitis?

A

Colicky pain typically in the LLQ

Fever, raised inflammatory markers and white cells

41
Q

What are the presenting features of AAAs?

A

Severe central abdominal pain radiating to the back
Presentation may be catastrophic (e.g. Sudden collapse) or sub-acute (persistent severe central abdominal pain with developing shock)

42
Q

What are the presenting features of intestinal obstruction?

A

History of malignancy/previous operations
Vomiting
Not opened bowels recently
‘Tinkling’ bowel sounds

43
Q

Define constipation

A

Infrequent stools (< 3 times weekly), difficult stool passage (with straining or discomfort), or seemingly incomplete defecation

44
Q

What are the possible complications of constipation?

A

overflow diarrhoea
acute urinary retention
haemorrhoids

45
Q

What are some causes of constipation?

A 
IBS
Rectal prolapse
Volvulus (absolute)
Obstruction (absolute)
Appendicitis
46
Q

What can cause reduced appetite?

A 
Hepatocellular carcinoma
Depression
Medication side effect
Stomach ulcers
Crohn's 
UC
Coeliac disease
Gastroenteritis
47
Q

What are some causes of groin masses?

A 
Herniae
Lipomas
Lymph nodes
Undescended testis
Femoral aneurysm
Saphena varix
48
Q

What are key questions to ask when investigating a groin lump?

A

Cough impulse?
Pulsatile and expansile?
Are both testes intrascrotal?
Signs of malignancy/infection? (lymph nodes)

49
Q

How would a lipoma present?

A

Soft, small, superficial lump

50
Q

How are groin lumps diagnosed normally?

A

Clinically

If not clear then via US

51
Q

When is an urgent surgical assessment necessary for a groin lump?

A

Suspected:
Strangulation of hernia
Pseudoaneurysms of the femoral artery

52
Q

How many lymph nodes are present in the groin region?

A

1-2 deep inguinal lymph nodes

Roughly 11 superficial

53
Q

What medications can cause meleana?

A

Blood thinners e.g Warfarin or Asprin

Iron tablets

54
Q

What are the 2 general mechanism of nausea and vomiting?

A

Neurological

Peripheral

55
Q

What are the features of neurological nausea?

A

Stimulation of area postrema that sense noxious chemical agents

Evokes nausea

Co-ordinates the emesis reflex

OR

Diseases of the CNS e.g. infection or tumour evoke N+V via vagal pathways

56
Q

What are the features of peripheral nausea?

A

Diseases etc. that originate in peripheral organ systems e.g. GI tract

Again stimulate vagal efferent motor nuclei

57
Q

What are common differentials for nausea and vomiting?

A 
Gastritis
GORD
PUD
Acute gastroenteritis
Food poisoning
Chronic post-viral
Migraine
Motion sickness
BPPV
Stroke 
Hypercalcaemia
Hypothyroidism
Small bowel/colon obstruction
Choledocholithiasis
Cholecystitis
Post-GI surgery
Severe constipation
Irritable bowel syndrome
Anorexia/Bullimia nervosa
Pregnancy
Drug-induced
58
Q

What are urgent presentations of splenomegaly?

A

Sudden pain
Splenic sequestration crisis of sickle cell anaemia
Splenic/Portal vein thrombosis

59
Q

What are some common differentials for splenomegaly?

A 
Alcohol induced
Hepatic steatosis
Primary biliary cholangitis
Haemochromatosis
Hodgkin's lymphoma
AML
CML
Polycythemia Vera
RA
Malaria
Thalassaemias
60
Q

Define pruritus

A

an unpleasant sensation that causes a desire to scratch

61
Q

What defines chronic pruritus?

A

Pruritus lasting >6 weeks is defined as chronic pruritus

62
Q

What are some common differentials for pruritus?

A 
Atopic dermatitis
Urticaria
Insect bite
Psoriasis
CKD
Depression
Schizophrenia
63
Q

What is rectal prolapse associated with?

A

Associated with childbirth and rectal intussceception.

May be internal or external

64
Q

What is rectal prolapse?

A

e last part of the rectum or bowel

becomes stretched and protrudes (bulging) from the bottom (anus)

65
Q

What are the 3 types of rectal prolapse?

A

Full thickness - protrusion of the full thickness of the rectal wall through the anus.

Mucosal prolapse - the rectal mucosa (not the entire wall) from the anus.

Internal prolapse - a part of the intestine which folds into the
section next to it.

66
Q

What can cause rectal proplase?

A 
age
chronic constipation
straining
pregnancy / child birth
poor bowel control
neurological disorders, for example, Dementia
weakness of the pelvic floor
67
Q

What are the symptoms of rectal prolapse?

A 
mucus discharge
bulging on straining
sensation of incomplete bowel motion
faecal incontinence
anal pain
constipation
rectal bleeding
68
Q

What is the mangement for rectal prolapse?

A

Delorme’s procedure

69
Q

Define dysphagia

A

difficulty with the act of swallowing solids or liquids

70
Q

What are common differentials for dysphagia?

A 
Pharyngitis (throat pain)
Oesophageal candidiasis
Stroke
Oesophageal spasm
GORD
Hiatus hernia
71
Q

What are the 2 mechanisms of N+V?

A

Neurological

Peripheral

72
Q

What causes neurological N+V?

A

Stimulation of the area postrema, which ‘senses’ noxious chemical agents

Stimulates the vagal nuclei which evokes the emesis reflex

73
Q

What causes peripheral N+V?

A

Peripheral disorders e.g. GI stimulate vagal or spinal afferent nerves that conect with the vagal sensory

Tumours, infections, drugs

74
Q

What are some common differentials for vomiting?

A 
Gastritis
GORD
PUD
Gastroenteritis
Food poisoning
Post-viral
Migraine
Motion sickness
BPPV
Storke
Hypercalcaemia
Cholecystitis
IBS
Anorexia/Bulimia
75
Q

What can be the consequence of a misplaced NG tube?

A

Aspiration pneumonia and death

many hospitals now require a radiologist to report on these x-rays before the NG tube can be used

Year 3 Gastro (39 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions