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Gastroenteritis Flashcards

1
Q

what can cause Angular Cheilitis?

treatment?

A

fungal infection, iron deficiency

it is self limiting and lip balm can work

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2
Q

what is another word for an ulcer?

A

apthous stomatitis

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3
Q

what do you look for when looking for an ulcer?

A

yellow surface (can scrape off)
red halo around ulcer
lasts a week

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4
Q

what can cause Oral Thrush?

A

inhaled steroids- beclomethasone as this has immunosuppresive effects leading to fungal infection

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5
Q

how do you treat oral thrush?

A

anti fungals

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6
Q

what does Lichen planus look like?

A

white lacy patches on areas of mucous membrane eg mouth

purple patches on skin

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7
Q

what are the ALARMS?

A

Anaemia, Loss of weight, Anorexia, Recent onset of PROGRESSIVE symptoms, masses or melena/ haematemesis, swallowing difficulty

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8
Q

what are the main things to look for when thinking of oral cancer?

A

smoker and or alchol drinker, IRREGULAR SHAPE, increasing in size
soft sites as high risk sites

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9
Q

what are the main types of HPV that can cause oral cancer?

A

HPV 16 and 18 (girls are often vaccinated against these)

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10
Q

where are the high risk sites for oral cancer?

A

soft sites eg ventral tongue, floor of mouth, lateral tongue, non keratinising sites

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11
Q

what are the main causes of chronic oesophagitis?

A

GORD and Crohn’s disease

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12
Q

what are the causes of acute oesophagitis?

A

chemicals and infection

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13
Q

what is allergic oesophagitis also called?

A

eosinophilic oesophagitis

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14
Q

how does allergic oesophagitis present?

A

similar to chronic oesophagitis

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15
Q

how do you differentiate between chronic and allergic oesophagitis?

A

do a pH probe test and if acidity is normal then its likely to be allergic oesophagitis
do bloods- if more eosinophils- allergic

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16
Q

what are the main causes of GORD?

A

pregnancy/ obesity (as abdominal pressure is increased)

Stress

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17
Q

what are the main symptoms of GORD?

A

heartburn, worse lying down, dysphagia (due to stricture formation)

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18
Q

what investigations would be done for GORD?

A 
PPI trial
Endoscopy to see if ulcer causing GORD
pH probe (if normal possibly allergic oesophagitis)
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19
Q

treatment of GORD?

A

smoking cessation, limit acidic foods, sit up in beds, weight loss
PPIs- omeprazole, lansoprazole

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20
Q

what do you use if PPIs are not too effective against stomach acid pH?

A

H2 antagonist such as Ranatidine

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21
Q

what is Barrett’s Oesophagus?

A

chronic reflux damaging the stratified squamous epithelium and thus they become simple columnar epithelium

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22
Q

is barrett’s oesophagus premalignant?

A

yes as the metaplasia means there is an increase chance of dysplasia

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23
Q

what type of cancer is barretts oesophagus premalignant to?

A

adenocarcinoma as it is the simple columnar epithelium (glandular epithelium)

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24
Q

how do you treat low grade dysplasia due to Barrett’s Oesophagus?

A

endoscopic radiofrequency ablation

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25
Q

how do you treat high grade dysplasia due to Barrett’s Oesophagus?

A

oesophagectomy

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26
Q

what can cause squamous cell carcinoma of the oesophagus?

A

HPV 16 or 18
Smoking and alcohol
Oesophagitis (due to chronic inflammation)

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27
Q

how do you confirm the presence of adenocarcinoma or squamous cell carcinoma?

A

endoscopic biopsy

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28
Q

what is a major symptom of oesophageal cancer?

A

PROGRESSIVE difficulty swallowing
hoarse voice (invasion of recurrent laryngeal nerve)
anaemia (due to small chronic bleed)

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29
Q

how is Oesophageal cancer staged?

A

TNM staging

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30
Q

what is TNM staging?

A

T- how far tumour has grown
N- how many lymph nodes affected
M- if there is metastasis or not

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31
Q

what are the main causes of Acute Gastritis?

A

chemicals and alcohol

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32
Q

what are the main causes of chronic Gastritis?

A

NSAIDs and H.pylori

aswell as alcohol and pernicious anaemia

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33
Q

what type of bacteria is H.pylori?

A

gram negative bacillus with flagella

34
Q

what relevant enzyme does H.pylori produce?

A

Urease (involved in pathway which causes ammonium production)

35
Q

how is H. Pylori transmitted?

A

faecal- oral

spread generally in infancy

36
Q

where in the stomach does H.Pylori live?

A

between the mucous and the epithelium

uses the mucous for protection

37
Q

what investigations can be used to determine presence of H.pylori?

A

Carbon 13 Urea breath test

FAT (faecal antigen test)

38
Q

what do Peptic Ulcers look like on Endoscopy?

A

ulcer with Clear Cut edges, punched out (not the same as cancer)

39
Q

how do NSAIDs cause peptic ulcer disease?

A

NSAIDs inhibit COX, thus inhibiting PGE1 and so there is an increase in Acid in Gastric Lumen so mucous membrane can break

40
Q

what are the main complications of Peptic Ulcer Disease?

A

Pain predominant Dyspepsia
Haemorrhage
Perforation (can cause peritonitis)

41
Q

what should be done prior to testing for H.pylori?

A

stop use of antibiotics and PPIs 2 weeks prior

42
Q

what is the triple therapy treatment for H.Pylori?

A

PPIs
Amoxicillin
Metronidazole/ Clarythromycin

43
Q

what are a few of the main risks of Gastric Cancer?

A

H.Pylori, Obesity, processed meats with high nitrates

44
Q

what is MALT lymphoma?

A

Gastric lymphoma, these can be cured by eradicating H.Pylori

45
Q

what particular lymph node can suggest Gastric cancer metaplasia?

A

Virchows lymph node

46
Q

what is Achalasia?

A

it is an Oesophageal motility disorder, the LOS does not open so food does not enter the stomach

47
Q

what is the biological cause of Achalasia?

A

degeneration of Myenteric Plexus (in the muscularis externa)

48
Q

is there peristaltic movement in Achalasia?

A

there is IMPAIRED peristaltic function

49
Q

what are some main symptoms of Achalasia?

A

vomiting structures (not churned in stomach)
chest pain
weight loss- no absorption in the stomach

50
Q

what investigations would you do for suspected Achalasia?

A

barium swallow- bird peak appearance
X-ray- shows dilated oesophagus
Endoscopy- to rule out cancer

51
Q

what is the management of Achalasia?

A

CCB and Nitrates to relax sphincter (not too effective and used when waiting for definitive surgery)

52
Q

what surgeries can young patients get for Achalasia?

A

Cardiomyotomy (Heller’s Myotomy)

53
Q

what treatments can older patients get for Achalasia?

A

balloon dilation (older patients may not be able to undergo surgery)

54
Q

what is Gastroparesis?

A

delayed gastric emptying

55
Q

what can cause Gastroparesis?

A

diabetes and chemotherapy

also smoking weed

56
Q

what are the general symptoms of Gastroparesis?

A

bloating, feeling of fullness, abdo pain

57
Q

what investigations would be done for Gastroparesis?

A

Manometry (see peristaltic movement if any)

Gastric emptying studies

58
Q

what is the management of Gastroparesis?

A

metoclopramide
nutritional support
implantable gastric stimulation

59
Q

what symptoms are evidence of an upper GI bleed?

A 
haematemesis= blood in vomit
melena= black, very foul smelling stool
60
Q

what are 4 things that can cause an upper GI bleed?

A

ruptured varices
ruptured ulcers
neoplasms
Mallory-Weiss Tear

61
Q

what is the treatment of Peptic Ulcer rupture bleeding?

A

Haemospray-1st line
Omeprazole- to stop acid from dissolving the formed clot
Eliminate H.pylori if caused by peptic ulcer
treat underlying cause- eg portal hypertension

62
Q

what are the 2 assessments to determine GI bleed severity?

A

Rockall Scoring System (RSS)

Glasgow Blatchford Bleeding Score (GBBS)

63
Q

Why is Terlipressin used n Acute Variceal Bleed?

A

it decreases blood flow in the Splanchic arteries by vasoconstriction

64
Q

what is the chronic long term treatment of high portal pressure?

A

transjugular intrahepatic portosystemic shunt

65
Q

what bacteria can you get from rice?

A

bacillus cereus

66
Q

what bacteria can you get from cream cake left on counter at room temp?

A

Staph Aureus

67
Q

what type of bacteria can you get from raw poultry that causes bloody D and V?

A

Camplyobacter

68
Q

what type of bacteria can be given from raw poultry, eggs and pet reptiles?

A

Salmonella

69
Q

what types of bacteria have a long incubation period?

A

shigella and E.coli 0157

70
Q

what bacteria comes from beef and can cause HUS?

A

E.coli 0157

71
Q

what bacteria comes from unhygienic food prep?

A

shigella

72
Q

what types of bacteria have a short incubation period?

A

bacillus cereus and staph aureus

73
Q

what types of bacteria have a medium incubation period?

A

camplyobacter and salmonella

74
Q

what is the shiga like toxin that comes from E.coli 0157?

A

Verotoxin (VTEC)

75
Q

what do shiga toxins do?

A

inhibit protein synthesis in certain cells eg renal cells

76
Q

what type of shiga toxin is more dangerous?

A

type 2 shiga toxin

77
Q

what bacteria is especially dangerous for Pregnant women?

A

Listeria

78
Q

how can you get Listeria?

A

soft cheeses, unpasturised milk, deli meats (FRIDGE FOOD)

79
Q

what is the incubation period for Listeria?

A

several months

80
Q

what virus is common in nurseries that causes non bloody diarrhoea?

A

Rotavirus

81
Q

what virus is common on cruise ships, nursing homes and wards and causes EXPLOSIVE Diarrhoea?

A

Notavirus

82
Q

what is the most common bacterial cause of Acute Travellers Diarrhoea?

A

Enterotoxigenic E.coli

GI (11 decks)

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