Gastroenterology Flashcards
What is Barret’s Oesophagus?
It is seen in patients with long standing GORD. Leads to changes in epithelium which can lead to oesophageal adenocarcinoma.
Patients are given high dose PPI and endoscopy
What are the risk factors for clostridium difficle infection?
- Treatment with broad spectrum antibiotics,
- Stay in healthcare setting,
- Over 65 years old,
- Weakened immune system
- Taking a proton pump inhibitor
What are the symptoms of acute pancreatitis
- Stabbing epigastric pain which radiates to the back. Relieved by sitting forward or laying in the foetal position
When should you be suspicious of acute pancreatitis and what investigations are needed?
If there is a history of an alcohol binge or gallstones.
Investigate by looking at lipase and amylase
What is coeliac’s disease and the symptoms
- T cell mediated inflammatory, autoimmune disease which affects the small bowel.
- It can present with abdominal pain, distention, nausea and vomiting, diarrhoea, steatorrhoea (fat malabsorption), fatigue, weight loss and anaemia.
How do you diagnose coeliac’s disease and what are the complications?
- Definitive diagnosis via gastroscopy and duodenal/jejunal biopsy. Managed via life long gluten free diet
- Complications include; iron deficiency, B12/folate deficiency, hyposplenism, osteoporosis, type 1 diabetes, thyroid disease and T cell lymphoma
Describe features of crohn’s disease
NESTS
No blood or mucus, Entire GI tract, Skip lesions, Terminal illeum most commonly affected and Transmural inflammation, smoking is a risk factor.
Presents with abdominal pain and watery diarrhoea.
Manage with steroids
What are investigations for inflammatory bowel disease?
- Bloods (Raised WCC, ESR/CRP, thrombocytosis, anaemia, low albumin, iron/B12/folate deficiency)
- Foecal calprotectin,
- Endoscopy with imaging,
- MRI for small bowel disease
Describe features of Ulcerative Collitis
CLOSE UP C - continuous inflammation, L - Limited to colon and rectum, O - Only superficial mucosa affected, S - Smoking is protective, E - Excrete blood and mucus, U - Use aminosalicylates, P - Primary sclerosing cholangitis Presents with abdominal pain, bloody/mucous diarrhoea, weight loss, tenesmus
What are pre-hepatic, hepatic and post-hepatic causes of jaundice?
Pre hepatic - Conjugation disorders such as gilbert’s disease, haemolytic anaemia, drugs.
Hepatic - Viral infections (hepatitis/EBV), cirrhosis, malignancy, drugs.
Post hepatic - Biliary tree obstruction, primary biliary cirrhosis and primary sclerosing cholangitis
What is liver cirrhosis and some causes?
- Chronic inflammation leads to fibrosis (scarring) of the liver.
- Alcohol liver disease, non-alcoholic fatty liver disease, hepatitis B/C
What are the signs of liver cirrhosis and some investigations
- Jaundice,
- Hepatomegaly,
- Splenomegaly,
- Spider Naevi,
- Palmar erythema,
- Gynaecomastia and testicular atrophy,
- Bruising,
- Ascites,
- Asterixis,
Investigations include bloods, ultrasound and liver biopsy.
Describe some features of pancreatic cancer
Often presents late as early stages are non-specific.
May present with painless palpable gallbladder and jaundice or diabetes.
Investigate via CT abdo/pelvis
What are peptic ulcers and some causes?
Peptic ulcers include gastric and duodenal.
- 90% of duodenal ulcers are caused by H.pylori infections. Other causes include: NSAIDs, chronic steroid use, SSRIs, Smoking, blood group O, increased acid secretion
What are risk factors for gastric ulcers?
NSAIDs, H.pylori, smoking, delayed gastric emptying, severe stress
