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first year revision > gastroenterology > Flashcards

gastroenterology Flashcards

1
Q

define achalasia

A

failure to relax LOS

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2
Q

symptoms of achalasia

A

dysphagia of solids AND liquids
regurgitation, heart burn
raised lower eosphageal sphincter pressure

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3
Q

diagnostic of alchalasia

A

gold: manometry
other: OGD, barium swallow (eso dilated, bird peak)

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4
Q

treatment of achalasia

A

POEM (pneumatic ballon dilatation)

dilatation and myotomy

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5
Q

complication of achalasia

A

aspiration pneumonia

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6
Q

diagnostic for GORD

A

pH studies

OGD (oesophagogastroduodenoscopy)

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7
Q

treatment for GORD

A

PPI (omeprazole 40mg) + life style
H2 antagonist
surgery (nissen fundoplication)

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8
Q

define hiatus hernia

A

stomach bulges up into your chest through an opening in your diaphragm
risk factor of GORD

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9
Q

treatment for hiatus hernia

A

anti-reflux surgery if patient has severe reflux/esophagitis

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10
Q

symptoms of peptic ulcer

A

epigastric pain, dyspepsia, heartburn

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11
Q

diagnostic of peptic ulcer

A

H.pylori testing (stool antigen, urease)

endoscopy

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12
Q

treatment of peptic ulcer

A

amoxicillin + clarithromycin + PPI

metronidazole+ clarithromycin + PPI

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13
Q

treatment for bleeding peptic ulcer

A
  1. resuscitation (ABC)
  2. endoscopic: mechanical clips and thermal coagulation with adrenaline
  3. medical: PPI
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14
Q

causes of esophageal varices

A

portal hypertension

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15
Q

treatment of bleeding esophageal varices

A
  1. resuscitation (ABC)
  2. endoscopic: 1. band ligation 2.TIPSS
  3. medical: terlipressin, prophylactic antibiotic therapy

propranolol to prevent future bleeding

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16
Q

types of esophageal cancer

A

Squamous cell carcinoma (upper 2/3)

Adenocarcinoma (lower 1/3, Barrett’s oesophagus)

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17
Q

symptoms of esophageal cancer

A

progressive dysphagia
haematestasis
weight loss
hoarse voice

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18
Q

typical presentation of esophageal cancer

A

old men smoking for years, new onset of dysphagia to solids but not liquids

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19
Q

diagnostic and staging of esophageal cancer

A

endoscopy+ biopsy

staging: CT, PET scan

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20
Q

treatment of esophageal cancer

A

endoscopic resection

surgery + chemo

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21
Q

treatment of eosinophilic esophagitis

A

steroids

montelukast

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22
Q

cause of gastritis

A

bacterial: H.pylori
chemical: NSAID
autoimmune: anti-parietal/intrinsic factors antibodies

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23
Q

types of gastric cancer

A

intestinal adenocarcinoma
diffuse adenocarcinoma
lymphoma

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24
Q

investigations of gastric cancer

A

endoscopy + biopsy (signet ring)

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25
Q

gastric cancer associated with H.pylori

A

intestinal adenocarcinoma

lymphoma

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26
Q

symptoms of Mallory weiss tear

A

large amount of red blood coughed up

Melena

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27
Q

characteristics of Crohn’s symptoms

A 
No blood or mucus
Entire GI tract
“Skip lesions” on endoscopy
Terminal ileum most affected
Transmural inflammation
Smoking is a risk factor (don’t set the nest on fire)
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28
Q

symptoms of Crohns

A

diarrhea

abdominal tender

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29
Q

characteristics of UC

A 
Continuous inflammation
colon and rectum
superficial mucosa affected
Smoking is protective
Excrete blood and mucus
PSC
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30
Q

symptoms of UC

A

nocturnal symptoms
diarrhea with blood
tenesmus
left iliac fossa pain

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31
Q

manifestations/ complications of Crohns

A

mouth ulcer

fistula, gallstones

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32
Q

histological findings of Crohns

A

non-ceasesting granulomas
increase goblet cells
Cobblestone
rose thorn ulcers

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33
Q

manifestation/ complications of UC

A

toxic megacolon
arthritis
PSC

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34
Q

histological findings of UC

A

crypt abscess

pseudopolyps

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35
Q

diagnostic of IBD

A

gold: endoscopy + biopsy

Faecal calprotectin (released by the intestines when inflamed) is a useful screening test (> 90% sensitive and specific to IBD in adults)

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36
Q

treatment of Crohns

A

induce remission: Steroids (e.g. oral prednisolone or IV hydrocortisone)

maintain remission: Azathioprine, Mercaptopurine

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37
Q

treatment of Crohns: surgery

A

effect only distal ileum

Surgery can also be used to treat strictures and fistulas secondary to Crohns disease.

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38
Q

treatment of UC to induce remission

A

Mild to moderate disease
aminosalicylate (mesalazine)
prednisolone

Severe disease
IV hydrocortisone

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39
Q

treatment of UC: maintain remission

A

Maintaining Remission

Aminosalicylate (e.g. mesalazine oral or rectal)
Azathioprine
Mercaptopurine

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40
Q

IBS risk factor

A

young women with mental health problems and past gastroenteritist

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41
Q

IBS symptoms

A

constipation/ diarrhea with no blood

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42
Q

diagnostic of IBS

A

ROME IV
faecal calptoetin: not elevated in IBS, elevated in IBD
FBC, ESR, CRP: normal in IBS

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43
Q

ROME IV for IBS

A 
ab pain 1/week, for 3 months 
2/3: 
pain defeaction
change in appearance of stool
change in frequency of stool
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44
Q

treatment for IBS

A

antispasmodic/ depressants for pain relief
IBS-C: bulk forming laxative, ie, ispagula husk
IBS-D: loperamide, rifaximin

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45
Q

typical presentation of coeliac disease

A

person who has diarrhea and bloating after eating gluten, who has osteoporosis, dermatitis herpetiformis, and ulceration

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46
Q

diagnosis for coeliac disease

A

serology: looks at IgA w/ antiTTGA.

endoscopy+ biopsy

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47
Q

diagnostic result of coeliac disease

A

decrease igA
villous atrophy
crypt hypertorphy

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48
Q

diagnostic of colon cancer

A

colonoscopy/ sigmoidoscopy

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49
Q

symptoms of colon cancer

A

right: iron deficient, RIF mass

left (common): rectal bleeding, LIF mass

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50
Q

genetic associations of colon cancer

A

HNPCC: DNA mismatch repair gene (Lynch syndrome)
APC: tumour supressor gene (growth of FAP, a polyp)

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51
Q

genetic mutation from adenoma to adenocarcinoma of colon cancer

A

APC-> COX2-> KRAS-> P53-> loss of 18q

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52
Q

what is rosving’s sign

A

appendicitis

RIF fossa pain on palpation of LIF

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53
Q

drinking limit

A

14 units per week

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54
Q

what are the 3 phases of alcoholic liver disease

A
  1. alcohol related fatty liver
  2. alcohol hepatitist
  3. cirrhosis
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55
Q

symptoms of alcoholic liver disease

A 
jaundice, hepatomely, ascites  
spider nave 
palmar erythema 
gynaecomastia 
caput medusa
anticoagulopathy 
hepatocytes encephalopathy
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56
Q

diagnostic of alcoholic liver disease

A

Liver biopsy: confirm diagnostic

LFT: ^ALT/ AST
Fibroscan: elasticity of liver, for cirrhosis testing

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57
Q

scoring systems used for cirrhosis

A

child-pugh: severity of cirrhosis

MELD: every 6 months for compensated cirrhosis

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58
Q

complications of cirrhosis

A 
portal hypertension and varices
ascites and spontaneous bacterial peritonitis 
hepato-renal syndrome 
hepatic encephalopathy 
HCC
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59
Q

treatment for portal hypertension and varices

A

propranolol for portal hypertension

elastic band ligation for stable varices

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60
Q

treatment for ascites and SBP

A

ascites: decrease Na+, spironolactone (anti aldosterone diuretics)
SBP: IV cefotaxime

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61
Q

what is Hepatic encephalopathy+ treatment

A

build up of toxin such as ammonia in brain causing confusion

laxative: lactulose for ammonia exertion
antibiotic: rifaxminin reduce intestinal bacteria producing ammonia

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62
Q

development of non-alcoholic fatty liver disease

A

NAFLD-> non-alcoholic steatohepatitis (NASH)-> fibrosis-> cirrhosis

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63
Q

NAFLD diagnostic

A

enhanced liver fibrosis (not available in many areas)

liver ultrasound: diagnosis of hepatic steatosis (^ echogenicity)

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64
Q

viral hepatitis symptoms

A

jaundice
vomit
diarrhea
abdominal pain

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65
Q

viral hepatitist diagnostic

A

serology: relevant igM during onsets
LFT: increase ALT & AST with low albumin

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66
Q

hepatitist B diagnostic: acute vs chronic vs immuned

A

acute: HBsAg, HbeAg, igG, igM
chronic: HBsAg (6months), igG
immuned: anti-HBsAg,

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67
Q

hepatitist C diagnostic

A

serology: HCV antibody (screening)
PCR: HCV RNA, negative=past infection, positive= active infection (diagnostic)

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68
Q

hepatitis B treatment

A

antivirals: tenofovir/ entecavir, PegIFN-alpha

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69
Q

hepatitis C treatment

A

DAA 8-12 weeks

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70
Q

cause of PBC

A

immune system attack intrahepatic small ducts causing obstruction of cholesterol, bilirubin, bile acid flow

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71
Q

symptoms of PBC/PSC

A

jaundice + pale stool
xanthomas
pruitist+ greasy stool

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72
Q

risk factors of PBC

A

middle age woman with immune/ rheumatoid diseases

ie, coeliac, thyroid, rheumatic arthritis

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73
Q

diagnostic of PBC

A

LFT: increase ALP

anti-AMA

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74
Q

treatment of PBC

A 
ursodeoxycholic aid (decrease cholesterol absorption)
colestryamine (pruritus from bile acid)
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75
Q

main difference between PBC and PSC?

A

typical patient

PSC: 30-40 men with UC and family history of PSC

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76
Q

diagnostic of PSC

A

MRCP magnetic resonance cholangiopancretography (MRI scan of liver, bile ducts, pancreas)
p-ANCA
LFT: increase ALP

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77
Q

management of PSC

A

liver transplant
ERCP
colestyramine
monitor: HCC, cirrhosis, varices

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78
Q

define haemochromatosis

A

genetic mutation of HFE protein on chromosome 6 causing iron build up

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79
Q

symptoms of haemochromatostsis

A

chronic tiredness
pigmentation
joint pain
later in woman

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80
Q

diagnostic of haemochromatostasis

A

serum ferritin + transferrin saturation

genetic testing

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81
Q

treatment of haemochromatostasis

A

venesection (removing blood to decrease iron)
monitor serum ferritin
no alcohol

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82
Q

define Wilsons disease

A

mutation of ATP7B copper binding protein on chromosome 13 causing copper build up

83
Q

symptoms of Wilsons disease

A

chronic hepatitist+ cirrhosis
dysarthria+ dystonia
Kayser-Fleischer rings

84
Q

diagnostic of Wilsons disease

A

serum caeruloplasmin: low levels

liver biopsy: gold standard

85
Q

treatment of Wilsons disease

A

penicillamine

trentene

86
Q

cause of alpha-1-antitrypsin deficiency

A

autosomal recessive mutation in A1AT on chromosome 14

87
Q

what does alpha-1-antitrypsin do? and what happens during deficiency

A

inhibit protease such as neutrophil elastase

deficiency: excessive protease to attack liver and lungs

88
Q

diseases caused by alpha-1-antitrypsin

A

liver cirrhosis after 50

bronchiectasis and emphysema after 30

89
Q

diagnosis of alpha-1-antitrypsin

A

low serum alpha 1 antitrypsin
genetic testing for A1AT

liver biopsy
high resolution CT thorax

90
Q

treatment of alpha-1-antitrypsin

A

stop smoking

manage symptoms and monitor complications

91
Q

what are the 3 layers of mucosa

A

epithelium
lamina propria
muscularis mucosa

92
Q

four layers inner to outermost layer of GI tract

A

mucosa
submucosa
muscular externa
serosa

93
Q

what are the 2 types of tissues in muscularis externa

A

inner circular muscle

outer longitude muscle

94
Q

what are the 2 types of tissue in serosa

A

areolar connective tissue

simple squamous

95
Q

function of the mucosa (epithelium)

A

exo+ endocrine cells: secretion of enzymes, hormones, digestive juice

96
Q

function of mucosa (lamina propria)

A

gut associated lymphoid: Peyer’s patches, defence against pathogens

97
Q

function of mucosa (muscular mucosa)

A

contraction allowing different absorption of luminal contents

98
Q

contents of submucosa

A

major blood and lymphatic vessels

submucosal/ meissner’s plexus (enteric nervous system)

99
Q

contents of muscular externa

A

inner: narrowing the lumen help mixing of digestive content
myenteric/ Auerbach’s plexus (contain ICC, enteric nervous system)

outer: propel food down

100
Q

complex molecules and their digestive forms (carbs, protein, lipids)

A

carbohydrates-> glucose, galactose, fructose (absorbed by enterocytes)
protein-> small peptide and amino acids
triglycerides-> monoglycerides and free fatty acids

101
Q

function of exocrine glands in secretion

A

secrete enzymes and digestive juices into the lumen helping digestion and absorption of nutrients

102
Q

function of endocrine glands in secretion

A

secrete hormones into blood, regulate function of digestive tract

103
Q

define peristalsis

A

involuntary contraction and relaxation of the bowel: under neurohormonal control

104
Q

what are the 4 contributors to neurohormonal mechanisms in digestive system

A

smooth muscle pacemaker cells
enteric nervous system
autonomic nervous system
hormones

105
Q

describe smooth muscle pacemaker cells in the GI

A

ICC/intestinal cells of cajal: deliver slow wave potentials with varying intrinsic rate depending on location

106
Q

how does slow wave potentials from ICC work

A

rhythmic fluctuations in membrane potential bring smooth muscle closer or further away from threshold

107
Q

what happens when threshold is reached for smooth muscles

A

action potentials fired=depolarization of muscle fibres and coordinated contraction via gap junctions

108
Q

describe the enteric nervous system

A

intramural nervous system unique to digestive tract providing local control
subset of autonomic nervous system
submucosal + myenteric plexus
sensory neurones + effector neurones

109
Q

function of sensory vs effector neurones in enteric nervous system

A

sensory: detect local alteration
effector: muscular contraction, exocrine gland secretion, hormone release

110
Q

describe Hirschsprung’s disease

A

congenital absence of submucosal and myenteric plexuses leading to absence of peristalsis, dilatation of proximal colon and constipation

111
Q

functions of the autonomic nervous system effect on the GI tract

A

control digestive tract

modify effect of intrinsic nerve plexus and hormonal release

112
Q

parasympathetic control of GI

A

vagus nerve
secretion of acetylcholine binding to muscarinic receptors
increase motility + promotes secretion

113
Q

sympathetic control of GI

A

splanchnic nerves

release of catecholamines: decrease motility and inhibit secretions

114
Q

function of hormones in GI

A

secreted by endocrine glands into bloods

simulator or inhibitory actions on muscular contraction and secretion

115
Q

what are the three salivary ducts

A

sublingual
submandibular
parotid

116
Q

features of sublingual gland

A

facial nerve (12)
small ducts in the floor of the mouth
smallest gland

117
Q

features of submandibular gland

A

facial nerve (12)
Wharton’s duct
frenulum on the underside of the tongue

118
Q

features of the parotid glands

A

glossopharyngeal nevre (9)
pre-auricular area
stensen’s duct at 2nd superior molar

119
Q

function and location of cardiac glands

A

lower esophageal splinter
mucous cells producing alkaline mucous protecting epithelium of stomach
act as lubricant

120
Q

function and location of oxyntic glands

A

body and fundus of the stomach

contain exocrine cells: mucous, chief, parietal

121
Q

function of chief cells

A

secret proenzyme pepsinogen-> activated by HCI into pepsin breaking down polypeptides into peptide fragments

122
Q

function of parietal cells

A

HCI (hydrochloric acid): acidic stomach pH2, activate pepsinogen, denature and breakdown molecules
intrinsic factor acids: absorb vitamin B12

123
Q

what is crucial occurrence during end of gastric phase of digestion

A

gastric emptying of chyme into duodenum actives D cells in the stomach to release somatostatin decrease gastric secretion

124
Q

what are the 2 enterogastrones released when chyme enters duodenum

A

secretin

CCK

125
Q

features of secretin

A

secreted by s cell in duodenum and jejunum

stimulates pancreas to secret alkaline fluid w/ HCO to neutralize acidic chyme entering duodenum

126
Q

features of CCK

A

secreted by I cells from duodenum

stimulate pancreatic release of zymogen granules (amylase + lipase + proteolytic enzyme)

127
Q

test to confirm H.pylori eradication

A

The 13C urea breath test

128
Q

compare and contrast gallstones and cholecystitis

A 
both middle aged female 
obstructive jaundice (gall) vs non obstructive jaundice (chole)
129
Q

typical presentation of ascending cholangitist

A

Charcot’s triad (jaundice, fever, RUQ pain)

gram negative rod infection

130
Q

Charcot’s triad

A

biliary obstruction

jaundice
fever
RUQ pain

131
Q

symptoms of cholecyctist

A

Murphy’s sign (patient take and hold in a deep breath while palpating right subcostal area, if pain occurs= positive sign)

RUQ pain

132
Q

diagnostic of choleycystist

A

ultrasound (MRCP if need further diagnosis)

^ALP

133
Q

upper GI endoscopy vs oesophageal manometry

A

Endo: cancer, tumours (progressive dysphagia)
mano: spasm (intermitted dysphagia to liquids and solids)

134
Q

symtpoms and treatment of UC complication toxic megacolon

A

fever
severe abdominal pain
anti-diarrhoea agent taken
abdominal X-ray

135
Q

diagnostic of HCC

A

raised alpha fetoprotein (AFP)
ultrasound scan: focal lesions
CT: hypervascularity

136
Q

causes of pancreatitis

A

alcohol abuse
NSAID
complication of ERCP

137
Q

symptoms of pancreatitis

A

abdominal pain radiating to the back, worse laying down
Cullen’s sign - periumbilical bruising
Grey Turner’s sign - flank bruising
fever

138
Q

diagnostic of pancreatitis

A

serum amylase 3x normal level

amylase > 1000

139
Q

transudative vs exudative ascites

A

Exudates: fluid cellular substances discharge from blood vessels usually from inflamed tissues
Transudates: fluids that pass through membrane to tissue/ extracellular space

140
Q

examples transudative vs exudative ascites

A

Exudative: malignancy, infection, inflammation
transudative: portal hypertension, CHF, hypoalbuminemia

141
Q

define vitamin B12 & deficiency

A

produce RBC
meat, fish, dairy
absorbed in ileum
deficiency: glossitis, jaundice, depression

142
Q

define vitamin B1 & deficiency

A

thiamine deficiency, alcoholics
horizontal nystagmus on lateral gaze
Wernicke’s encephalopathy (confusion)

143
Q

alcohol withdrawal symptoms and treatment

A 
delirium tremens (hallucinate, sweating)
oral lorazepam
144
Q

presentation of diverticulitst

A

elderly patient with left iliac fossa pain
pouches of inflammation in intestines
lead to abscess and perforation if not treated

145
Q

UC severity scoring system

A

Truelove and Witts

146
Q

common sign of biliary colic

A

pain worse after big/ fatty meal due to gallbladder contracting to secret bile following a meal (gall stones presence makes this painful)

147
Q

biliary colic vs gallstone

A

biliary colic is cause by gall stones passing through the biliary tree
both have same risk factors, symptoms, diagnostic

148
Q

difference between biliary colic vs other gallstone related conditions

A

no fever

normal LFT/ inflammatory markers

149
Q

diagnostic of biliary colic

A

ultrasound

dilated common bile duct

150
Q

where are inguinal hernias located

A

superior and medial to public tubercle

151
Q

where are femoral hernias located

A

inferior and lateral to public tubercle

152
Q

describe peristalsis in the oesophagus

A

circular smooth muscle contract behind the food bolus and longitudinal smooth muscle propel food through the oesophagus

153
Q

primary vs secondary peristalsis

A

primary: spontaneously move food from the oesophagus to stomach (9sec)
secondary: food which doesn’t enter the stomach stimulates stretch receptors to cause peristalsis

154
Q

causes of acute pancreatitis

A

gall stones and ERCP
ethanol, steroids, drugs
mumps and scorpion

155
Q

what are Blatchford vs Rockall for and difference

A

upper GI bleed
blatchford: first line
Rockall: pre and post endoscopy score

156
Q

what is ABC in resuscitation

A

A: airway
B: breathing
C: circulation

157
Q

what is airway in resuscitation

A

airway is patent and protected

158
Q

what is breathing in resuscitation

A

oxygen saturation
resp rate
breath sounds

159
Q

what is circulation in resuscitation

A

blood pressure/ HR, ecg
establish IV access (2 wide bored cannula)
blood tests
IV fluid/ blood products if needed

160
Q

what does NSAID inhibit and how does it cause gastritis

A

inhibit COX 2 for anti-inflammatory effect, however, it is non-selective and also inhibit COX 1 which helps production of prostgaldins
COX1 inhibition= increase in histamine

161
Q

what is the function of prostaglandins

A

inhibit ECL cells that secrete histamine

162
Q

how does increase in histamine cause gastritis

A

histamine secretion is one method of stimulating HCI which irritates gastric mucosa causing gastritis/ esophageal reflux

163
Q

what is the ligament of treitz

A

anatomical division for foregut from midgut

located in duodenal segment D2

164
Q

define Lynch disease

A

autosomal dominant disease associated w/ high risk of colorectal cancer
diagnosed with genetic testing

165
Q

what and where is gastrin produced

A

antrum of stomach by G cells

166
Q

raised biomarker for acute pancreatitis

A

Amylase

167
Q

common features of pancreatic cancer

A

adenocarcinoma

painless jaundice

168
Q

mode of action: PPI (ie, omeprazole)

A

inhibits gastric parietal cell H+/k+ ATPase

169
Q

define Budd-chiari syndrome

A

occlusion of hepatic vein from blood clot
ab pain, ascites, hepatomegaly
lupus erythematosus+ contraceptive pill

170
Q

treatment for C.diff

A

metronidazole

vancomycin

171
Q

what monosaccharides are sucrose, lactose, maltose

A

sucrose: glucose + fructose
lactose: glucose + galactose
malstose glucose+ glucose

172
Q

function of parietal cells in the stomach

A

produced intrinsic factor / absorb B12

secreted HCI

173
Q

how are gallstones formed

A
  1. cholesterol stones due to bile contains high cholesterol + low bile salts
  2. pigement stones due to excess bilirubin
  3. 80% of gallstones are mixed - pigment and cholesterol
174
Q

purpose of NGT (nasogastric tube )

A

internal feeding/ medication administration

decompression of stomach

175
Q

testing before NGT placements

A

chest angiography

pH studies

176
Q

what does child Pugh look for

A

encephalopathy
ascites
bilirubin
prothrombin time

177
Q

define Zollinger Ellison syndrome

A

gastrin-secreting tumour/ hyperplasia of islet cells in the pancreas
overproduction of gastric acid-> repeat peptic ulcers

178
Q

diagnostic of Zollinger Ellison

A

bloods: abnormal gastrin

ultrasound

179
Q

Zollinger Ellison symptoms

A

diarrhea
heartburn
burning or dull pain in the abdomen

180
Q

norovirus features

A

explosive D+V
short incubation (< 24h)
cruise ships

181
Q

rotavirus feature

A

young kids

D+V

182
Q

clostrium difficile features

A

normal bacterial flora
4c antibiotic induced-> allows C. diff to overgrow
toxin A (enterotoxin) and toxin B (cytotoxin)

183
Q

Bacillus cereus features

A

starchy foods:reheated rice

profuse vomiting

184
Q

Campylobacter jejuni

A

most common bacterial cause of foodborne
poultry, unpasteurized milk
travel to SE Asia

185
Q

shigella vs e.coli

A

both: bloody diarrhea, HUS

E.coli: travel + beef

186
Q

what is HUS: haemolytic uremic syndrome

A

low RBCs, low platelets, high WBCs and acute kidney failure

E. coli 0157, Shigella and Salmonella

187
Q

define anal fissure

A

Tear in the mucosa of the anal canal, inside the anal margin

if there are multiple may be due to crohns

188
Q

symptoms of anal fissure

A

serve anal pain lasting about 30min after constipation

189
Q

treatment of anal fissure

A

dietary advice and stool softener

sphincterectomy

190
Q

define perianal fistula

A

Abnormal connection between the anal canal and the perianal skin from delayed/inadequate treatment of anorectal abscesses

191
Q

presentation of perianal fistula

A

patient with cronhs comes in with Painful tender swellings and Discharge in the perineum, including mucus, blood, pus, or faeces

192
Q

diagnostics of perianal fistula

A

EUA of anorectum

Proctoscopy to visualize the opening of the tract

193
Q

perianal fistula treatment

A

Surgically excised then drained

Followed up with antibiotics

194
Q

haemorrhoids definition

A

abnormally enlarged vascular mucosal cushions in the anal canal

195
Q

haemorrhoids risk factors

A

constipation
^age
Raised intra-abdominal pressure (e.g. pregnancy, chronic cough, ascites)

196
Q

where are internal haemorrhoids found

A

above dentate line, where the rectum joints the anus

197
Q

where are external haemorrhoids found

A

below the dentate line, found at the anal opening and are covered by skin

198
Q

symptoms of haemorrhoids

A

Painless bright red rectal bleeding
Perianal itchiness
No change in bowel habit, no weight loss or other associated symptoms

199
Q

diagnostics of haemorrhoids

A

PR exam and Proctoscopy

Flexible sigmoidoscopy in patients over 50 or where malignancy is a possibility

200
Q

treatment of haemorrhoids

A

Stool softeners, fibre diet, Topical creams
Rubber-band ligation
HALO/THD procedure

201
Q

define rectal prolapse

A

The walls of the rectum protrude through the opening of the anus and become visible

202
Q

2 type of rectal prolapse thickness

A

Partial thickness:rectal mucosa protrudes out of the anus

Full thickness:rectal wall protrudes out the anus

203
Q

some symptoms of rectal prolapse

A

Protruding mass from anus during defeacation
Bleeding and passing mucus
poor anal tone

204
Q

diagnostic of rectal prolapse

A

Barium enema, colonoscopy

first year revision (5 decks)

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