Gastroenterology Flashcards
Eosinophilic esophagitis
Endoscopy: strictures, linear/ longitudinal furrows, circumferential lesions
Associated with atopy.
Tx: avoid allergens, PPI, dilatation of strictures
CMV eosophagitis
Presents with dysphagia, retrosternal pain, and epigastric tenderness
Endoscopy: multiple linear ulcers
More common in immunocompromised patients.
GORD
Presents with retrosternal pain and dysphagia.
Good response to PPI.
Endoscopy: mucosal erosions and strictures.
Eosophageal candidiasis
Endoscopy: whitish/yellow plaques
Presents with dysphagia, retrosternal pain and epigastric pain
More common in immunocompromised individuals
Primary biliary cholangitis
- Pathophysiology
- Presentation
- Imaging
- Investigations
Autoimmune destruction of INTRAlobular bile ducts.
More common in women.
Manifests as fatigue, pruritus, signs of cholestasis, elevated liver enzymes.
MRCP: focal intrahepatic bile duct strictures
Presence of AMA’s
Primary sclerosing cholangitis
- Pathophysiology
- Presentation
- Imaging
- Investigations
- Complications
Progressive chronic inflammation of both the intrahepatic and extrahepatic bile ducts. Associated with UC.
Cholestatic picture, pruritus, fatigue, abdominal pain
MRCP: INTRAhepatic and EXTRAhepatic focal bile duct strictures.
p-ANCA
Complications: cholangiocarcinoma, colorectal ca, GB ca, hepatocellular ca, liver cirrhosis
Achalasia
-Pathophysiology
- Presentation
Lower oesophageal sphincter dysfunction due to degeneration of neurons in the oesophageal wall.
Dysphagia to both SOLIDS and LIQUIDS, cramps, retrosternal fullness, pain.
Oesophageal cancer
Presentation
Subtypes
Progressive dysphagia from solids –> liquids
SCC - upper 2/3
Adenocarcinoma - lower 1/3
Features of gastric outlet obstruction
Postprandial, nonbilious vomiting, early satiety, progressive gastric dilation, weight loss, a succussion splash, and hypokalemic hypochloremic metabolic alkalosis.
