Gastroenterology Flashcards
Ulcerative colitis presentation
Bloody diarrhoea
Abdo pain - usually left lower quadrant
Urgency
Tenesmus
Ulcerative colitis colonoscopy/biopsy findings
Red raw mucosa, easily bleeds
No inflammation beyond submucosa (unless fulminant disease)
Pseudopolyps - widespread ulceration with preservation of adjacent mucosa
Inflammatory cell infiltrate in lamina propria
Crypt abscesses - neutrophils migrate through walls of glands
Depletion of goblet cells and mucin
Infrequent granulomas
Crohn’s disease presentation
Non-bloody diarrhoea
Abdo pain - usually right sided
Weight loss
Oral ulcers, skin lesions
Extra-intestinal manifestations in IBD
Arthritis
Erythema nodosum
Episcleritis (more common in CD)
Osteoporosis
Uveitis (more common in UC)
Pyoderma gangrenosum
Clubbing
Primary sclerosing cholangitis (more common in UC)
Which diuretic to use in ascites?
Spironolactone
Drug-induced cholestasis (+/- hepatitis) caused by
COCP
ABX - fluclox, co-amox, erythromycin
Anabolic steroids, testosterones
Phenothiazines - chlorpromazine, prochlorperazine
Sulphonylureas e.g. gliclazide
Fibrates
Nifedipine
Drug-induced hepatocellular picture of liver disease caused by
Paracetamol
Sodium valproate, phenytoin
MAOIs
Halothane
Anti-tuberculosis drugs - rifampicin, isoniazid, pyrazinamide
Statins
Alcohol
Amiodarone
Methyldopa
Nitrofurantoin
Primary sclerosing cholangitis
Inflammation and fibrosis of intra and extra-hepatic bile ducts
Associated with UC, HIV
Symptoms - cholestasis (jaundice, pruritis), RUQ pain, fatigue
Beaded appearance on ERCP/MRCP - multiple biliary strictures
Achalasia presentation
Dysphagia of solids and liquids from start
Heartburn
Regurgitation of food - may lead to cough or aspiration pneumonia
Pharyngeal pouch presentation
More common in older men
Gurgles on palpation if large
Dysphagia, regurgitation, aspiration and chronic cough
Halitosis
Myasthenia gravis presentation
Dysphagia with liquids and solids
Extraocular muscle weakness
Ptosis
