Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

Definition of GORD

A

A motility disorder of the oesophagus caused by reflux of gastric contents into the oesophagus and characterised primarily by heartburn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Prevalence of GORD

A

approx 30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Medications that reduce lower oesophageal sphincter pressure (increase reflux)

A 
Calcium channel blockers
Alpha-adrenergic antagonists
Nitrates
Anticholinergics
Sedatives
Prostaglandins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Extra-oesophageal syndromes associated with GORD

A

Chronic cough
Laryngitis
Asthma
Dental erosions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Management of GORD

A 
Avoid drugs/food that reduce LES pressure
Avoid acidic foods
Adopt behaviours to minimise reflux:
- weight reduction, elevation of head of bed, avoid lying directly after eating, smaller more frequent meals, avoid alcohol and cigarettes
Antacids (for mild symptoms
Proton pump inhibitors
Histamine2 receptor antagonists
Nissen fundoplication if refractory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Examples of PPIs

A

Esomeprazole (Nexium)
Omeprazole
Rabeprazole (Pariet)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Examples of histamine2 receptor antagonists for GORD

A

Ranitidine

Nizatidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Antacids examples

A

Mylanta (aluminium hydroxide + magnesium hydroxide)

Calcium carbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which is the most common inflammatory bowel disease

A 
Ulcerative colitis (80-150/100,000)
CD prevalence 25-100/100,000
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

macroscopic pathological findings of Crohn’s disease

A

Skip lesions
Thickened, narrow bowel
Cobblestone appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Macroscopic pathological findings of ulcerative colitis

A 
Contiguous involvement
Reddened
Inflamed
Friable (bleeds easily)
Extensive ulceration and polyps in severe disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Colonic cancer risk in IBD

A

Increased in Crohn’s affecting colon, no difference in UC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Clinical presentation of Crohn’s disease

A 
Diarrhoea (80%) usually bloody, mucus
Crampy abdominal pain
Weight loss
Constitutional symptoms (malaise, lethargy, anorexia, nausea and vomiting, low-grade fever)
Aphthous ulcers, perianal disease

Emergency presentation of acute abdomen mimicking appendicitis (RIF pain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Clinical presentation of ulcerative colitis

A

Diarrhoea: severe attacks of more than 6 stools per day - bloody, mucus, night time diarrhoea
Lower abdominal discomfort
Constitutional symptoms (malaise, lethargy, anorexia, weight loss)
Proctitis (urgency, tenesmus, sensation of incomplete evacuation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Management of Crohn’s disease

A

Induce remission: oral or IV glucocorticoids, enteral nutrition, anti-TNF antibodies (e.g. infliximab)
Maintain remission: AZA, MTX, anti-TNF antibodies
Symptom relief: supplement deficiencies (Fe, B12), loperamide for diarrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Surgery in Crohn’s disease

A

Options:

  • stricturoplasty
  • Bowel resection and anastomosis
  • ileostomy

Indications:

  • failure of medical treatment
  • complications
  • FTT
  • perianal sepsis
17
Q

Management of UC

A

Oral or rectal 5-aminosalicylic acid treatments
Oral prednisolone if poor response
Surgical resection of affected bowel may be curative

18
Q

Causes of constipation

A

DOPED
Drugs (opioids, anticholinergics, neurally active drugs, iron supplements)
Obstruction (small or large bowel)
Pain (e.g. anal fissures)
Endocrine (DM, hypothyroid, hyperCa, hypoK)
Depression

19
Q

Red flags of constipation

A 
Age over 50
Acute or recent onset
Weight loss
Abdominal pain or cramping
Rectal bleeding or melaena
Nausea or vomiting
Rectal pain
Fever
Change in stool calibre
Iron deficiency anaemia
20
Q

Clinical features of diverticulitis

A 
Acute LLQ pain
Fever, chills
Leukocytosis
Nausea and vomiting
Bleeding
21
Q

Primary prevention of diverticulosis

A

High-fibre diet to avoid constipation
Sufficient fluid intake
Adequate physical activity

22
Q

Management of diverticulitis

A

Increase dietary fibre intake and regular exercise
Nil by mouth + IV fluids in severe disease
Broad spectrum antibiotics (e.g. ciprofloxacin or bactrim)
Surgical: resection and reanastomosis or ileostomy
Indications for surgery:
- repeated episodes of diverticulitis (2 or more)
- failure of conservative management
- abscess or fistula formation
- obstruction
- peritonitis
- immunocompromised patients, first episode less than 40
- unable to exclude carcinoma

23
Q

Significant family history of bowel cancer

A

Immediate relative developed before 55y

More than one relative on the same side of the family

24
Q

Potential presentations of colon cancer

A 
Rectal bleeding 
Bowel or abdo symptoms
- change in bowel habit
- bloating
- weight loss
- malaise
- mucus in stool
Iron deficiency anaemia
25
Q

Prevalence of femoral hernias

A

only 2-3% of all hernias in the inguinal area

  • more common in women than men
  • more often present with symptoms
  • higher risk of strangulation (30-40%)
26
Q

Presentation of femoral hernia

A

May cause thigh pain
palpable or visible lump below the inguinal ligament
Cough impulse often not felt

27
Q

Definition of familial adenomatous polyposis (FAP)

A

Autosomal dominant conditions arising from mutation of the adenomatous polyposis gene on chromosome 5 resulting in multiple polyps throughout the colon, but particularly the left colon

28
Q

Epidemiology of FAP

A

Mean age of adenoma development = 16

Mean age of colorectal cancer development = 39

29
Q

Management of FAP

A

Annual colonoscopy/sigmoidoscopy for surveillance

+/- prophylactic colectomy with iliorectal anastomosis (rectal stump still requires lifelong surveillance)

30
Q

Definition of Peutz-Jegher’s syndrome

A

An autosomal dominant condition consisting of gastrointestinal polyps and mucocutaneous pigmentation

31
Q

Clinical features of Peutz-Jegher’s syndrome

A 
GI bleeds
Intussusception
Rectal prolapse
Nasal polyposis - chronic sinusitis
Pigmented macules on lips and digits (melanin spots)
Gynaecomastia
32
Q

Management of Peutz-Jegher’s syndrome

A

Endoscopic polypectomy
Yearly screening for uterine, ovarian and cervical cancer beginning in teens
Breast and testicular screening should begin by age of 20

33
Q

Cancers associated with Peutz-Jegher’s syndrome

A 
GI and non-GI
Uterine
Ovarian
Cervical
Breast
Testicular
34
Q

Main site of polyps in Peutz-Jeghers syndrome

A

Jejenum

Medicine (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions