Gastroenterology Flashcards
Woman presents with colicky central abdo pain, distension, N+V, palpable lump in groin.
Small bowel obstruction secondary to femoral hernia
Sickle cell patient with jaundice
Gallstones (increased chance)
DDx anorectal bleeding
Bright red blood of stool/paper
HAEMORRHOIDS - no abdo Sx, itchy, mass on defecation
ANAL FISSURE - severe pain, anal spasm, midline skin tag
RECTAL PROLAPSE - incontinence, mass on defecation/standing
DDx rectosigmoid bleeding
Darker blood +/- clots on/in stool
RECTAL TUMOUR - FLAWS, change in BH, tenesmus, old
PROCTOCOLITIS - infective
DIVERTICULITIS - >65, recurrent LIF pain, bloating, constipation/diarrhoea, painless haematochezia
DDx proximal colonic bleeding
Dark red blood IN stool / altered blood
COLONIC TUMOUR - FLAWS, change in BH, tenesmus, elderly
ANGIODYSPLASIA - >65, haematochezia, renal Dx, vWD, aortic stenosis
Ischaemic colitis - >60, crampy diarrhoea, self-limited haematochezia, Hx HTN/DM
DDx Inflammatory bowel disease
ULCERATIVE COLITIS = young adults, blood/mucus in stool, LEFT-sided, bloody diarrhoea, systemic Sx
CROHN’S DISEASE = extraintenstinal Sx, mouth ulcers, colicky pain (RIF), weight loss, systemic features, rectal bleeding RARE
Toxic megacolon
Massive dilatation of colon (>6cm) with thicked walls on AXR
ACUTE abdo pain, distension, diarrhoea, blood-stained stools, fever, tachycardia
Cutaneous manifestations of MALABSORPTION
Ichthyosis (dry scaly skin)
Eczema
Oedema
Cutaneous manifestations of LIVER DISEASE
Jaundice
Spider naevia
Palmar erythema
Leukonychia
Cutaneous manifestations of CROHN DISEASE
Perianal abscess
Fistulae
Skin tags
Apthous ulcers
Cutaneous manifestations of ULCERATIVE COLITIS
Erythema nodosum
Pyoderma gangrenosum
Cutaneous manifestations of SARCOIDOSIS
Erythema nodosum
Lupus pernio
Infective gastroenteritis
Clostridium difficile
Gram-positive commensal
Flares up with broad-spectrum ABx
Severe diarrhoea, dehydration, electrolyte imbalance, death
METRONIDAZOLE / VANCOMYCIN
Infective gastroenteritis
Campylobacter jejuni
Contaminated food + unpasteurised milk
2-5day incubation
Profuse and BLOODY diarrhoea (+/- pus)
GBS
Short history of vomiting? Possibility of eating contaminated food?
Staphylococcus aureus
HIV risk patient has profuse diarrhoea - organism?
Cryptosporidium
Older patient presents with profuse diarrhoea with mucus and hypokalaemia - diagnosis
Villous adenoma
Outline the serology of Hepatitis B
HBsAg —> earliest serological marker, detected within 4 weeks of acute infection (NB: if found after 6 months, pt is chronic carrier)
HBcAg –> found in patients with prior HepB infection
HBeAg –> acute and chronic –> HIGH levels of infectivity
HBcAb –> acute and chronic infeciton –> HIGH with low HBeAg suggests low infectivity
MCC of upper GI bleed?
Peptic ulcer disease (specifically duodenal if asked)
