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Phase 3A Quiz > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

Where does pain present in Appendicitis

A

Originates in the umbilical area and migrates to RIF

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2
Q

Investigations for suspected Appendicitis

A

US
Bloods - FBC, U&E, CRP
Pregnancy test - Rule out ectopic

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3
Q

Rx for Appendicitis

A

Surgical Excision - Appendectomy

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4
Q

Complication of Appendicitis

A

Peritonitis

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5
Q

GORD Signs and Symptoms

A

Oesophageal/ Extra-Oesophageal

Oesophageal 
􀁸 Heartburn
􀂃 Related to meals
􀂃 Dysphagia 
􀂃 Relieved by antacids
􀁸 Belching
􀁸 Acid brash, water brash
􀁸 Odonophagia

Extra-oesophageal
􀁸 Nocturnal asthma
􀁸 Chronic cough
􀁸 Laryngitis, sinusitis

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6
Q

Causes of GORD

A

Hiatus hernia - Rolling and sliding
Oesophagitis
Lower oesophageal sphincter angle - Inherited

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7
Q

Treatment of GORD

A

Medical
Surgical
Conservative

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8
Q

Medical GORD Tx

A

Anatacids - Aluminium hydroxide,
H2 Receptor antagonists - Ranitidine
PPI-Omeprazole/Lansoprazole

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9
Q

Surgical GORD Tx

A

Nissen’s fundoplication

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10
Q

Conservative management for GORD?

A

Education
Weight loss
Sleeping adjustments - Raising head of bed
Avoiding triggers - Large meals, smoking, hot drinks, spicy foods, reduce alcohol.
Drug cessation
Small regular meals

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11
Q

Complications of GORD

A 
Barrets Oesophagus
Oesophageal Ca
Benign Stricture -> Dysphagia
Ulceration 
Oesophagitis
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12
Q

GORD Risk factors?

A 
Smoking 
Excessive alcohol
Excessive coffee
Obesity 
Pregnancy
Drugs - CCB, TCA, Antimuscarinic, Nitrates
Iatrogenic - Heller's Myotomy
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13
Q

ALARM SYMPTOMS

A 
Unintentional weight loss
Dysphagia 
Haematemesis
Melena
Anorexia
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14
Q

GORD Pathophysiology

A

Abnormal reflux of stomach acid into the oesophagus damaging the squamous lining causing discomfort.

LOS dysfunction -> Gastric reflux contents -> oesophagitis

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15
Q

GORD Investigations (Ix)

A

􀁸 Isolated symptoms don’t need Ix

􀁸 Bloods: FBC

􀁸 CXR: hiatus hernia may be seen

􀁸 OGD if:
􀂃 >55yrs
􀂃 Symptoms >4wks
􀂃 Dysphagia
􀂃 Persistent symptoms despite Rx

or <55 with ALARM symptoms

􀁸 Ba swallow: hiatus hernia, dysmotility
􀁸 24h pH testing ± manometry
􀂃 pH <4 for >4hrs

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16
Q

GORD Differentials

A 
􀁸 Oesophagitis
􀂃 Infection: CMV, candida
􀂃 IBD
􀂃 Caustic substances / burns
􀁸 PUD
􀁸 Oesophageal Ca
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17
Q

Differentials for R Hypochondriac Pain

A
  • Pancreatitis.
  • Ulcer (gastric).
  • Gallstones.
  • Biliary colic.
18
Q

Differentials for L Hypochondriac Pain

A
  • Pancreatitis.

* Ulcer (gastric or duodenal).

19
Q

Differentials for Epigastric Pain

A
  • Heartburn.
  • Pancreatitis.
  • Epigastric hernia.
  • Gallstones.
  • Ulcer (gastric).
20
Q

Differentials for Hyogastric Pain

A
  • Urinary tract infection.
  • Appendicitis.
  • IBD.
  • Diverticular disease.
21
Q

Differentials for R Illac Pain

A
  • Appendicitis.
  • Ectopic pregnancy.
  • Ovarian torsion.
  • Inguinal or femoral hernias.
22
Q

Differentials for L Illac Pain

A 
• Diverticular disease. 
• IBD.
• Ectopic pregnancy. 
• Ovarian torsion.
• Diverticular disease.
Umbilical region
• Inguinal or femoral hernias.
23
Q

Differentials for R Lumbar Pain

A
  • Kidney stones.
  • Urinary tract infection.
  • Constipation.
24
Q

Differentials for L Lumbar Pain

A
  • Kidney stones.
  • Urinary tract infection.
  • Constipation.
  • Inflammatory bowel disease
  • Diverticular disease.
25
Q

Differentials for Umbilical Pain

A
  • Gastric ulcer.
  • Early stages of appendicitis.
  • Aortic aneurysm.
  • Ruptured aortic aneurysm.
  • Pancreatitis.
  • IBD.
26
Q

Causes for Upper GI Bleeds

A 
Gastritis
Oesophageal varices 
Peptic ulcers
Mallory Weiss tears 
Maliganancy
27
Q

Causes for Lower GI Bleeds

A 
Haemorrhoids
Polyps
Malignancy
Angiodysplasia
IBD - CR/UC
Diverticulitis
Infectious diarrhoea
28
Q

Causes of GI Malabsorption

A

DT CAP

Disaccharidase deficiency
Tropical sprue 
Coeliac &amp; Crohns 
A-beta-lipoproteinaemia
Pancreatic insufficiency
29
Q

Define Coeliac Disease

A

• An autoimmune disorder caused by an abnormal immune response to dietary gluten.

30
Q

Coeliac Disease Ix?

A

Bloods -
Antibodies - Anti-TTG, Anti- EMA, Anti-Gliadin, IgA, IgG(in IgA deficient)
Stool Culture - To exclude Giardia
OGD -

31
Q

Coeliac Disease Complications

A

GLIAD

G - GI Malabsorption
L - Lymphoma and Carcinoma (T Cell, small bowel adenocarcinoma, breast/bladder ca)
I - Immune Associations (IgA deficiency, T1D, PBC)
A - Anaemia
D - Dermatological

32
Q

Coeliac Disease Signs and Symptoms

[ Name 10 ]

A 
Fatigue, Weakness
Weight loss, 
Abdominal pain, 
Diarrhoea
Flatus
Abdo distension + colic
N/V
Anaemia
Steatorrhea
Hyperoxaluria - Renal Stones
33
Q

Coeliac Disease Tx

A

Strict lifelong GF diet.
Avoid: barley, rye, oats, wheat
OK: Maize, soya, ric

34
Q

What molecules are malabsorbed due to coeliac’s

A 
Carbohydrates
Fats 
Proteins
Vitamins - D,K,Ca, B2, B1, B6
Haematinics - Folate, Fe
35
Q

Pathophysiology of Coeliac

A

Autoimmune response to gliadin in gluten

CD8+ Mediated

36
Q

What Genes are common with people suffering from Coeliac Disease

A

HLA-DQ2 & DQ8

37
Q

What organism causes giardiasis?

A

Giardia lamblia

38
Q

What are some features of Giardiasis

7 Things

A 
Asymptotic 
Bloating 
Abdominal pain
Flatulence
Non-bloody diarrhoea 
Chronic diarrhoea 
Malabsorption / Lactose intolerance
39
Q

What is the most common cause of travellers diarrhoea

A

E. coli

40
Q

Tx for Giardisis?

A

Metronidazole

Phase 3A Quiz (7 decks)

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