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Finals > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

What is achalasia and how does it present?

A
  • Loss of myenteric plexus ganglion causing functional distal obstruction of the oesophagus
  • Dysphagia, weight loss, chest pain, regurgitation and chest infection
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2
Q

How is achalasia treated?

A
  • Nitrates
  • CCBs
  • Botulism
  • Balloon dilatation
  • Myotomy
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3
Q

How does GORD present?

A
  • Heartburn
  • Cough
  • Water brash
  • Sleep disturbance
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4
Q

Name the two types of hiatus hernia

A
  • Sliding

- Para-oesophageal

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5
Q

Name some of the complications of GORD

A
  • Ulceration
  • Stricture
  • Barrett’s oesophagus
  • Carcinoma
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6
Q

How is Barrett’s oesophagus treated?

A
  • Endoscopic mucosal resection
  • Radio-frequency ablation
  • Oesophagectomy
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7
Q

How is GORD managed?

A
  • Lifestyle measures
  • Gaviscon
  • Ranitidine
  • PPIs
  • Fundoplication
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8
Q

How does oesophageal cancer present?

A
  • Progressive dysphagia
  • Weight loss
  • Odynophagia
  • Chest pain
  • Cough
  • Pneumonia
  • Vocal cord paralysis
  • Haematemesis
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9
Q

Name the alarm symptoms that require urgent endoscopy

A
  • Anaemia
  • Loss of weight
  • Anorexia
  • Recent onset
  • Masses and malaenia/haematemesis
  • Swallowing difficulties
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10
Q

How does irritable bowel syndrome present?

A
  • Abdo pain
  • Altered bowel habit
  • Abdominal bloating
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11
Q

How can irritable bowel be treated?

A
  • Education and reassurance
  • Dietetic review
  • Fodmap diet
  • Antispasmodics
  • Probiotics
  • Laxatives
  • Anti-motility agents
  • Psychological interventions
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12
Q

Name the three subtypes of gastritis

A
  • Autoimmune
  • Bacterial
  • Chemical
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13
Q

How can gastritis be managed?

A
  • Antacids
  • H2 blockers
  • PPIs
  • Treat H pylori
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14
Q

How does ulcerative colitis present?

A
  • Bloody diarrhoea
  • Abdominal pain
  • Weight loss
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15
Q

Name the features of a severe ulcerative colitis

A
  • Stools >6 per day
  • Fever
  • Tachycardia
  • Raised CRP
  • Anaemia
  • Albumin <30
  • Leucocytosis and thrombocytosis
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16
Q

How does Crohn’s disease present?

A
  • Diarrhoea
  • Abdo pain
  • Weight loss
  • Malaise, lethargy, anorexia, N&V and fever
  • Malabsorption
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17
Q

How can IBD be managed as an outpatient?

A
  • 5ASA
  • Steroids
  • Immunosuppression: azathioprine, methotrexate and infliximab
  • Elemental feeding
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18
Q

How can IBD be managed in hospital?

A
  • Steroids
  • Anticoagulation
  • Surgery
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19
Q

How are H pylori infections treated?

A
  • Clarithromycin
  • Amoxicillin
  • PPI
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20
Q

How do gastric cancers present?

A
  • Dyspepsia
  • Early satiety
  • Nausea and vomiting
  • Weight loss
  • GI bleeding
  • Iron deficiency anaemia
  • Gastric outlet obstruction
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21
Q

How can spontaneous bacterial peritonitis be managed?

A
  • IV antibiotics
  • Ascitic fluid drainage
  • IV albumin infusion
22
Q

How can intra-abdominal sepsis be managed?

A
  • Amoxicillin
  • Gentamicin
  • Metronidazole
23
Q

Describe the features of Primary Biliary Cholangitis

A
  • Females
  • Anti-mitochondrial auto-antibodies
  • Raised ALP
24
Q

Describe the features of Primary Sclerosing Cholangitis

A
  • Associated with IBD
  • Progresses to cirrhosis
  • Increased risk of cholangiocarcinoma
25
Q

How can biliary sepsis be managed?

A
  • Amoxicillin
  • Metronidazole
  • Gentamicin
26
Q

Describe the components of Charcot’s triad (ascending cholangitis)

A
  • Jaundice
  • Fevers
  • RUQ pain
27
Q

How can refeeding syndrome be managed?

A
  • 10kcal/kg/day nutrition
  • Close monitoring of fluid balance
  • Thiamine and other vitamin supplements
  • Potassium, phosphate and magnesium replacement
28
Q

How does acute mesenteric ischaemia present?

A
  • Colicky pain
  • Peritonism
  • Causes (e.g. AF)
29
Q

How should acute mesenteric ischaemia be investigated?

A
  • CT angiography
  • FBC (raised WCC)
  • Abdo X-ray
  • ECG or ECHO
30
Q

How should acute mesenteric ischaemia be managed?

A
  • IV fluids and oxygen
  • NG tube
  • IV antibiotics
  • IV heparin
  • Laparotomy
31
Q

How does chronic mesenteric ischaemia present?

A
  • Colicky pain
  • Weight loss
  • Postprandial pain
  • Fear of eating
  • Nausea/vomiting
  • Bowel irregularity
32
Q

How can chronic mesenteric ischaemia be managed?

A
  • Smoking cessation
  • Antiplatelet therapy
  • Open or endovascular revascularisation
  • TPN
33
Q

How does ischaemic colitis present?

A
  • Acute abdomen
  • LIF pain
  • Nausea and vomiting
  • PR bleeding
  • Peritonitis
  • Metabolic acidosis
34
Q

How can ischaemic colitis be managed?

A
  • Bowel rest
  • Stop any causes
  • Antibiotics
  • Repeat colonoscopy if symptomatic after 24-48 hours
  • Laparotomy (guarding, rebound tenderness, fever, paralytic ileus)
35
Q

How does peritonitis present?

A
  • Abdominal pain
  • Fever
  • Tachycardia
  • Guarding and rebound tenderness
  • Absent bowel sounds
  • Hypotension
36
Q

How can peritonitis be managed?

A
  • Antibiotics

- Surgery

37
Q

How does acute pancreatitis present?

A
  • Severe upper abdominal pain
  • Vomiting
  • Tachycardia
  • Jaundice
  • Hypoxaemia
  • Serum amylase 3x normal
38
Q

How can acute pancreatitis be managed?

A
  • Fluid resuscitation
  • Nutritional support
  • Analgesia
  • Supportive measures
39
Q

Name the risk factors for adenocarcinoma of the oesophagus

A
  • Tobacco
  • Barrett’s oesophagus
  • Obesity
40
Q

Name the risk factors for squamous cell carcinoma of the oesophagus

A
  • Tobacco

- Achalasia

41
Q

Name the causes of chronic pancreatitis

A
  • Alcohol
  • Cystic fibrosis
  • Congenital anatomical abnormalities
  • Hypercalcaemia
42
Q

How does chronic pancreatitis present?

A
  • Abdo pain
  • Weight loss
  • Steatorrhoea
  • Diabetes
  • Jaundice, portal hypertension
43
Q

How can chronic pancreatitis be managed?

A
  • Avoid alcohol
  • Pancreatic enzyme supplements
  • Opiates
  • Coeliac plexus blok
  • Treatment of pancreatic duct stones and strictures
44
Q

How does pancreatic cancer present?

A
  • Upper abdominal pain (body and tail)
  • Painless obstructive jaundice (head)
  • Weight loss
  • Diarrhoea/steatorrhoea
  • Nausea and vomiting
  • Hepatomegaly and splenomegaly
  • Abdominal mass
45
Q

How can pancreatic cancer be managed?

A
  • Whipple’s procedure

- Palliative: stent or surgery

46
Q

How can haemorrhoids be managed?

A
  • Laxatives
  • Lifestyle avdice
  • Ligation
  • Diathermy
  • Haemorrhoidectomy
47
Q

How can anal fissures be managed?

A
  • Topical nitric oxide
  • GTN paste
  • Internal lateral sphincterotomy
48
Q

How can a perianal abscess be managed?

A

Incision and drainage

49
Q

How does diverticulitis present?

A
  • LIF pain
  • Changes in bowel habits
  • Localised tenderness and a palpable mass
  • Fever and tachycardia
50
Q

How can diverticular disease be managed?

A
  • High fibre diet
  • Adequate fluid intake
  • Bulk forming laxatives
  • Anti-spasmodic
51
Q

How can diverticulitis be managed?

A
  • Oral antibiotics if systemically unwell (IV if complicated)
  • Paracetamol
  • Clear fluids
  • Surgery if complications
52
Q

How can post-operative infections be managed?

A
  • Co-trimoxazole and metronidazole

- Debridement

Finals (18 decks)

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