Gastrointestinal Flashcards
Is PSC or PBC associated with IBD?
Primary sclerosing cholangitis (PSC)
What disease is associated with IBD?
Primary sclerosing cholangitis
Is PSC associated with IBD?
yes
Is PBC associated with IBD?
no
what is the typical PBC patient?
middle aged woman presenting with: pruritus + jaundice + pigmentation
What is the typical PSC patient?
usually the middle-aged man presenting with: pruritus + jaundice + abdominal pain
raised ALP, negative AMA
associated with IBD
features of Crohn’s disease
mouth - anus can be affected
weight loss, diarrhoea, abdo pain, strictures, fistulae
cobble-stoning (barium), rose-thorn ulcers, granulomas
features of UC
colon only
diarrhoea + blood/mucus
fever, tachycardia, toxic megacolon in severe acute UC
barium: loss of haustra, sigmoid - oedematous, friable mucosa
what does elevated AST and ALT with AST > ALT suggest?
alcoholic hepatitis/liver dysfunction
what does elevated AST and ALT with ALT > AST suggest?
viral hepatitis
What would a raised GGT and ALP suggest?
bile obstruction
what is the pathophysiology of achalasia?
ganglion cell degeneration in the mesenteric plexus. this leads to loss of inhibitory cells causing over stimulation of the LOS and failure to relax -> dysphagia
what are the most common causes of ascending cholangitis?
gallstones or strictures (benign or malignant in the bile duct)
what are the forms of alcohol liver disease?
alcoholic fatty liver
alcoholic hepatitis
chronic cirrhosis
what are the presentations of decompensated liver failure?
jaundice
ascites
hepatic encephalopathy
variceal haemorrhage
what 2 antibiotics are generally used to cover GI organisms?
cefuroxime and metronidazole
what are the major types of autoimmune hepatitis?
TYPE 1 - 80%, classic
all ages, mainly young women. ANA, ASMA, AAA, anti-SLA
TYPE 2 - young girls w/ other autoimmune disease (e.g. thyroid). ALKM-1 antibodies and ALC-1 antibodies
what are the changes that occur in Barret’s oesophagus?
the normal squamous epithelium is replaced by columnar epithelium
what are the symptoms of GORD?
heartburn
nausea
water-brush
bloating, belching
burning pain on swallowing
dry cough at night
what is a cholangiocarcinoma?
it is a primary adenocarcinoma of the biliary tree
what is the association with cholangiocarcinoma?
generally a rare condition but related to parasite infections
whats the most common type of gallstone?
what are the other types?
most common = mixed stone
pure cholesterol stone, pigment stones
what might cause cholecystitis in the absence of a gallstone?
starvation
TPN
narcotic analgesia
immobility
what kind of gallstones are haemolytic anaemias such as sickle cell a risk factor for?
pigment stones