Brainscape's Knowledge GenomeTM

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


See full index

Phase 2a - conditions > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

What is the most common symptom of gastrointestinal infection?

A

Diarrhoea

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

What other non-infective causes of diarrhoea?

A

Cancer
Inflammatory bowel disease
Irritable bowel syndrome
Drugs

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

What are the other symptoms of GI infections?

A

Nausea
Vomiting
Abdominal cramps

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

What about the diarrhoea can indicate the severity of the infection?

A

Watery - non-inflammatory

Bloody/mucoid - inflammatory

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

What group of organisms causes the most diarrhoea in the UK?

A

Viruses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are bacterial causes of watery diarrhoea?

A

Cholera, E.coli, S. aureus, Bacillus cereus.

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

What are viral causes of watery diarrhoea?

A

Rotavirus, norovirus

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

What is a parasitic cause of water diarrhoea?

A

Giardia

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

What is a bacterial cause of bloody diarrhoea?

A

Shigella, E.coli, Salmonella, C. diff, Campylobacter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are risk factors for GI infection?

A 
Recent travel
Immunocompromised
Contact with an infected individual
A hobby that has exposures - ie. water sports or with animals. 
Food and drink - ie. BBQ
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What bacteria is linked to infection from BBQ?

A

Campylobacter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What bacteria is linked to infection from reheated rice?

A

Bacillus cereus

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

What investigations should be carried out in suspected GI infections?

A

Blood tests - microscopy and culture

Stool tests - microscopy and culture

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

What is the most common causative organism of traveller’s diarrhoea?

A

E.coli

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

What is the diagnostic features of traveller’s diarrhoea?

A

3+ unformed stools per day with one of symptoms as well. Withink two weeks of arrivak in a new country.

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

What symptoms does Vibrio cholera infection give?

A

Very watery diarrhoea - up to 20l a day

Vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How does Vibrio cholera cause diarrhoea?

A

Produces the cholera toxin - causes chloride to be transported into the lumen - water follows - severe watery diarrhoea.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is a mechanism of clostridium difficile infection?

A

It is a normal gut flora in 5% of population - gut flora is altered by broad spectrum antibiotics - C. diff can grow uninhibited - then releases toxins that cause pain and fever.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What antibiotics can cause the overgrowth of C diff?

A

Clindamycin
Cephalosporins
Ampicillin
Amoxicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What antibiotics can treat C diff infection?

A

Metronidazole or oral vancomycin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the basic treatments for diarrhoea?

A

Give fluids to avoid dehydration
If severe - give anti-emetics
If systemically unwell - give antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What infection can cause peptic ulcer disease?

A

Helicobacter pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are intraluminal causes of GI obstruction?

A

Tumour
Strictures
Gallstone ileus
Meconium ileus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are intramural causes of GI obstruction?

A

Inflammatory - Crohn’s or UC
Diverticular disease
Intramural tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are extraluminal causes of GI obstruction?

A

Adhesions
Volvulus
Peritoneal tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is an adhesion? Causes of an abdominal adhesion?

A

Fibrous attachments between areas of the bowel. Often occur as a result of abdominal surgery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Where is the most common location for an abdominal volvulus?

A

Sigmoid colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

In what part of the bowel are most obstructions?

A

Small bowel.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the presentation of abdominal obstruction?

A

Abdominal colic
Distension
Constipation (no passage of wind also)
Vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How does vomiting present in a small bowelobstruction?

A

Profuse and projectile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How does vomiting present in a large bowel obstruction?

A

Absent (due to a competent ileocaecal valve)

Much later in presentation (incompetent valve)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What does bilious vomit indicate in GI obstruction?

A

Post duodenum obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What does faeculant vomiting suggest in GI obstruction?

A

It has been a long duration of obstruction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the signs of a GI obstruction?

A 
Tachycardia
Dehydration
Distension
Tenderness
Tinkling bowel sounds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What does an abdominal X-Ray show in GI obstruction?

A

Distended bowel proximal to the obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are the treatment options for GI obstruction?

A

Fluids
Nasogastric tube - to relieve pressure build up
Surgery to relieve blockage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are the possible complications of Gi obstruction?

A

Dehydration
Perforation and infection
Sepsis
Kidney failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What two conditions make up inflammatory bowel disease?

A

Crohn’s disease

Ulcerative colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are the symptoms of Crohn’s disease?

A 
Diarrhoea
Abdominal pain 
Weight loss 
Malaise
Lethargy 
Nausea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What investigations should be carried out in suspected inflammatory bowel disease?

A

Blood tests - raised ESR and CRP
Stool tests to exclude infection
Endoscopy and biopsy
Exclude coeliac disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Where is the inflammation in Crohn’s disease?

A

Anywhere from mouth to anus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the pathophysiology of Crohn’s inflammation?

A 
It is patchy along the GI tract 
Granulomatous inflammation (50%)
If prolonged leads to fibrous scarring and a cobblestone appearance.
Can occur in any layer of the bowel wall.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are the specific symptoms of ulcerative colitis?

A 
Bloody and mucous diarrhoea always (colon only) 
Lower abdominal discomfort 
Weight loss 
Malaise 
Lethargy 
Nausea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the lifestyle advice for Crohn’s disease?

A

Smoking cessation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the pathophysiology of ulcerative colitis inflammation?

A

Isolated to the colon only
Starts at rectum and progresses continuously
Only in the mucosal layer of the bowel wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the treatment for mild IBD?

A

Crohn’s - mild steroids (prednisolone)

UC - 5-ASAs (mesalazine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the treatment for severe IBD?

A

IV hydrocortisone

Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What are the differences between Crohn’s and UC?

A 
any part of the GI tract v colon only.
patchy v continuous
transmural v mucosal only 
granulomas v no granulomas
bowel complications v systemic complications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What are the complications of Crohn’s disease?

A

Malabsorption
Obstruction
Perforation - infection
Neoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What are the complications of UC?

A

Cancer
Perforation - infection
Arthritis
Rashes and ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is gastritis?

A

Inflammation of stomach epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What are the causes of gastritis?

A

NSAIDs
H Pylori infection
Smoking
Autoimmune

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is the presentation of gastritis?

A 
Dyspepsia 
Nausea 
Vomiting 
Early satiety 
Indigestion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What investigations should be carried out in gastritis?

A

Endoscopy

H Pylori tests - C-urea breath test, antigen stool test.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What lifestyle can be given for gastritis?

A 
Less NSAID use 
Avoid irritants 
Smoking cessation 
Alcohol reduction 
Smaller meals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

How to treat gastritis?

A

Antacids
PPIs
H2 receptor agonists
Treat H pylori infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What are the complications of gastritis?

A

Gastric ulcer
Polyps
Malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is the basis of coeliac disease?

A

Immune mediated inflammatory response to gluten, which can lead to chronic inflammation and malabsorption.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What component of gluten triggers the immune response?

A

Gliadin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is the immune response to gliadin?

A

Gliadin passes through epithelium - deaminated by tissue transglutaminase - T cells produce pro-inflmmatory cytokines and activate B-cells - B cells produce antibodies - vilous atrophy and malabsorption.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What antibodies to B cells produce in coeliac disease?

A

anti-gliadin
tissue transglutaminase
anti-endomysial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is the genetic association in coeliac disease?

A

HLA DQ2 in 95%

HLA DQ8 in the rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What ages are affected by coeliac disease?

A

Any. peaks infancy and middle/late age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is the presentation of coeliac disease?

A 
Diarrhoea
Stinking stools/steathorrhea
Weight loss
Abdominal pain 
Bloating 
Nausea and vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is classical and non-classical presentations of coeliac disease?

A

Classical - infancy with IBS symptoms

Non-classical - adult with IBS symptoms and others (fatigue, osteoporosis, ataxia).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What are the signs of coeliac disease?

A

Anaemia (due to B12 or folate deficiencies)
Mouth ulcers
Skin rashes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What are the investigations for coeliac disease?

A 
Duodenal biopsy (4 + samples)
Serological testing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What diet must the patient be on when the tests are taken?

A

Gluten

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What antibodies are tested for in the serological tests?

A

anti-gliadin
tissue transglutaminase
anti-endomysial
(all IgA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is seen on histology of a duodenal biopsy in coeliac disease?

A

Villous atrophy
Increased epithelial lymphocytes
Crypt hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is the histological classification for coeliac disease?

A

Marsh classification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

How do you decide when to biopsy in coeliac disease?

A

If high risk always biopsy.

If low risk, biopsy if serology tests are positive.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is the management for coeliac disease?

A

Gluten free diet
Nutritional supplements as required
Information and education

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Wy may someone have poor compliance to a gluten free diet?

A

High cost of gluten free products
Hard in social situations
Food unpalatable
Inadvertent exposure to gluten

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What are the possible complications of coeliac disease?

A

Anaemia
Lymphoma risk
Other malignancy raised risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What are the symptoms of malabsorption?

A 
Diarrhoea 
Weight loss 
Lethargy 
Steathorroea 
Bloating
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What are the signs of malabsorption?

A 
Anaemia (dec iron, folate or B12)
Bleeding disorders (dec vit K)
Oedema (dec protein) 
Bone disease (dec vit D) 
Neurological features
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What are the possible pathophysiological causes of malabsorption?

A 
Insufficient intake
Defective digestion 
Insufficient absorptive area 
Lack of digestive enzymes 
Defective epithelial transport 
Lymphatic obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What are the causes of defective digestion leading to malabsorption?

A

Pancreatic insufficiency - pancreatits/cystic fibrosis
Defective bile secretion - obstruction, ileal resection
Bacterial overgrowth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What are the causes of insufficient absorptive area leading to malabsorption?

A

Coeliac disease
Crohn’s disease
Parasite invasion
Resection or bypass

81
Q

What are the causes of lack of digestive enzymes leading to malabsorption?

A

lactose intolerance – diasaccheridase def

bacterial overgrowth

82
Q

What are the two types of oesophageal cancer?

A

Squamous cell

Adenocarcinoma

83
Q

What are the risk factors for adenocarcinoma of the oesophagus?

A

Obesity
GORD
Older age

84
Q

What is the link between GORD and adenocarcinoma of the oesophagus?

A

GORD causes metaplasia of squamous to columnar epithelium (Barratt’s) - may eventually produce dysplastic or neoplastic cells.

85
Q

What are the risk factors for squamous cell carcinoma of the oesophagus?

A

Smoking
High alcohol intake
Male gender
Chinese

86
Q

What is the presentation of oesophageal cancer?

A 
It often presents very late and vaguely 
Dysphagia (often solids first then liquids later)
Weight loss and anorexia 
Lymphadenopathy 
Indigestion and heart burn
87
Q

What are investigations for an oesophageal cancer?

A

Endoscopy - diagnosis

CT/MRI for staging purposes.

88
Q

What is the location of local metastases of oesophageal cancer?

A

Trachea
Vena cava
Aorta

89
Q

What is the management of an oesophageal cancer?

A

Surgery - only if an early enough presentation
Chemotherapy
Radiotherapy
Palliative therapies

90
Q

What type of cancer is gastric cancer?

A

Adenocarcinoma

91
Q

What are risk factors for gastric cancer?

A 
Smoking 
H. pylori infection
High salt and nitrate diet 
Family history 
Old age
92
Q

When is a gastric cancer classified as early?

A

Mucosa and submucosa only

93
Q

When is gastric cancer classified as late?

A

Spread into the muscular wall and beyond - most common presentation

94
Q

What is the presentation of gastric cancer?

A 
Often presents very late in the disease progression.
Epigastric pain 
Nausea 
Anorexia
Weight loss
95
Q

What are the signs of gastric cancer?

A

Epigastric mass

Abdominal tenderness

96
Q

What is the investigation for gastric cancer?

A

Gastroscopy and biopsy

Then CT/MRI for TNM staging

97
Q

What are the treatment options for gastric cancer?

A

Surgical excision - if possible

Not a good prognosis <10% 5 year.

98
Q

What is the most common lower GI tract cancer?

A

Colorectal adenocarcinoma

99
Q

What are the risk factors for colorectal cancer?

A 
Old age 
Low fibre diet 
High red and processed meat diet 
IDB 
Colorectal polyps 
Alcohol 
Smoking 
Family history 
Previous cancer
100
Q

What is the link between adenomas and colorectal cancers?

A

Adenomas are areas of dysplastic epithelium, have a raised risk of turning into neoplastic epithelium and cancer.

101
Q

What is familial adenomatous polyposis

A

Genetic condition where 100s of polyps develop in childhood, colorectal cancer is usually present by 20s.

102
Q

What is hereditary nonpolyposis colorectal cancer?

A

One of the DNA repair proteins is faulty. Throughout lifetime if there is another mutation the there is a very high risk of cancer.

103
Q

Where is the majority or colorectal cancer?

A

Rectum

104
Q

What is the presentation of colorectal cancer?

A

Change in bowel habit
Looser, more frequent stools
Rectal bleeding
Rectal or abdominal mass may be palpable

105
Q

What investigations should be carried out in colorectal cancer?

A

DRE
Colonoscopy and biopsy
Staging - MRI/CT

106
Q

What system is used to stage colorectal cancer?

A

Dukes’ classification. Goes from A (mucosa only) to D (distant mets).

107
Q

What is the management of colorectal cancer?

A

Surgical excision
Chemotherapy
Radiotherapy

108
Q

What is the UK colorectal cancer screening programme?

A

One-off screen at 55 years old.

Home testing kits every 2 years 60-75.

109
Q

What drug could have a preventative effect in colorectal cancer?

A

Aspirin

110
Q

What is peritonitis?

A

Inflammation of the peritoneum.

111
Q

What are the causes of peritonitis?

A

Perforation of a peptic ulcer
Diverticular perforation
Trauma
Ascites - can cause spontaneous peritonitis.

112
Q

What is the physiology of the parietal peritoneum?

A

Lines the abdominal wall
Somatic innervation - can localise pain
Needs a large inflammation to be directly irritated.

113
Q

What is the physiology of the visceral peritoneum?

A

Lines the organs
Autonomic innervation - refers pain
Small inflammation causes referred pain

114
Q

What are the symptoms of peritonitis?

A 
Pain 
Fever 
Rigidity 
Vomiting 
Tenderness
115
Q

What are the signs of peritonitis?

A

Lying still
No bowel sounds
Guarding
Kehr’s sign - pain in shoulder due to phrenic nerve

116
Q

What investigations should be carried out in peritonitis?

A

Bloods
X-ray
CT
serum amylase - check from pancreatitis

117
Q

What is the management of peritonitis?

A

Resuscitation - fluids
Broad spectrum antibiotics
Surgery - peritoneal lavage and treat cause

118
Q

What are the causes of haematemisis?

A 
Peptic ulcers
Mallory-Weiss tear
Oesophageal varices 
Gastritis 
Drugs
Malignancy
119
Q

What is the management for haematemisis?

A

Fluids
Transfusions if needed
Arrange an urgent endoscopy.

120
Q

What is GORD?

A

Gastroesophageal reflux disorder

121
Q

What are the causes of GORD?

A

Lower oesophageal sphincter failure
Hiatus hernia
Gastric acid hypersecretion

122
Q

What are the risk factors of GORD?

A 
Obesity 
Smoking 
Alcohol 
Pregnancy
Over-eating
123
Q

What is Barratt’s oesophagus?

A

Metaplasia of oesophageal squamous cells to gastric columnar cells. Cells are damaged by gastric acid reflux.

124
Q

What is the presentation of GORD?

A

Heartburn - worse lying down or after meals
Painful swallowing
Regurgitation

125
Q

Investigations for GORD?

A

A mostly clinical diagnosis. If further complications are suspected then endoscopy.

126
Q

What lifestyle changes can be recommended in GORD?

A

Reduction of alcohol and caffeine

Smoking cessation

127
Q

What pharmacological options are available in GORD?

A

Antacids
H2 receptor antagonists
PPIs

128
Q

What are the complications of GORD?

A

Barratt’s oesophagus
Ulcers
Oesophageal cancer

129
Q

What is an ulcer?

A

A break in the mucosal surface.

130
Q

Where is the most common location for a gastric ulcer?

A

Duodenum

131
Q

What are the causes of a peptic ulcer?

A 
Mucosal ischaemia 
Increased gastric acid secretion 
NSAIDs
H Pylori infection 
Smoking 
Alcohol in high concentrations
132
Q

What is the physiology of gastric acid defence?

A

The gastric acid cells produce mucin which forms a protective layer and prevents attack by the acid. If this layer is damaged or overwhelmed the cells are damaged.

133
Q

What is the mechanism of peptic ulcers caused by NSAIDs?

A

COX2 inhibition by NSAIDs inhibits mucous production so weakens the mucosal defence to gastric acid.

134
Q

What is the presentation of a peptic ulcer?

A

Dyspepsia
Bloating
Heartburn
Nausea

135
Q

How may the pain of a peptic ulcer alter depending on its locations?

A

Gastric - pain when eating

Duodenal - pain after eating or when hungry.

136
Q

What tests can be carried out to identify H pylori infection?

A

C-Urea breath test

Stool antigen test

137
Q

What investigations should be carried out for peptic ulcer diagnosis?

A

Endoscopy

138
Q

What is the treatment for H pylori +ve peptic ulcer?

A

PPI - ie. lanzoprazole

139
Q

What is the treatment for H pylori -ve peptic ulcer?

A

Stop NSAIDs
PPI
H2 blocker

140
Q

What lifestyle changes are recommended in peptic ulcers?

A

Smoking cessation
Stop NSAID use
Decreased alcohol
Avoid aggravating foods

141
Q

What is irritable bowel syndrome?

A

A mixed group of abdominal symptoms with no known organic cause.

142
Q

What is the prevalence is irritable bowel syndrome?

A

10-20%

143
Q

What are the symptoms of IBS?

A 
Bloating 
Feeling of incomplete emptying 
Worsening of symptoms after food 
Nausea
Chronic symptoms 
Constipation 
Diarrhoea
144
Q

What are exacerbating features of IBS?

A

Stress

Menstruation

145
Q

How do you diagnose IBS?

A

One of -
Symptoms improved with defecation
Altered stool form or frequency
And 2+ other symptoms

146
Q

Red flags that may need further investigation in IBS?

A 
>40 years old 
Rectal bleeding 
Nocturnal pain 
Weight loss
Family history of bowel/ovarian cancer
147
Q

What lifestyle advice can be offered in IBS?

A

Healthy balance diet
Avoid alcohol and fizzy drinks
Adjust fibre intake according to symptoms
Education

148
Q

What is the symptomatic treatment for constipation in IBS?

A

Laxative

149
Q

What is the symptomatic treatment for diarrhoea in IBS?

A

loperamide (anti-motility drug)

150
Q

What is a hernia?

A

Protrusion of organ or tissue out of the body cavity in which it normally lies.

151
Q

What are the causes of hernias?

A 
Muscle weakness
Body stain 
Chronic cough 
Trauma 
Constipation 
Heavy weight lifting 
Pregnancy
152
Q

What is an irreducible hernia?

A

Cannot be pushed back into the right place.

153
Q

What is a reduction of a hernia?

A

Pushing the tissue/organ back into place.

154
Q

What is an incarcerated hernia?

A

Contents of the hernial sac are trapped by adhesions.

155
Q

What is a hiatal hernia?

A

When part of the stomach herniates through the oesophageal hiatus of the diaphragm.

156
Q

What are the two types of hiatal hernia?

A

Sliding and rolling

157
Q

What is an inguinal hernia?

A

Part of the bowel herniates into the inguinal canal.

158
Q

What are the two types of inguinal hernia?

A

Direct and indirect.

159
Q

What is a direct inguinal hernia and how can you tell?

A

Protrudes directly into the inguinal canal. The inferior epigastric vessels sit medially to the hernia.

160
Q

What is an indirect inguinal hernia and how can you tell?

A

Protrudes down through the inguinal ring. The inferior epigastric vessels sit laterally to the hernia.

161
Q

What is ischaemic colitis?

A

Inflammation and injury to the colon resulting from inadequate blood supply.

162
Q

What are the causes of ischaemic colitis?

A

Heart failure
Atherosclerosis
Malignancy
Surgical damage

163
Q

What is the presentation of ischaemic colitis?

A 
Diarrhoea 
Rectal bleeding 
Abdominal pain 
Distended 
Tender
164
Q

What are the risks of ischemic colitis?

A

Perforation
Peritonitis
Shock
Strictures

165
Q

What area of the bowel does acute mesenteric ischaemia affect?

A

Small bowel most commonly (superior mesenteric artery damage)

166
Q

What are the causes of acute mesenteric ischaemia?

A

Embolism
Thrombus
Trauma
Shock

167
Q

What is the presentation of acute mesenteric ischaemia?

A

Acute severe abdominal pain
No abdominal findings
Rapid hypovolaemia
Symptoms appear to be out of proportion with clinical findings.

168
Q

What is the management of acute mesenteric ischaemia?

A

Fluids
Antibiotics
Surgery - removal of dead bowel

169
Q

What is the pathophysiology of chronic mesenteric ischaemia?

A

At rest the demand of the bowel is met, after eating the demand increases and transient ischaemia occurs.

170
Q

What is the presentation of chronic mesenteric ischaemia?

A

Post-prandial pain
weight loss
Vascular co-morbidities

171
Q

What is the epidemiology of appendicitis?

A

Most commonly affects young people (10-20 years).

172
Q

What is the presentation of appendicitis?

A

Central vague abdominal pain that migrates to the RIF as it progresses.
Vomiting
Loss of appetite

173
Q

What are the signs of appendicitis?

A

Tachycardia
RIF guarding
Fever

174
Q

What is the treatment for appendicitis?

A

Prompt appendicectomy

175
Q

What are the complications of appendicitis?

A

Perforation

Appendix abscess

176
Q

Which point marks the location of the appendix?

A

McBurney’s Point.

2/3rds from umbilicus to superior iliac spine.

177
Q

What is diverticular disease?

A

Pouches of mucosa extrude through the colonic wall to form diverticula and become symptomatic.

178
Q

Where is the most common location for diverticulosis?

A

Sigmoid colon

179
Q

What is a possible cause of diverticular disease?

A

Lack of dietary fibre - high intraluminal pressure - mucosal herniation.

180
Q

What are the clinical features of diverticular disease?

A 
Mostly asymptomatic 
Intermittent LIF pain 
Altered bowel habit 
Nausea 
Flatulence
181
Q

What are the investigations for diverticular disease?

A

CT

Colonoscopy

182
Q

What is the treatment for acute diverticular disease?

A

Oral antibiotics
IV fluids
Surgery

183
Q

What are the complications of diverticular disease?

A

Perforation and infection
Intestinal obstruction
Bleeding
Mucusal inflammation - diverticulitis

184
Q

What are the causes of acute pancreatitis?

A 
Gallstones*
Ethanol (alcohol)*
Trauma 
Steroids 
Mumps 
Autoimmune 
Scorpion venom 
Hyperlipidaemia 
ERCP
Drugs
GETSMASHED
185
Q

What are the symptoms of acute pancreatitis?

A

Epigastric pain - radiates to the back, relived sitting forwards.
Vomiting and nausea

186
Q

What are the signs of pancreatitis?

A

Tachycardia
Fever
Jaundice
Guarding and rigidity

187
Q

How do gallstones cause pancreatitis?

A

They can block the outflow of the cystic duct and cause a backlog and inflammation of the pancreas.

188
Q

What is Cullen’s and Grey Turner’s sign of pancreatitis?

A

Cullen’s - periumbilical bruising
Grey Turner’s - flank bruising
From blood vessel auto-digestion.

189
Q

What is the diagnostic test for pancreatitis?

A

Serum amylase 3x the normal

190
Q

What other pancreatic enzymes may be raised in pancreatitis?

A

Lipase

191
Q

What is the prognosis of pancreatitis?

A

Most pancreatitis is mild and self limiting - unless it causes further complications.

192
Q

What are the treatments for acute pancreatitis?

A 
Analgesia 
Fluids 
Antibiotics 
Respiratory support 
Nasogastric tube for feeding
193
Q

What are the early complications of pancreatitis?

A

Renal failure *
ARDS *
Sepsis
Shock

194
Q

What are the late complications of pancreatitis?

A

Pancreatic necrosis
Diabetes
Abscess
Bleeding

195
Q

What are the symptoms of chronic pancreatitis?

A

Epigastric pain - radiates to back and relieved sitting forwards.
Weight loss
Diabetes
Steatorrhoea

196
Q

What are the investigations in chronic pancreatitis?

A

Ultrasound - shows calcification

Bloods - pancreatic enzymes may not be raised as there may not be enough tissue to produce the enzymes.

197
Q

What are the causes of chronic pancreatitis?

A

Alcohol
Cystic fibrosis
Autoimmune
Duct obstruction

198
Q

What is the management of acute pancreatitis?

A

Lifestyle - quit alcohol
Autoimmune - steroids
Pain relief
Pancreatic enzyme supplements

Phase 2a - conditions (11 decks)

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