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Phase 2A Med Concise > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

Abdominal pain - Epigastric region conditions

A

Heartburn/indigestion
Pancreatitis
Stomach ulcer
Epigastric hernia

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2
Q

Abdominal pain - Umbilical region conditions

A

Pancreatitis
Stomach ulcer
Inflammatory bowel
Umbilical hernia

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3
Q

Abdominal pain - Hypogastric region conditions

A

Urine infection
Diverticular disease
Pelvic pain (gynae)

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4
Q

Abdominal pain - Right hypochondrium region conditions

A

Gall stones

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5
Q

Abdominal pain - Right flank region conditions

A

Kidney stones

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6
Q

Abdominal pain - Right iliac region conditions

A 
Appendicitis 
Groin pain (inguinal hernia)
Pelvic pain (gynae)
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7
Q

Abdominal pain - Left hypochondrium region conditions

A

Stomach ulcer

Duodenal ulcer

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8
Q

Abdominal pain - Left flank region conditions

A

Kidney stones

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9
Q

Abdominal pain - Left iliac region conditions

A 
Pelvic pain (gynae)
Groin pain (inguinal hernia)
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10
Q

Gastro-oesophageal reflux disease (GORD) - Pathophysiology

A

Lower oesophageal sphincter relaxes independently of a swallow, leading to reflux of gastric acid, bile and duodenal contents back into oesophagus

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11
Q

Gastro-oesophageal reflux disease (GORD) - Risk factors

A

Increased abdo pressure (pregnancy)
Obesity
Smoking
Hiatus hernia

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12
Q

Gastro-oesophageal reflux disease (GORD) - Symptoms

A

Heartburn

Acidic taste in mouth

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13
Q

Gastro-oesophageal reflux disease (GORD) - Management

A

Oral antacids - Gaviscon

PPI - Lansoprazole (inhibit gastric hydrogen release, preventing gastric acid production)

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14
Q

Gastro-oesophageal reflux disease (GORD) - Complication

A

Barret’s oesophagus (oesophageal epithelia changes from squamous to columnar)

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15
Q

Peptic ulcers - Pathophysiology

A

A break in epithelium which penetrates down to the mucosa

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16
Q

Peptic ulcers - 2 Types

A

Duodenal ulcer

Gastric ulcer

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17
Q

Peptic ulcers - Causes

A

Helicobacter pylori

NSAID use

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18
Q

Peptic ulcers - Investigation

A

Urea breath test
Serology
Stool antigen test

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19
Q

Peptic ulcers - Treatment

A

PPI (Lansoprazole)

2 Antibiotics - Metronidazole and clarithromycin

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20
Q

Coeliac disease - Pathophysiology

A

T helper cells release inflammatory cytokines and stimulate B cells, causing gut damage

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21
Q

Coeliac disease - Investigation

A 
Duodenal biopsy 
Blood test (IgA-tTG)
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22
Q

Coeliac disease - Symptoms

A

Bloating
Diarrhoea
Dermatitis herpetiformis

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23
Q

Malabsorption - Causes

A 
Poor intake
Lack of digestive enzymes
Defective epithelial transport
Reduced surface area
Poor intraluminal digestion
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24
Q

Malabsorption - Symptoms

A

Weight loss
Anaemia
Steatorrhoea (excess fat in faeces)

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25
Q

Crohn’s disease - Pathophysiology

A

Transmural, granulomatous inflammation affecting any part of the gut
Macroscopic - thickened and narrowed
Microscopic - Granulomas, goblet cells

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26
Q

Crohn’s disease - Signs and symptoms

A

Signs - Mouth ulcers, tenderness in RLQ

Symptoms - Diarrhoea, RLQ abdo pain, weight loss

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27
Q

Crohn’s disease - Risk factors

A

Smoking

Chronic stress

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28
Q

Crohn’s disease - Investigations

A

Colonoscopy
Stool sample (to rule out infectious causes)
FBC - Raised ESR/CRP (inflammation), low Hb (anaemia)

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29
Q

Crohn’s disease - Management

A

Oral corticosteroids
Infliximab (Anti-TNF antibodies)
Methotrexate
IV hydrocortisone (severe flare ups)

30
Q

Ulcerative colitis - Pathophysiology

A

Inflammatory condition of colon mucosa
Macroscopic - Continuous inflammation, ulcers
Microscopic - Mucosal inflammation, no granulomata, depleted goblet cells

31
Q

Ulcerative colitis - Signs and symptoms

A

Signs - Fever

Symptoms - LLQ pain, bloody diarrhoea with mucus

32
Q

Ulcerative colitis - Investigations

A

FBC - Raised ESR/CRP

Stool sample to rule our infectious diseases

33
Q

Ulcerative colitis - Management

A

Prednisolone

Colectomy (severe UC)

34
Q

Differences between crohn’s and UC

A

Crohn’s - Anywhere in gut, skip lesions, granulomas, goblet cells, transmural (all layers), cobblestone appearance
UC - Only colon affected, no skip lesions, no granulomas, goblet cells depleted, mucosa only layer affected, no cobblestone appearance

35
Q

Irritable bowel syndrome - Pathophysiology

A

Group of abdominal symptoms without any causes

36
Q

Irritable bowel syndrome - Risk factors

A

Female>male

Stress

37
Q

Irritable bowel syndrome - Symptoms

A

Abdo pain relieved by defecating
Bloating
Alternating bowel habits

38
Q

Irritable bowel syndrome - Management

A

Buscopan (pain)
Senna - laxative (constipation)
Loperamide - anti-motility (diarrhoea)

39
Q

Infective diarrhoea - Risk factors

A

Foreign travel
Poor hygiene
new/different foods

40
Q

Infective diarrhoea - Causes

A

Viral - Rotavirus (children), norovirus, adenovirus
Bacterial - E.coli, salmonella, shigella, campylobacter jejuni
Parasites
Clostridium difficile

41
Q

Infective diarrhoea - Symptoms

A 
Blood in diarrhoea 
Vomiting 
Fever
Fatigue
Headache
Muscle pains
42
Q

Infective diarrhoea - Investigation

A 
Stool sample (culture)
Sigmoidosopy
Blood sample
43
Q

Infective diarrhoea - Treatment

A

Rehydration
Antibiotics
Loperamide (ant-motility)
Antiemetics

44
Q

Intestinal obstruction - Lumen causes

A

Tumours

Gallstone

45
Q

Intestinal obstruction - Wall causes

A

Tumours

Crohn’s

46
Q

Intestinal obstruction - Outside

A

Tumours (peritoneal)
Adhesions (fibrosis after surgery)
Mesentery

47
Q

Hernia - Pathophysiology

A

A protrusion of organ/tissue out of the body cavity that it normally lies

48
Q

Hernia - Causes

A 
Muscle weakness (age, trauma)
Body strain (heavy lifting, pregnancy, chronic cough)
49
Q

Inguinal hernia - Pathophysiology

A

Protrusion of abdominal cavity contents through the inguinal canal

50
Q

Inguinal hernia - 2 Types

A

Direct - Protrudes directly into inguinal canal, medial to inferior epigastric vessels
Indirect - Protrudes through the internal inguinal ring, Lateral to inferior epigastric vessels

51
Q

Hiatus hernia - Pathophysiology

A

Part of stomach herniates through the oesophageal hiatus of the diaphragm

52
Q

Hiatus hernia - 2 Types

A

Sliding - Oesophageal-gastric junction slides through the hiatus and lies above the diaphragm (reflux symptoms present)
Para-oesophageal - Gastric fundus rolls up through hiatus alongside oesophagus (treated via surgery)

53
Q

Appendicitis - Pathophysiology

A

1) Gut flora multiplies (E.coli) in appendix
2) Increased pressure
3) Inflammation

54
Q

Appendicitis - Symptoms

A

Acute pain (umbilicus to RIF)
Nausea/vomiting
Fever

55
Q

Appendicitis - Treatment

A

Appendicectomy

56
Q

Peritonitis - Pathophysiology

A

Inflammation of peritoneum due to entry of blood, air, bacteria or GI contents (faeces/bile)

57
Q

Peritonitis - Symptoms

A

Dull pain that becomes sharp

Pain worse on coughing/moving

58
Q

Peritonitis - Causes

A 
Appendicitis 
Ectopic pregnancy 
TB infection
Obstruction
Ulcer
59
Q

Peritonitis - Investigations

A 
Abdo exam
AXR - Dilated bowel
Bloods - FBCs, U&Es, LFTs, clotting
Ascitic tap - Raised neutrophils
Low BP (Sepsis)
60
Q

Pancreatitis - Pathophysiology

A

Pancreatic enzymes destroy pancreas and nearby blood vessels

61
Q

Pancreatitis - Signs and symptoms

A

Signs - Tachycardia
Symptoms - Nausea/vomiting, epigastric pain radiating to back (relieved by sitting forwards), cullens/grey turner’s (bruising around umbilicus and flank)

62
Q

Pancreatitis - Causes

A 
Idiopathic
Gall stones
Alcohol
Trauma
Malignancy
Autoimmune
Scorpion stings
63
Q

Pancreatitis - Investigations

A

Bloods - Raised amylase and lipase
AXR
CT abdo

64
Q

Pancreatitis - Treatment

A 
IV fluids (maintain electrolyte balance)
Analgesic
65
Q

Ischaemic colitis - Pathophysiology

A

Low flow in inferior mesenteric artery

66
Q

Ischaemic colitis - Symptoms

A

LLQ pain

Bloody diarrhoea

67
Q

Ischaemic colitis - Investigation

A

Colonoscopy

68
Q

Acute mesenteric ischaemia - Pathophysiology

A

Low flow in superior mesenteric artery

69
Q

Acute mesenteric ischaemia - Symptoms

A

Acute severe abdo pain

70
Q

Acute mesenteric ischaemia - Investigation

A

Laparotomy

71
Q

Acute mesenteric ischaemia - Treatment

A

Surgery to remove dead bowel
Fluid resus
Antibiotics

Phase 2A Med Concise (18 decks)

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