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BDS 2 BAMS > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

what can cause GORD

A

poor lower oesophageal sphincter
increased pressure in stomach with reduced clearing
hiatus hernia

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2
Q

what might be complication of GORD

A

barrett’s oesophagus - metaplasia of the epithelial lining of stomach, to withstand acid, pre-neoplastic

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3
Q

what medications may patients with GORD be on

A

proton pump inhibitors - prevent production of acid by pp in parietal cells - omeprazole
antacid - convert acid to salt - rennies
H2 receptor agonist - rinitidine

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4
Q

what are the different types of mouth ulcers

A

minor aphthae, major aphthae or herpetiform aphthae

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5
Q

what is orofacial granulomatos

A

when macrophages engulf cells but cannot break them down, forms giant multi-nucleated cells. these then block the lymphatic ducts and prevent drainage. granuloma production with giant cells and fluid

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6
Q

what is a hiatus hernia

A

when part of the stomach herniates - either into oesophagus (sliding) or as a separate thing (rolling). severe GORD can be seen in sliding as every time the diaphragm contracts, the stomach and acid goes into the oesophagus

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7
Q

what is peptic ulcer disease

A

ulceration of lining caused by perforation by stomach acid

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8
Q

what causes peptic ulcer disease

A

over production of acid - acid into small intestine where the lining cannot withstand
normal production but not normal mucous production, so the stomach lining is not protected
helicobacter pylori - bacteria that causes inflammation of lining at pylorus at stomach. chronic inflammation can result in lymphoma

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9
Q

what complications can occur with peptic ulcers

A

can perforate through lining, right through to muscle and eventually cause a complete perforation into peritoneum, may get haemorrage or peritonitis.

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10
Q

what are signs and symptoms of peptic ulcer disease

A

normally none until it has perforated through

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11
Q

what investigations can be done into peptic ulcer disease

A

endoscopy, blood test for anaemia if bleeding, can check for antibodies to h pylori

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12
Q

how can peptic ulcer disease be treated

A

if reversible - medication such as PPI, antacid but if perforated may need surgery

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13
Q

what are possible causes for inflammatory bowel disease

A

psychological - stress and anxiety
immune system - over reaction to non threatening things
genetic

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14
Q

what are the differences between crohns disease and ulcerative colitis

A

crohns disease - can affect anywhere in tract, discontinuous, transmural (the whole way through), granulo formation cobble stone appearance, non vascular
UC - vascular appearance, mucosal ulcers, serosa not involved, continuous disease

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15
Q

what investigations can be done for IBD

A

faeces - calprotectin suggest inflammation
for a child - measuring their growth, make sure it isnt halted by malnutrition. blood test for anaemia markers, barium studies and endoscopy

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16
Q

what treatment is available for IBD

A

steroids if an immune reaction but not good long term
anti-tnf - directly attack, can get surgery to remove part for bowel but may result in stoma bag which has social implications

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17
Q

if a patient is presenting with recurrent oral ulcers what might you suspect

A

anaemia - may be due to malabsorption and inflammatory bowel disease

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18
Q

what can malabsorption result in

A

weight loss, diarrhoea, sterrohea, pernicious anaemia

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19
Q

what is the aetiology of coeliac disease

A

sensitivity to alpha gliaden which is in gluten. causes immune system to produce cytokines and attack villi, resulting in villous atrophy and an inability for absorption

20
Q

what investigations can be done for coeliac disease

A

blood test for haemantics, endoscopy with biopsy, can be done before and after period with no gluten to check for improvement, faeces to check for fat in stool

21
Q

describe the screening tool used for colon cancer

A

every person over the age of 50 sends a faecal sample in the post, its then check for blood, if none detected, nothing for the next 5 years. polyps cause bleeding and can turn neoplastic within 5 years

22
Q

what is a polyp

A

a growth on the mucosal lining, as food passes through, it is irritated and can cause the mucosa to bleed, if left, likely to turn into malignant cancer, but can be removed easily

23
Q

what can increase the likelihood of polyps

A

ulcerative colitis, smoking, low fibre high fat diet,

24
Q

what is jaundice

A

excess unconjugated billirubin deposited on skin

25
Q

what is billirubin

A

product of breakdown of RBC, especially haem group

26
Q

how are RBC broken down

A

broken down by bone marrow to produce unconjugated billirubin. this then goes to liver where it can be conjugated for excretion from kidneys or git

27
Q

what are the 3 ways jaundice can occur and give examples of when this would happen

A

pre-hepatic - build up of rbc breakdown, too many RBC, mismatch blood transfusion or maternal blood in fetus
hepatic - problem with hepatocytes conjugating bilirubin, cirrhosis
post-hepatic - blockage in bile duct, preventing bilirubin being cleared, backs up into vein - gall stones

28
Q

how can the colour of urine or faeces tell what type of jaundice it is

A

if urine is normal colour - conjugated bilirubin into blood to get to kidney - pre or post but not hepatic
if faeces is normal colour - conjugated bilirubin into GIT, cannot be hepatic or post, must be pre

29
Q

how can jaundice be treated

A

light therapy in neonate, but not much can do other than let it pass. ursodeoxycholic acid can be used to prevent build up of bile acid in post

30
Q

what is acute cholecysitis

A

inflammation of bile ducts due to blockage from a gall stone

31
Q

how can bile ducts be investigated

A

ultrasound to check dilation
endoscopy retrograde cholangiopancreatography, done through to small intestine then up through bile duct to check for blockage - can put in stent while there to open up but if cancer - need more treatment

32
Q

how can gall stones be treated

A

lithotripsy - breaking up with sound waves then vaccuming up or removal of gall bladder

33
Q

what are the types of liver failure

A

acute - sudden damage to liver with alcohol or drugs
chronic - constant damage to liver, as it tries to repair, lays down fibrotic tissue, any hepatocytes produced, dont link to bile ducts

34
Q

what causes cirrhosis

A

alcohol, drugs, primary biliary sclerosis, infection

35
Q

what are the functions of liver

A

metabolic - metabolise drugs, toxins, RBC

synthetic - synthesis clotting factors and plasma proteins

36
Q

what are some signs and symptoms of liver failure

A

ascites - build up of pulmonary pressure in abdomen due to reduced drainage in liver, also not producing plasma proteins so lower oncotic pressure, results in oedema in abdomen
oesophageal varices - pressure through to oesophagus, cause dilation can rupture

37
Q

what tests can be done to check liver function

A

should be doing what it is - INR check production of clotting factors

38
Q

who are more at risk of C diff infections

A

those on antibiotics - clears good bacteria, these normally protect and prevent others from colonising
those immunosuppressed

39
Q

how is norovirus transmitted

A

oro-faecal route

40
Q

what are symptoms of norovirus

A

fever, abdominal pain, diarrhoea, vomitting

41
Q

how is norovirus treated

A

electrolyte and water rebalance, can be done at home

42
Q

describe c diff bacteria

A

anaerobic gram positive bacilli producing spores that are resillient in the environment - can last up to 5 months

43
Q

how does c diff spread

A

healthcare workers - faecal to oral, contaminating surfaces

44
Q

what are symptoms of c diff

A

fever, nausea, loose stool

45
Q

what are treatments of c diff

A

antibiotics, probiotics, faecal transplant, rehydration

BDS 2 BAMS (12 decks)

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