Gastrointestinal and Liver Flashcards
Name 3 types of microbe that cause watery diarrhoea
- vibro cholerae
- e.coli
- clostridium perfringens
- bacillus cereus
- staph. aureus
- rotavirus
- norovirus
- giardia
- cytosporidium
Name 3 types of microbe that cause bloody/mucoid diarrhoea
- shigella
- e. coli
- salmonella
- clostridium difficle
- campylobacter jejuni
Define coeliac disease/ gluten sensitive enteropathy
A state of heightened immunological responsiveness to ingested gluten in genetically susceptible individuals
Describe the pathology of coeliac disease
- gluten broken down into peptides called gliadin
- Gliadin enters between cells (due to weak junctions)
- Antibodies are produced against gliadin and other factors
- Inflammatory cascade produces cytokines, proteinases and other tissue damaging factors
- This leads to histopathological alterations
Presentation of Coeliac disease
- young patients or in 3rd or 4th decade
- Diarrhoea
- Steatorrhoea (increased fat content)
- Weight loss
- Failure to thrive
Gold standard diagnosis for coeliac disease
- serology:
tTG (tissue transglutaninase)
EMA (anti-endomysial antibody) - Gastroscopy with biopsy showing villus atrophy after 6 months eating gluten
Management of Coeliac disease
- lifelong gluten free diet (no wheat, rye, barley or oats)
- dietician review
- DEXA scan (increased osteoporosis risk)
- prescription for gluten free foods
Name 3 causes of malabsorption
- insufficient intake
- defective intraluminal digestion insufficiency
- insufficient absorptive area
- lack of digestive enzymes
- defective epithelial transport
- lymphatic obstruction
Name 3 causes of peritonitis
- inflamed organ
- trapped air
- pus
- faeces
- luminal contents from before the colon
- blood (often from trauma)
Name 3 clinical features of peritonitis
- abdominal pain or discomfort
- fever and chills
- nausea and vomiting
- ascites
- abdominal rigidity and rebound tenderness
What investigations can be done to diagnose peritonitis
- CT scan, ultrasoundm abdo XRay to see fluid or air
- full blood count
- peritoneal fluid analysis
Name 3 complications of peritonitis
- sepsis
- multi-organ failure
- cardiovascular events
- respiratory complications
- surgical complications
Name the 2 surgical procedures for peritonitis
- laparotomy - very invasive
- laparoscopy - key hole
What is the aim of surgery in peritonitis
to wash the internal organs with warm saline and to treat the problem (eg patch hole or remove organ)
Name 3 aftercare procedures after peritonitis surgery
- intensive care
- support kidneys
- physio/early mobilisation
- nutritional support
- broad spectrum antibiotics
