Gastrointestinal Buzzwords Flashcards
Abdominal pain: Colicky loin pain radiating to groin
Ureteric colic
Abdominal pain: Jaundice and intermittent right upper quadrant pain
Biliary colic
Abdominal pain: Severe epigastric pain radiating to back associated with vomiting
Acute pancreatitis
Abdominal pain: Peri-umbilical pain initially, then shift to right iliac fossa
Acute appendicitis
Abdominal pain: Central abdominal pain, expansile pulsatile mass
Abdominal aortic aneurysm
Abdominal pain: Iliac fossa pain, positive pregnancy test
Ectopic pregnancy
GI Examination sign: Asterixis (liver flap)
Hepatic encephalopathy
GI Examination sign: Leukonychia
Hypoalbuminaemia
GI Examination sign: Glossitis (beefy tongue)
Vitamin B12 deficiency (or sometimes foliate deficiency)
GI Examination sign: Aphthous ulceration
Inflammatory bowel disease, Coeliac disease
ascites, pleural effusion and benign ovarian tumour
Meigs’ syndrome
Lymphadenopathy, left supraclavicular fossa
Gastric adenocarcinoma (Virchow’s node), predominantly found on antrum along lesser curvature
GI Examination sign: Angular stomatitis
Iron-deficiency anaemia
Middle-aged woman presents with: Pruritus, jaundice, pigmentation. Anti-mitochondrial antibody (AMA) positive. Associated with: rheumatoid arthritis, Sjögren’s syndrome, Hypothyroidism or autoimmune disease
Primary biliary cirrhosis
Usually middle-aged man, presents with: Pruritus, jaundice, abdominal pain ↑ ALP (alkaline phosphatase), AMA negative. Associated with inflammatory bowel disease (especially ulcerative colitis)
Primary sclerosing cholangitis
4 Fs that predisposes primary biliary cirrhosis
Female, Forty, Familial, Fertile
Reynold’s Pentad + very high bilirubin, Alk Phos, GGT
RUQ pain, Jaundice, Fever, Hypotension, Encephalopathy
Likely Ascending cholangitis
Cholangitis vs cholecystitis (4 F’s predispose to cholangitis, septic features point towards cholangitis)
Pyoderma gangrenosum, erythema nodosum
UC/Crohn’s
High pitched Tinkling bowel sounds
Bowel Obstruction
“Rice-water”-like stools
Vibro Cholera
Presence of AMA (Anti mitochondrial antibodies)
Primary Biliary Cirrhosis
Presence of ASMA (anti smooth muscle antibodies) + ANF (Anti nuclear factor)
Autoimmune hepatitis
Alpha Feto Protein assay or Serum AFP elevation
Primary hepatocellular carcinoma
Causes of bowel obstruction
Bolus (Faecal Impaction common) Adhesions Tumour Hernia Volvulus Intsuussception Pseudo-obstruction Stricture
Crohn’s acronym CAMMPERS
C: Cobblestone (on barium swallow) & clubbing A: Apthous ulcers M: Mass in right iliac fossa M: Malabsorption P: Peri-anal disease E: Erythema nodosum R: Rectal sparing S: Skip leisions/strictures
Ulcerative colitis characteristics
Superficial inflammation, limited to mucosa
Continuous
Start from rectum and moves proximal
Crypt abscess
Associated with primary schlerosing cholangitis
Smoking has a protective effect
Toxic megacolon
Crohn’s characteristics
Knife-like, transdermal fissures Skip leisions Terminal ileum most common, can affect mouth to anus Non-caeseating granulomas Worsen by smoking Malabsorption Stricture formation and obstruction Peri-anal disease Anterior Uveitis
Corrugated, ‘feline’ oesophagus + history of atopy
Eosinophillic oesophagitis (-ve for reflux)
Bird’s beak appearance
Achalasia of lower oesophageal sphincter
Kayser Fleischer ring (greenish-brownish ring around pupil) + non-specific symptoms of cognitive decline
Wilson’s disease
Non-specific motor degeneration is due to accumulation of copper in brain and motor regions. Can be dyskinesia, tremour, dementia, dysarthalgia (speech impairment)
Weight loss + Fatty stool + itchy blisters on elbow and knee
Coeliac disease most likely Dermatitis herpetiformis (itchy rash commonly on elbow, knee, shoulder, buttock, face) is a skin manifestation of coeliac disease
Lanugo Hair
Associated with malabsorption in adults, Anorexia nervosa and/or bulimia nervosa usually underlying cause
Dilated tapering oesophagus
Achalasia of lower oesophageal sphincter
Tapering: diminish in thickness/size towards the end. Same meaning as bird’s beak appearance
sensation of ‘lump at back of throat’
Globus hystericus - usually caused by criccopharyngeal spasm (no obvious pharynx and oesophagus pathology), Zenker’s diverticulum (accompanying dysphagia & halitosis), inflammation of larynx/hypopharynx, GORD
Cockscrew Oesophagus (on barium swallow)
Diffuse Oesophageal Spasm
1 year old baby with excessive inconsolable crying + sausage-shaped abdominal mass
Intussussception (most common in babies 2 months to 2 years, +/- rectal bleeding with red jelly-like appearance)
Duodenal ulcer vs Peptic ulcer key difference
Duodenal ulcer relieved by eating or drinking milk, peptic ulcer worsened by eating
Absent psoas shadow and sentinel loop of jejunum on AXR
Acute pancreatitis
Signet Ring
Adenocarinoma (Signet Ring cells are a special type of mucin-secreting carcinoma, most common associated with stomach cancer, but also found in colon, breast, gallbladder and gonads)
Gastric biopsy show heavy infiltrate of atypical lymphocytes + increased intra-epithelial lymphocytes
Most likely MALT-associated Lymphomas (if lymphocyte infiltrations is typical, then gastritis would be the diagnoses)
Parasitic infection mostly in duodenum and jejunum
Giardiasis
Special scan that determines lesion at ileocaecal valve
Meckel’s Diverticulum (Ectopic Gastric mucosa is present at the site, usually near ileocaecal valve, Technetium-99 scan will indicate presence of gastric mucosa at ileocaecal valve. Meckel’s diverticulum is usually asymptomatic)
