Gastrointestinal Pathology Flashcards
Define gastro-oesophageal reflux disease.
- acid from the stomach refluxes above the lower oesophageal sphincter and irritates the lower third of oesophageal mucosa
Give symptoms of GORD.
- dyspepsia
- regurgitation
How would you treat GORD?
- alginate-containing antacids
- proton-pump inhibitors
Define a Mallory Weiss tear.
- mucosa is torn at the gastro-oesophageal junction produced by a sudden increase in intra-abdominal pressure
Give symptoms/signs of a Mallory Weiss tear.
- black blood in the stool
- vomiting blood
- anaemia
- pallor
- tachycardia
- tachypnoea
- weak pulse
How would you investigate a Mallory Weiss tear?
- endoscopy
How would you treat a Mallory Weiss tear?
- often repairs itself
- may require clipping
Give symptoms/signs of oesophageal carcinoma.
- dysphagia
- pain
- unexplained weight loss
- anorexia
- lymphadenopathy
How would you investigate an oesophageal carcinoma?
- endoscopy
- barium swallow
- CT
- MRI
- endoscopic US
- PET
Define achalasia.
- functional aperistalsis of the oesophagus along with impaired relaxation of the lower oesophageal sphincter
Give symptoms/signs of achalasia.
- progressive dysphagia
- weight loss
- chest pain
- regurgitation
- chest infections
How would you investigate achalasia?
- chest x-ray
- barium swallow
- endoscopy
- CT
How would you treat achalasia?
- calcium channel blocker
- nitrates
- balloon dilation
Define oesophageal spasm.
- contractions are exaggerated and uncoordinated leading to dysmotility
How would you investigate oesophageal spasm?
- barium swallow
- endoscopy
- manometry
How would you treat oesophageal spasm?
- proton-pump inhibitors
- anti-spasmodics
- nitrates
- calcium channel blockers
Define oesophageal varicies.
- bleeding at the oesophageal varicie (anastomose with the portal system) due to portal hypertension
Give symptoms/signs of oesophageal varicies.
- often asymptomatic
- splenomegaly
- jaundice
- tachypnoea
- tachycardia
- increased albumin and bilirubin
Define gastritis.
- inflammation of the stomach
- can be autoimmune, bacterial or chemical
Define peptic ulceration.
- a break in the superficial epithelial cells, penetrating down to the muscularis mucosa in either the stomach or dueodenum
What causes peptic ulceration?
- an imbalance of acid secretion
- usually associated with H. pylori infection
Give signs/symptom of peptic ulceration.
- recurrent, burning epigastic pain
- extremely localised pain
- worse when hungry
- nausea
- anorexia
- weight loss
- abdominal tenderness
How would you investigate peptic ulceration?
- urea breath test
- stool antigen test
- endoscopy
How would you treat peptic ulceration?
- antibiotics (amoxicillin and clarithromycin)
- proton-pump inhibitors
When would gastric cancer be more common?
- after H. pylori infection
Give signs/symptoms of gastric cancer.
- epigastric pain
- nausea
- anorexia
- weight loss
- palpable mass
- tenderness
- vomiting
- dysphagia
- Virchow’s node
How would investigate gastric cancer?
- CT
- endoscopic US
- PET
Define gastric outlet obstruction.
- obstruction, either pre-pyloric, pyloric or duodenal, due to an active ulcer, or scar tissue formed after repair
Give signs/symptoms of gastric outlet obstruction.
- infrequent, large volume vomiting
- no pain
- gastric splash
How would you treat gastric outlet obstruction?
- IV fluid
- stomach drainage
- potent acid suppression
- endoscopic dilation
Define non-ulcer dyspepsia.
- dyspepsic type pain
- no ulcer on endoscopy
Describe coeliac disease.
- mucosa of the small intestine becomes inflamed due to wheat being unable to digest, activating an immune response
Give signs/symptoms of coeliac disease.
- diarrhoea
- steatorrhoea
- abdominal pain
- weight loss
- malaise
- lethargy
- mouth ulcers
- angular stomatitis
How would you treat coeliac disease?
- gluten-free diet
Define Crohn’s disease.
- an inflammatory bowel disease which can affect any part of the GI tract
Give signs/symptoms of Crohn’s disease.
- diarrhoea
- abdominal pain
- weight loss
- malaise
- lethary
- anorexia
- nausea
- vomiting
- pyrexia
- mouth ulcers
- tenderness
Define irritable bowel syndrome.
- functional disorder of the small bowel
List some triggers for IBS.
- low mood
- stress
- trauma
- infection
- antibiotics
Give some signs/symptoms of IBS.
- abdominal discomfort/pain
- mucus in stool
- increased frequency
- increased urgency
- painful periods
- improved after defecating
Give some signs/symptoms of colorectal cancer.
- fresh rectal bleeding
- altered bowel habit
- iron deficency
- weight loss
- anorexia
- malaise
- palpable mass
- colonic obstruction
What classification is used for colorectal cancer?
- Duke’s classification
Define ulcerative colitis.
- inflammatory bowel disease occuring in the colon/rectum
Give signs/symptoms of ulcerative colitis.
- diarrhoea
- blood and mucus in stool
- discomfort
- malaise
- lethary
- anorexia
- weight loss
How would you investigate ulcerative colitis?
- colonoscopy
- C. diff stool test
How would you treat ulcerative colitis?
- 5-ASA
- biologics
- steroids
- immunosuppressants
In what group would you most likely see slow transit consipation?
- usually occurs in young women with infrequent bowel movements
How would you investigate slow transit consipation?
- colonoscopy
- faecal-occult blood
- calprotein
- CRP
Define haemorrhoids.
- haemorrhoid plexui become inflamed and protrude out from the anus due to increased intrabdominal pressure
Define an anal fissure.
- a tear in the skin-lined lower anal canal distal to the dentate line
How would you treat an anal fissure?
- stool softeners
- local anaesthetic gel
What tests would you carry out into hepatitis?
- bilirubin
- AST
- IgG
- IgM
Define non-alcoholic fatty liver disease.
- an unbrella terms encompassing steatosis, non-alcoholic steatohepatitis (NASH), fibrosis and cirrhosis
How would you treat NAFLD?
- weight loss
- vitamin E supplements
- bariatric surgery
Define autoimmune hepatitis.
- a female dominent condition characterised by raised IgG leading to fibrosis and cirrhosis
Define primary biliary cholangitis.
- autoimmune condition of increased IgM with bile duct involvement
How would you investigate primary biliary cholangitis?
- MRCP
- cholangiogram
- serum alkaline phosphatase
Define hepatic encephalopathy.
- failure of the liver causing mental impairment
List some potential causes of hepatic encephalopathy.
- infection
- drugs
- constipation
- GI bleeding
- electrolyte distrubance
How would you treat spontaneous bacterial peritonitis?
- IV antibiotics
- ascitic drainage
- IV albumin
Give signs/symptoms of spontaneous bacterial peritonitis?
- abdominal pain
- pyrexia
- rigors
- renal impairment
- decreased urine output
- changes in mental ability
- discolouration
- tachycardia
- chills
- low platelet count
Define alcoholic hepatitis.
- liver becomes cirrhosed due to repeated need for tissue repair
How would you investigate alcoholic hepatitis?
- test serum bilirubin
- AST
- ALT
- alkaline phosphatase
- biopsy
Define cholelithasis.
- blockage of biliary system due to gall stones
How would you treat cholelithasis?
- extracorpeal shockwave therapy
- ERCP
Define acute pancreatitis.
- inflammation of the pancreas due to acute injury
Define chronic pancreatitis.
- inflammation of the pancreas mostly caused by increased alcohol intake
How would you treat acute pancreatitis?
- analgesia
- IV fluids
- oxygen
How would you treat chronic pancreatitis?
- alcohol abstinence
- low fat diet
- pancreatic enzyme supplements
Give signs/symptoms of pancreatic cancer.
- upper abdominal pain
- painless obstructive jaundice
- weight loss
- anorexia
- fatigue
- diarrhoea
- nausea and vomiting
- steatorrhoea
- erythema nodosum
- ascites
- portal hypertension
How would you treat pancreatic cancer?
- Whipple’s proceedure
- hepatic stenting
- chemotherapy
- analgesia
