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Systems 2A Pathology > Gastrointestinal Pathology > Flashcards

Gastrointestinal Pathology Flashcards

1
Q

Define gastro-oesophageal reflux disease.

A
  • acid from the stomach refluxes above the lower oesophageal sphincter and irritates the lower third of oesophageal mucosa
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2
Q

Give symptoms of GORD.

A
  • dyspepsia

- regurgitation

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3
Q

How would you treat GORD?

A
  • alginate-containing antacids

- proton-pump inhibitors

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4
Q

Define a Mallory Weiss tear.

A
  • mucosa is torn at the gastro-oesophageal junction produced by a sudden increase in intra-abdominal pressure
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5
Q

Give symptoms/signs of a Mallory Weiss tear.

A
  • black blood in the stool
  • vomiting blood
  • anaemia
  • pallor
  • tachycardia
  • tachypnoea
  • weak pulse
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6
Q

How would you investigate a Mallory Weiss tear?

A
  • endoscopy
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7
Q

How would you treat a Mallory Weiss tear?

A
  • often repairs itself

- may require clipping

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8
Q

Give symptoms/signs of oesophageal carcinoma.

A
  • dysphagia
  • pain
  • unexplained weight loss
  • anorexia
  • lymphadenopathy
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9
Q

How would you investigate an oesophageal carcinoma?

A
  • endoscopy
  • barium swallow
  • CT
  • MRI
  • endoscopic US
  • PET
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10
Q

Define achalasia.

A
  • functional aperistalsis of the oesophagus along with impaired relaxation of the lower oesophageal sphincter
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11
Q

Give symptoms/signs of achalasia.

A
  • progressive dysphagia
  • weight loss
  • chest pain
  • regurgitation
  • chest infections
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12
Q

How would you investigate achalasia?

A
  • chest x-ray
  • barium swallow
  • endoscopy
  • CT
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13
Q

How would you treat achalasia?

A
  • calcium channel blocker
  • nitrates
  • balloon dilation
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14
Q

Define oesophageal spasm.

A
  • contractions are exaggerated and uncoordinated leading to dysmotility
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15
Q

How would you investigate oesophageal spasm?

A
  • barium swallow
  • endoscopy
  • manometry
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16
Q

How would you treat oesophageal spasm?

A
  • proton-pump inhibitors
  • anti-spasmodics
  • nitrates
  • calcium channel blockers
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17
Q

Define oesophageal varicies.

A
  • bleeding at the oesophageal varicie (anastomose with the portal system) due to portal hypertension
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18
Q

Give symptoms/signs of oesophageal varicies.

A
  • often asymptomatic
  • splenomegaly
  • jaundice
  • tachypnoea
  • tachycardia
  • increased albumin and bilirubin
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19
Q

Define gastritis.

A
  • inflammation of the stomach

- can be autoimmune, bacterial or chemical

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20
Q

Define peptic ulceration.

A
  • a break in the superficial epithelial cells, penetrating down to the muscularis mucosa in either the stomach or dueodenum
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21
Q

What causes peptic ulceration?

A
  • an imbalance of acid secretion

- usually associated with H. pylori infection

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22
Q

Give signs/symptom of peptic ulceration.

A
  • recurrent, burning epigastic pain
  • extremely localised pain
  • worse when hungry
  • nausea
  • anorexia
  • weight loss
  • abdominal tenderness
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23
Q

How would you investigate peptic ulceration?

A
  • urea breath test
  • stool antigen test
  • endoscopy
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24
Q

How would you treat peptic ulceration?

A
  • antibiotics (amoxicillin and clarithromycin)

- proton-pump inhibitors

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25
Q

When would gastric cancer be more common?

A
  • after H. pylori infection
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26
Q

Give signs/symptoms of gastric cancer.

A
  • epigastric pain
  • nausea
  • anorexia
  • weight loss
  • palpable mass
  • tenderness
  • vomiting
  • dysphagia
  • Virchow’s node
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27
Q

How would investigate gastric cancer?

A
  • CT
  • endoscopic US
  • PET
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28
Q

Define gastric outlet obstruction.

A
  • obstruction, either pre-pyloric, pyloric or duodenal, due to an active ulcer, or scar tissue formed after repair
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29
Q

Give signs/symptoms of gastric outlet obstruction.

A
  • infrequent, large volume vomiting
  • no pain
  • gastric splash
30
Q

How would you treat gastric outlet obstruction?

A
  • IV fluid
  • stomach drainage
  • potent acid suppression
  • endoscopic dilation
31
Q

Define non-ulcer dyspepsia.

A
  • dyspepsic type pain

- no ulcer on endoscopy

32
Q

Describe coeliac disease.

A
  • mucosa of the small intestine becomes inflamed due to wheat being unable to digest, activating an immune response
33
Q

Give signs/symptoms of coeliac disease.

A
  • diarrhoea
  • steatorrhoea
  • abdominal pain
  • weight loss
  • malaise
  • lethargy
  • mouth ulcers
  • angular stomatitis
34
Q

How would you treat coeliac disease?

A
  • gluten-free diet
35
Q

Define Crohn’s disease.

A
  • an inflammatory bowel disease which can affect any part of the GI tract
36
Q

Give signs/symptoms of Crohn’s disease.

A
  • diarrhoea
  • abdominal pain
  • weight loss
  • malaise
  • lethary
  • anorexia
  • nausea
  • vomiting
  • pyrexia
  • mouth ulcers
  • tenderness
37
Q

Define irritable bowel syndrome.

A
  • functional disorder of the small bowel
38
Q

List some triggers for IBS.

A
  • low mood
  • stress
  • trauma
  • infection
  • antibiotics
39
Q

Give some signs/symptoms of IBS.

A
  • abdominal discomfort/pain
  • mucus in stool
  • increased frequency
  • increased urgency
  • painful periods
  • improved after defecating
40
Q

Give some signs/symptoms of colorectal cancer.

A
  • fresh rectal bleeding
  • altered bowel habit
  • iron deficency
  • weight loss
  • anorexia
  • malaise
  • palpable mass
  • colonic obstruction
41
Q

What classification is used for colorectal cancer?

A
  • Duke’s classification
42
Q

Define ulcerative colitis.

A
  • inflammatory bowel disease occuring in the colon/rectum
43
Q

Give signs/symptoms of ulcerative colitis.

A
  • diarrhoea
  • blood and mucus in stool
  • discomfort
  • malaise
  • lethary
  • anorexia
  • weight loss
44
Q

How would you investigate ulcerative colitis?

A
  • colonoscopy

- C. diff stool test

45
Q

How would you treat ulcerative colitis?

A
  • 5-ASA
  • biologics
  • steroids
  • immunosuppressants
46
Q

In what group would you most likely see slow transit consipation?

A
  • usually occurs in young women with infrequent bowel movements
47
Q

How would you investigate slow transit consipation?

A
  • colonoscopy
  • faecal-occult blood
  • calprotein
  • CRP
48
Q

Define haemorrhoids.

A
  • haemorrhoid plexui become inflamed and protrude out from the anus due to increased intrabdominal pressure
49
Q

Define an anal fissure.

A
  • a tear in the skin-lined lower anal canal distal to the dentate line
50
Q

How would you treat an anal fissure?

A
  • stool softeners

- local anaesthetic gel

51
Q

What tests would you carry out into hepatitis?

A
  • bilirubin
  • AST
  • IgG
  • IgM
52
Q

Define non-alcoholic fatty liver disease.

A
  • an unbrella terms encompassing steatosis, non-alcoholic steatohepatitis (NASH), fibrosis and cirrhosis
53
Q

How would you treat NAFLD?

A
  • weight loss
  • vitamin E supplements
  • bariatric surgery
54
Q

Define autoimmune hepatitis.

A
  • a female dominent condition characterised by raised IgG leading to fibrosis and cirrhosis
55
Q

Define primary biliary cholangitis.

A
  • autoimmune condition of increased IgM with bile duct involvement
56
Q

How would you investigate primary biliary cholangitis?

A
  • MRCP
  • cholangiogram
  • serum alkaline phosphatase
57
Q

Define hepatic encephalopathy.

A
  • failure of the liver causing mental impairment
58
Q

List some potential causes of hepatic encephalopathy.

A
  • infection
  • drugs
  • constipation
  • GI bleeding
  • electrolyte distrubance
59
Q

How would you treat spontaneous bacterial peritonitis?

A
  • IV antibiotics
  • ascitic drainage
  • IV albumin
60
Q

Give signs/symptoms of spontaneous bacterial peritonitis?

A
  • abdominal pain
  • pyrexia
  • rigors
  • renal impairment
  • decreased urine output
  • changes in mental ability
  • discolouration
  • tachycardia
  • chills
  • low platelet count
61
Q

Define alcoholic hepatitis.

A
  • liver becomes cirrhosed due to repeated need for tissue repair
62
Q

How would you investigate alcoholic hepatitis?

A
  • test serum bilirubin
  • AST
  • ALT
  • alkaline phosphatase
  • biopsy
63
Q

Define cholelithasis.

A
  • blockage of biliary system due to gall stones
64
Q

How would you treat cholelithasis?

A
  • extracorpeal shockwave therapy

- ERCP

65
Q

Define acute pancreatitis.

A
  • inflammation of the pancreas due to acute injury
66
Q

Define chronic pancreatitis.

A
  • inflammation of the pancreas mostly caused by increased alcohol intake
67
Q

How would you treat acute pancreatitis?

A
  • analgesia
  • IV fluids
  • oxygen
68
Q

How would you treat chronic pancreatitis?

A
  • alcohol abstinence
  • low fat diet
  • pancreatic enzyme supplements
69
Q

Give signs/symptoms of pancreatic cancer.

A
  • upper abdominal pain
  • painless obstructive jaundice
  • weight loss
  • anorexia
  • fatigue
  • diarrhoea
  • nausea and vomiting
  • steatorrhoea
  • erythema nodosum
  • ascites
  • portal hypertension
70
Q

How would you treat pancreatic cancer?

A
  • Whipple’s proceedure
  • hepatic stenting
  • chemotherapy
  • analgesia

Systems 2A Pathology (6 decks)

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