Gastrointestinal System Flashcards
1
Q
What investigations would you do for a person presenting with GI like symptoms?
A
- Liver function tests (LFT)
a) Alanine aminotransferase (ALT)
- ALT is an enzyme found in the liver and kidney
- it catalyses ammonia groups
- may be found circulating in patients with acute liver damage from any cause
- blood from vein is taken
- elevation can be cause by: hepatitis, cirrhosis, billary obstruction
2
Q
How will you conduct a physical exam for someone you expect to have GI issues.
A
- Introduction- wash hands, introduce yourself, explain procedure, gain consent, ask if they have pain anywhere or worries?
- Insepction:
a) entirity- look to see if they loo generally unwell, jaundice, weight, wasting, skin lesions, mental state
b) hands- nails- white under nails, clubbing, spooned nails (iron def, infection, colour (blue-cyanosis,
Actually just refer to reader. But go through system every time this card appears.
3
Q
What investigations will you do?
1st Liver function tests?
A
- Alanine aminotransferase (ALT)
- ALT is an enzyme found in the liver and kidney
- ALT catalyses an ammonia group
- may be found circulating in patients with acute liver damage from any cause.
- elevation can be caused by hepatitis, cirrhosis, billary obstruction, renal infarct, tumor, infection. - Aspartate Aminitransferase (AST)
- found mainly in liver, skeletal muscle cardiac muscle and red cells.
- cataclyses an ammonia group too
- found circulating in patients with damage, but ALT is more specific
- elevation can be caused by hepatitis, billary obstruction, myocardial damage, muscle damage, red cell damage, cirrhosis, liver metases and other - AST/ ALT ratio-ratio determines if the liver has been damaged, another organs or alcohol dependancy (due to fat infiltration- steatosis)
- Alkaline Phosphatases (ALP)
Why? found in many tissues and can identify problem areas. In liver its used for cholestatic (billary) enzyme analysis. High levels due to physiological (bone and liver) damage can be due to normal bone growth =.
Pathology: If its raised could can get increased bone deposition (osteoblasts) this occurs due to puberty, disease and drugs. While low levels occur with decreased bone deposition.
results- high-anemia, billary obstruction, liver damage, drugs, bone problems and normality, bit F, problems and real damage
low- malnutrition, protein deficiency. - Gamma-GT
- Serum bilirubin
4
Q
What are liver serological tests that should be conducted and why?
A
- hepatitis Antigen?
2. Hepititis Antibodies?
5
Q
read and understand summary of liver serology?
pg 180
A
h
6
Q
What is the pathology of Oesophagitis/ GORD? define? Aetiology? Pathophysiology? risk factors? History/exams? Investigations? Prevention? DDx? Complications? Prognosis?
A
pg 181
7
Q
peptic ulcer define Aetiology Pathophysiology Risk factors History/ exams Invetigations Prevention DDx COmplications Prognosis
A
182
8
Q
Hiatal Hernia
Pathology
Clinical presentation
A
183
9
Q
gastroenteritis Pathology Clinical presnetation management Clinical considerations- ie diff diagnosis
A
184
10
Q
gastritis Pathoogy clinical presentation clinical considerations management
A
184
11
Q
Irritable Bowel Syndrome (IBS) Pathology Clinical presentations Clinical considerations Management
A
185
12
Q
Inflammatory bowel disease- differ between Chrons disease and ulcerative colitis? Ie define aetiology pathophysiology Key features macroscopic region microscopic region Risk factors History factors? Investigations Prevention? DDx? Complications? Prognosis?
A
189
13
Q
Appendicitis Pathology Clinical presentation Clinical considerations Management
A
s
14
Q
Colorectal cancer Define aetiology pathophysiology prevention/ screening risk factors history/ exams investigations Tx/ Mx DDx Complications Prognosis clinical considerations
A
s
15
Q
Piles and fissures (haemorrhoids)
Pathology
clinical presentation
Management
A
191
