General Flashcards
List three differentials of dysphagia
Reflux oesophagitis leading to stricture Food bolus obstruction Carcinoma- oesophageal/gastric Achalasia Diffuse oesophageal spasm
What are the symptoms of dysphagia?
anorexia, weight loss, solids getting stuck (progressive), sudden onset complete dysphagia
What are the investigations for dysphagia?
upper GI endoscopy barium swallow oesophageal manometry (test that evaluates motility and muscle contractions of oesophagus via contractile pressures), pH studies
Name four symptoms of upper GI bleeding?
haematemesis, malaena, epigastric pain, anaemia, collapse
Name four causes of upper GI bleeding
peptic ulcers (duodenal and gastric) gastritis oesophageal varices mallory-weiss tear gastric carcinoma
What are the investigations for upper GI bleed?
upper GI endoscopy
CLO test for helicobacter pylori
(+routine bloods…group and save etc)
What is the treatment for upper GI bleeding?
fluid resus
blood transfusion
endoscopic management- adrenaline injection, banding of varices, heater probe
surgery- porto-systemic shunt, partial gastrectomy, oversewing bleeding vessel in duodenal ulcer
What is Murphy’s sign and how is it carried out?
Patient breaths out, place hand just below the costal margin, mid-clavicularly (this is just above the gallbladder);
then instruct the patient to slowly breath in.
A positive sign is identified when the patient stops breathing in due to pain – this is caused by the move of the diaphragm pushing the inflamed gallbladder into the palpating hand. This indicates Cholycystitis, where as a negative Murphy’s sign may suggest pyelonephritis, and ascending cholangitis.
Which manouvre/sign indicates appendicitis?
Rovsing sign- referred pain in right lower quadrant when palpating the left lower quadrant
What is Mcburney’s sign?
patient’s most tender area is 1.5-2 inches from the anterior superior iliac spine in the direction of the umbilicus. RLQ.
