GI Flashcards
typical patient with sigmoid volvulus
elderly
constipated
abdominal pain
coffee bean AXR
sigmoid volvulus
loop of distended bowel
paralytic ileus presentation
adynamic bowel (lack of normal peristalsis) can cause constipation, painful abdominal distension and absent bowel sounds
Colorectal carcinoma presentation
acutely as bowel obstruction, with symptoms of constipation and abdominal pain
red flags: weight loss, night sweats
Intussusception
part of the intestine slides into an adjacent part of the intestine
intussusception presentation
nonspecific abdominal pain that comes and goes, change in bowel habit and decreased/absent bowel sounds
children <5
Hirschsprung disease
presents with childhood
nerve cells in the bowel cause problem with peristalsis
achalasia
degenerative loss of ganglia from auerbach’s plexus
dysphagia to solids and liquids
sometimes accompanied by regurgitation
globus hystericus cause
anxiety
mechanism of cirrhosis
degeneration and necrosis of hepatocytes, and replacement of liver parenchyma by fibrotic tissues and regenerative nodules, and loss of liver function
peginterferon
viral hepatitis
azathioprine
autoimmune hepatitis
Ursodeoxycholic acid
Primary biliary cholangitis
mechanism of PSC
autoimmune destruction of both the intra and extra hepatic bile ducts
mechanism of PBC
Autoimmune destruction of intra-hepatic bile ducts only
gallstone ileus
form of small bowel obstruction caused by gallstone in the small intestine
gallstone enters bowel via cholecysto-enteric fistula
Acute cholecystitis presentation
RUQ pain- radiate to right shoulder positive murphys sign fever nausea tachycardia
primary sclerosing cholangitis presentation
jaundice chronic RUQ pain pruritus fatigue heptomegaly
raised serum amylase
acute pancreatitis
Appendicitis presentation
central pain radiating to RIF
mild pyrexia, tachycardia
rebound tenderness
vomited
treatment for appendicitis
appendectomy
analgesia
antibiotics
wilson’s disease
rare autosomal recessive condition in which the patient cannot eliminate copper effectively
presentation of wilson’s disease
can lead to chronic hepatitis and eventually cirrhosis
neurological problems
psychiatric problem
indication of severity for acute pancreatitis
PaO2 <8 Age >55 Neutrophilia Calcium <2 renal function >16 enzymes Albumin < 32 Sugar >10
what blood marker classically rises with an upper GI bleed
Urea
plain Xray reveals dilated loop of bowel and thumb printing
UC
history of dysphagia and regurgitation of undigested solids + liquids along with the distal narrowing seen on the barium swallow
achalasia
most common cause of acute appendicitis
obstruction of the appendix with dried compacted faeces termed a faceolith
barrett’s oesophagus is a type of which pathological process
metaplasia
what is the most sensitive test for coeliac disease
serum anti-tTG antibodies
RUQ pain, jaundice and fever
acute cholangitis
managing variceal bleeding
terlipressin- stop after definitive haemostasis has been achieved
prophylactive antibiotic therapy
presentation of small bowel disease
diarrhoea
abdominal pain and discomfort
weight loss
iron, B12 and folate def
feature of C.diff that makes is hard to destroy
spore formation
which LFT reflects the synthetic function of the liver
albumin
causes of upper GI bleeding
oesophageal varicies
MW tear
Peptic ulcers
cancer of stomach or duodenum
MW tear
mucosal tear at the oesophagastric junction
can be due to bulimia
presentation of MW tear
dizziness
hypotension
vomiting blood
presentation of PBC
middle aged women fatigue pruritus abdo pain jaundice in end-stage
LFT in PBC
raised ALP
blood supply of duodenum
proximal- gastroduodenal artery (including superior pancreaticoduodenal)
distal- SMA and inferior pancreaticoduodenal artery
granulation tissue with layer of necrotic debris
peptic ulcer
presentation of gallstones
severe epigastric pain
vomiting
occurs after eating
how to confirm gallstones
US
treatment of sigmoid volvus
insertion of flatus tube
management of GORD
first line- antacids
second line- PPI
life style measure associated with colorectal cancer
red and processed meat
most common location of ischaemic colitis
splenic flexure
ischaemic colitis on XRAY
thrumbprinting
pernicious anaemia cause
antibodies that target either intrinsic factor or gastric parietal cells