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Year 6 Written > GI > Flashcards

GI Flashcards

1
Q

What is achalasia?

A

Neurological disorder of  gastrointestinal tract due to failure of lower oesophageal sphincter to relax

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2
Q

Features of sigmoid diverticulitis

A
  • change in bowel habit
  • LIF pain
  • features infx
  • +/- blood mixed into stool
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3
Q

Features of UC

A
  • Bloody diarrhoea
  • Eye syx
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4
Q

Norovirus features

A
  • ~48h D+V from one another
  • Often when people live/work close proximity
  • Not necessary to have shared food
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5
Q

Norovirus Ix

A

Stool for viral PCR

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6
Q

Features of Crohn’s

A
  • Non caseating granulomata
  • Transmural inflammation
  • Mouth to anus
  • Skip lesions
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7
Q

What vaccination do pts with coeliac need

A

Pneumococcal (due to hyposplenism)

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8
Q

Causes of SBO

A
  • Adhesions
  • Hernias
  • Tumours
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9
Q

What is chronic mesenteric ischaemia/angina and how does it present?

A

Narrowing of superior mesenteric artery - inadequate blood flow to intestines.
- Pain OE, I.e., cramping soon after eating
- Weight loss
- N+V

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10
Q

Oesophageal rupture/ Boerhaave’s syndrome features

A
  • Vomiting and severe chest pain after eating large meal
  • Hypotensive
  • Tachypnoeic
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11
Q

Duodenal ulcer features

A
  • Epigastric pain, radiating to back
  • Better after eating
  • Worse at night
  • Worse when stressed
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12
Q

Paralytic ileus v bowel obstruction

A

PI
- temporary paralysis or inhibition of normal contractions that propel food and liquid through GIT (functional, not physical)
- often post surg/caused by meds etc
- No bowel sounds
BO
- hard, physical blockage
- tinkling bowel sounds

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13
Q

Mesenteric adenitis

A

Inflammation of lymph nodes of the mesentery (tissue that attaches intestines to abdo wall)

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14
Q

Mesenteric adenitis and features

A

Inflamm of lymph nodes of mesentery often due to viral illness
- Abdo pain (+/- crampy)
- Fever, sore throat
- Swollen lymph nodes

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15
Q

Meckel’s diverticulum

A

Congenital abnormality where you have a pouch-like structure that protrudes from wall of small intestine

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16
Q

Blood supply to each part of GIT

A

-Coeliac trunk (or celiac trunk) supplies foregut
mouth to beginning of duodenum <gastroduoedenal>
- Superior mesenteric artery supplies midgut
mid duod to 2/3 transv colon
- Inferior mesenteric artery supplies hindgut
2/3 tansv colon to anus</gastroduoedenal>

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17
Q

Which electrolyte abnormality is associated with paralytic ileus?

A

hypo K

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18
Q

Haemorrhoids and features

A

(Piles) are swollen veins in rectum and anus

  • Discomfort/pain (can be painless)
  • Bleeding
  • Internal/external
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19
Q

Anal fissures and features

A

Small tears in the skin or lining of anus
- Pain
- Bleeding
- Itching

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20
Q

Most common causes LBO

A
  1. Colorectal ca
  2. Diverticular stricture
  3. Volvulus
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21
Q

What is the most common type of polyp in the colon and anus?

A

Adenoma

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22
Q

GORD v duodenal ulcer

A

GORD
- worse on lying down
- burning sensation throat/chest
Duodenal ulcer
- worse in AM
- epigastric tenderness

23
Q

Barrett’s oesophagus histology

A

metaplastic columnar epithelium replacing the oesophageal squamous epithelium

24
Q

Barrett’s oesophagus and mx

A

Changes due to longstanding reflux disease
- High dose PPIs
- Regular endoscopies

25
Q

Anal abscess mx

A

incision and drainage

26
Q

Mallory weiss v boerhaave

A

MV: from repeated retching/vomiting; tear to mucous membrane lining of lower oesoph/upper stomach

Boerhaave: Complete tear/rupture oesophagus - needing immediate surgical intervention

27
Q

What can be seen on biopsy of coeliac?

A
  • villous atrophy
  • crypt hyperplasia
28
Q

Skin manifestation coeliac

A

dermatitis herpetiformis
(blistering skin condition commonly on extensor surface)

29
Q

Histology crohn’s v UC

A

Crohns: granuloma + incr goblet cells
UC: crypt abscess + decr goblet

30
Q

Endoscopy crohn’s v UC

A

Crohn’s: cobblestone
UC: Pseudopolyps

31
Q

Skin manifestations for crohn’s v UC

A

Crohn’s: pyoderma gangrenosum (painful, big-ass ulcers)
UC: erythema nodosum (bruise vibes)

32
Q

True Love and Witt’s UC flares

A

Mild
- <4 BO
Mod
- 4-6 BO
Sev
- >6 BO
- Frank blood
- Syx features
- ESR >= 30

33
Q

Acute, severe UC flare mx

A
  1. Admit + IV hydrocortisone
  2. after 72h, if improve: cont steroids and then wean off
    if no improvem: IC ciclosporin + surg input -> biologics, e.g., infliximab
34
Q

UC - proctitis/proctosigmoiditis/ LHS colitis mx

A
  • Topical aminosalicyclate (e.g., mesalazine)
  • If no improv after 4 weeks, PO aminosali.
35
Q

UC - pancolitis mx

A
  • Topical + PO aminosalicyclate
  • If no improv after 4 weeks, POcorticosteroids
36
Q

Toxic megacolon mx

A

IV hydrocortisone, infliximab, or sug (if perf)

37
Q

Colonic polyps +++ and autosomal dominant APC gene mutation

A

FAP

38
Q

Autosomal dom mutation in mismatch repair gene

A

HNPCC (lynch syndrome)

39
Q

SB polyps + macules in lips or genitals + AD mutation STK11 gene

A

peutz-jegher syndrome

40
Q

Bowel ca screening

A

aged 60-74 + FIT or FOB test every2 years

41
Q

T staging for colorectal ca

A

T1 - no muscular involvement
T2 - involves muscularis propria
T3 - involves serosa/adventitia
T4 - invades local structures

42
Q

Rectal ca mx according to T score

A

T1-2: transanal excision
T3-4: neoadjuvant trx + colonic resection
Nodal disease: adjuvant chemo

43
Q

Colon ca mx according to T score

A

T1-3: colonic resection
Nodal disease: adjuvant chemo
T4: neoadjuvant mx

44
Q

Anterior resection v abdominoperineal resection for rectal tumour

A

Anterior resection
- Rectal tumour >5cm from anal verge
- Rectum, sparing sphincters

Abdominoperineal resection
- Rectual tumour <5cm from anal verge
- Rectum, sphincters, anus
- Stoma needed - colostomy

45
Q

RIF pain after appendicectomy

A

Meckel’s diverticulum

46
Q

BO acutely unstable / bowel ischaemia / closed loop obstruction

A

emergency laparotomy

47
Q

AAA screening

A

Men at 65 will have US

48
Q

Syx AAA mx

A

refer to surgeons

49
Q

AAA asyx mx

A

3-4.4cm - yearly USS
4.5-5.4cm - 3 monthly USS
>=5.5cm - refer to surgeons

50
Q

actue, severe abdo pain + AF

A

Acute mesenteric ischaemia

51
Q

Early v late stages acute mesenteric ischaemia

A

Early: Severe abdo pain, lactate v slight raise
Late: Peritonism + high lactate

52
Q

Most common hernia in F w relatively high incidence of strangulation/obstr?

A

Femoral

53
Q

Recurrent episodes acute LBO

A

Recurrent sigmoid volvulus

54
Q

V sudden onset abdo pain + CXR showing free gas under hemi-diaphragm

A

Perforated peptic ulcer
(quick onset pain due to leakage of gastric acid causing immediate chemical peritonitis)

Year 6 Written (26 decks)

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