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Year 6 Written > GI > Flashcards

GI Flashcards

(54 cards)

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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

Study These Flashcards
A

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

23
Q

Barrett’s oesophagus histology

Study These Flashcards
A

metaplastic columnar epithelium replacing the oesophageal squamous epithelium

24
Q

Barrett’s oesophagus and mx

Study These Flashcards
A

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

25
Anal abscess mx
incision and drainage
26
Mallory weiss v boerhaave
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
What can be seen on biopsy of coeliac?
- villous atrophy - crypt hyperplasia
28
Skin manifestation coeliac
dermatitis herpetiformis (blistering skin condition commonly on extensor surface)
29
Histology crohn's v UC
Crohns: granuloma + incr goblet cells UC: crypt abscess + decr goblet
30
Endoscopy crohn's v UC
Crohn's: cobblestone UC: Pseudopolyps
31
Skin manifestations for crohn's v UC
Crohn's: pyoderma gangrenosum (painful, big-ass ulcers) UC: erythema nodosum (bruise vibes)
32
True Love and Witt's UC flares
Mild - <4 BO Mod - 4-6 BO Sev - >6 BO - Frank blood - Syx features - ESR >= 30
33
Acute, severe UC flare mx
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
UC - proctitis/proctosigmoiditis/ LHS colitis mx
- Topical aminosalicyclate (e.g., mesalazine) - If no improv after 4 weeks, PO aminosali.
35
UC - pancolitis mx
- Topical + PO aminosalicyclate - If no improv after 4 weeks, POcorticosteroids
36
Toxic megacolon mx
IV hydrocortisone, infliximab, or sug (if perf)
37
Colonic polyps +++ and autosomal dominant APC gene mutation
FAP
38
Autosomal dom mutation in mismatch repair gene
HNPCC (lynch syndrome)
39
SB polyps + macules in lips or genitals + AD mutation STK11 gene
peutz-jegher syndrome
40
Bowel ca screening
aged 60-74 + FIT or FOB test every2 years
41
T staging for colorectal ca
T1 - no muscular involvement T2 - involves muscularis propria T3 - involves serosa/adventitia T4 - invades local structures
42
Rectal ca mx according to T score
T1-2: transanal excision T3-4: neoadjuvant trx + colonic resection Nodal disease: adjuvant chemo
43
Colon ca mx according to T score
T1-3: colonic resection Nodal disease: adjuvant chemo T4: neoadjuvant mx
44
Anterior resection v abdominoperineal resection for rectal tumour
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
RIF pain after appendicectomy
Meckel's diverticulum
46
BO acutely unstable / bowel ischaemia / closed loop obstruction
emergency laparotomy
47
AAA screening
Men at 65 will have US
48
Syx AAA mx
refer to surgeons
49
AAA asyx mx
3-4.4cm - yearly USS 4.5-5.4cm - 3 monthly USS >=5.5cm - refer to surgeons
50
actue, severe abdo pain + AF
Acute mesenteric ischaemia
51
Early v late stages acute mesenteric ischaemia
Early: Severe abdo pain, lactate v slight raise Late: Peritonism + high lactate
52
Most common hernia in F w relatively high incidence of strangulation/obstr?
Femoral
53
Recurrent episodes acute LBO
Recurrent sigmoid volvulus
54
V sudden onset abdo pain + CXR showing free gas under hemi-diaphragm
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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