GI Flashcards
Incompetent LOS, Barrier impairment, delayed oespahgeal clearance, heartburn and waterbrash
GORD
Dyasphagia that is worse for solids than liquids
Benign osesphageal stricture
Treatment for GORD
1) Antacid
2) Full dose PPI
3) Step down to H2 receptor antagonists then antacids
More common in children, mucosal ring strictures or narrow calibrated oesophagus
Eosinophilic oesphagitis
Halitosis, gurgling and barium swallow
Pharyngeal Pouch
Manometry
Achalasia
Episodic chest pain may mimic angina, treat using PPE
Oesophageal spasm
Schatzki rings
Found at oesophago-gastric function–> benign strictures
Most common benign tumour of the oesphagus
Leiomyoma
Pathogenesis of oesophageal adenocarcinoma
Normal–> Oesophagitis–> Barrett’s–> Adenocarcinoma
HLA DQ8, Small bowel, blunting of villi, flattening of epithelium, Marsh Score, Antibody test then biopsy, Dermatitis Herpetiformis
Coeliac
Chronic, progressive malabsorption from the tropics, India, Malaysia, Indonesia, treat using tetracycline, presents similarly to coeliac disease, adults more than children
Tropical Sprue
High numbers of coliforms, watery diarrhoea and steatorrhea due to vitamin B12 deficiency, hydrogen breath tests, tetracycline
Small bowel overgrowth
Infiltration of small intestinal mucosa by “foamy” macrophages, middle aged men, PCR diagnosis, PAS positive macrophages, joint pain, arthritis, fevers, diaroea and lymphadenopathy
Whipple’s Disease
Malaborption of vitamin B12 and bile salts, need parenteral nutrition and vitamin B12 supplements. Jejunum-colon or Jejunostomy.
Ileal Resection and short bowel syndrome
Nausea, vomiting, adominal distension, alternating constipation and diarrhoea but no mechanical obstruction
Pseudoobstruction
Most common congenital abnormality of the GI tract, failure of closure of the vitelline duct, 100cm of ileocaecal valve. complications in first 2 years of life. Can mimic appenditis
Meckel’s Diverticulum
Can affect any part of GI tract, usually results from swallowing after coughing, PCR, RIPE, Granulomatous hepatitis occurs
Abdominal TB
Patient with AF and abdominal pain. “Angina of the guts”, metabolic acidosis. Most commonly embolus from heart lodges and blocks the mesenteric artery. Complications: resolution, gangrene, fibrous stricture
Small bowel Ichaemia
Acute sever abdominal pain, no abdominal signs, rapid hypovolaemia–> shock
Acute Small bowel Ischaemia
When inflammation goes into the muscle layers, it loses tone and starts to distend
Toxic Megacolon
Projective mad of scar tissue which develops from granulation tissue during healing process. Failed attempt of wall to heal naturally. Signs of previous intense inflammation
Pseudopolyps
Rome Criteria and FODMAP
IBS
Uncommon, autosomal dominant, APC gene, 90% of patients develop CRC by age 50
Familial Ademomatous Polyps
Multiple hamartomatous polyps can occur in intestine and colon. Melanin pigementation of lips, mouth and digits. Autosomal dominant
Peutz-Jeghers Syndrome
1/3rd inherited in autosomal recessve manner, harmatous polyps, 20% develop CRC before age 40
Juvenile Polyps