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Anatomy (make or break marks) > GI > Flashcards

GI Flashcards

1
Q

What kind of inflammation is seen in Chron’s?

A

Transmural inflammation.
Skip lesions (areas of normal mucosa between affected zones). “Cobblestone” appearance.
Crypt branching

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2
Q

What kind of inflammation is seen in UC?

A

Lamina propria only inflammation.
Crypt distortion.
No areas of normal mucosa between affected zones

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3
Q

What are the signs/ symptoms of Chron’s?

A 
Umbilical/ RIF pain. Diarrhoea. 
WEIGHT LOSS. ANAEMIA (malabsorption)
ABDO MASS (RIF)
ERYTHEMA NODOSUM 
EPISCLERITIS
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4
Q

how do you diagnose chron’s?

A

colonoscopy + biopsy

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5
Q

how do you treat Chron’s?

A

Prednisolone to induce remission.

2nd) Azathioprine 3rd) Methotrexate to maintain remission (1st - stop smoking)

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6
Q

What are the symptoms of UC?

A

Lower left quadrant pain (chrons is right)
Diarrhoea (blood more common than chrons). Blood PR
TENESMUS
UVEITIS

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7
Q

How do you diagnose UC?

A

colonoscopy + biopsy

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8
Q

How do you treat UC?

A

MESALAZINE plus/minus prednisolone

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9
Q

What are some differences between Chrons and UC?

A

Chrons: Transmural inflammation (compared to lamina propria only). Wight loss and anaemia possible (malabsorption in chrons but not UC). Erythema nodosum. Abdo mass. mouth ulcers

UC: risk of colorectal cancer higher than chrons.
tenesmus
uveitis (compared to episclirits)
blood PR and in diarrhoea
linked to Primary sclerosing cholangitis

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10
Q

What are three common causes of upper GI bleeding?

A

gastric/ duodenal ulcer
mallory-weiss tear
oesophageal varices (suspect in alcoholics)

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11
Q

over 55 years or ALARMS (dyspepsia or dysphagia) investigation?

A

upper GI endosocopy

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12
Q

under 55 years, dyspepsia or dysphagia investigation?

A

C/ urea breath test

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13
Q

How do you treat H. Pylori infection?

A

full dose PPI
amoxacillin
clarithromycin
(tripple eradication)

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14
Q

What investigations would you do for achalasia?

A 
Barium swallow (bird beak appearance)
CXR
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15
Q

What are the symptoms and treatment of achalasia?

A

haeliotosis (bad breath)

Oesophageal balloon dilation or Hellers myotomy

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16
Q

What are the investigations, treatment and signs of GORD?

A

Upper GI endoscopy
PPI and antacids
wheeze lying flat, more common in obese

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17
Q

What is the most common GI disease associated with H. Pylori?

A

duodenal ulcers.

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18
Q

What are the differences between duodenal and gastric ulcers?

A

duodenal: pain before meals or at night. releived by milk.
gastric: pain associated with meals. relieved by antacids. Weight loss more common

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19
Q

If patient has duodenal/gastric ulcer but negative for H. Pylori, what is the treatment?

A

PPI (eg. lansoprazole)

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20
Q

Define IBS?

A

abdo pain for over 3 days per month for over 3 months with 2 or more of: pain relieved on defication, change in stool frequency, change in stool appearance

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21
Q

What is the treatment of IBS?

A

Low fibre diet and regular meal times.

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22
Q

What is cholangitis?

A

inflammation of bile duct. Ascending cholangitis due to infection. PSC is autoimmune.

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23
Q

what are the symptoms of ascending cholangitis?

A

classic triad of: juandice, fever, abdo pain (continuos Epi/RUQ pain)

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24
Q

What is the investigation and treatment of ascending cholangitis?

A 
ERCP 
Biliary drainage (endoscopically) and IV antibiotics for fever
25
Q

Describe the pain in biliary colic.

A

Begins in the Epigastrium. Radiates to RUQ/back. Colicky. Related to large/fatty meals

26
Q

What is the investigation of choice in biliary colic?

A

Ultrasound (US for all gallstone related diseases [cholecystitis])

27
Q

How do you treat biliary colic?

A

Cholecystectomy (surgical removal of the gall bladder)

28
Q

What is acute cholecystitis?

A

obstruction of cystic duct or neck of gallbladder (most often due to gallstones)

29
Q

What investigations can be done for cholecystitis?

A

Ultrasound.
Murphys sign postive
WCC

30
Q

Describe the pain in acute cholecystitis.

A

(similar to biliary colic but more severe and continuos)

Epigastric/ RUQ pain (may radiate to shoulder/back)

31
Q

What is primary biliary cirrhosis?

A

Autoimmune disease of liver. destruction of the small bile ducts in liver, leading to accumulation of bile in liver. (more common in females)

32
Q

what are the symptoms/signs of primary biliary cirrhosis?

A

(often asymptomatic)

itch, jaundice, xanthelasma, hyperpigmentation, hepatomegaly, arthralgia

33
Q

What antibodies are positive in 1) Primary sclerosing cholangitis?
2) primary biliary cirrhosis?

A

1) anti-neutrophilic cytoplasmic antibodies (ANCA+)

2) anti-mitochondrial antibodies (AMA+)

34
Q

What disease causes “onion skinning fibrosis, beading of bile ducts?”

A

primary sclerosing cholangitis

35
Q

How is the diagnosis of pre-hepatic jaundice made?

A

testing for urine-urobilinogen (increase) with no change in urine colour.

36
Q

What are 2 causes of pre-hepatic jaundice?

A

sickle cell anaemia.

malaria.

37
Q

What are the signs of intra-heptic jaundice?

A

Dark urine.

38
Q

What is the most significant LFT change in intra-hepatic jaundice?

A

rise in ALT (ALT + AST represent hepaTocyTe function)

slight rise in biliruben

39
Q

What are 3 cause of intra-heptic jaundice?

A

Hepatitis. Cirrhosis. Alcoholic liver disease.

40
Q

What are the signs of Post-hepatic jaundice?

A

PALE STOOLS and dark urine

41
Q

What are 2 causes of Post-hepatic jaundice?

A

gallstones. carcinoma of head of pancreas.

42
Q

what 2 LFTs are most raised in Post-hepatic jaundice?

A

ALP and billiruben.

ALP and GGT = obstruction bile duct

43
Q

What is coeliac disease?

A

intolerance to gluten

44
Q

What investigations are done for coeliacs disease?

A

IgA anti-tissue transglutaminase test.

Duodenal biopsy to confirm.

45
Q

What are the signs/symptoms of coeliac disease?

A

Acute diarrhoea and vomitting.
vesicular rash and weight loss.
(may present as iron defficiency anaemia–> do FBC to check)

46
Q

What is Budd-Chiari syndrome and what does it cause?

A

occlusion of the hepatic vein.
causing triad of abdominal pain, ascites and liver enlargement.
(investigation = US)

47
Q

What are signs/symptoms of compensated liver failure?

A

spider naevi. palmar erythema. gynocomastia. clubbing. spleenomegaly.

48
Q

What are signs/symptoms of decompensated liver failure?

A

Jaundice. Ascites. Encephalopathy.

hepatomegaly.

49
Q

How do you treat decompensated liver failure?

A

Calcium and Vit D.
Thaimine (Vit B1) if alcohol induced cirrhosis
reduce salt intake and avoid NSAIDs.

50
Q

What is ascites and what are the signs/symptoms?

A

Accumulation of fluid in the peritoneal cavity.

causing abdominal distension, caput medusae, shifting dulness (due to PORTAL HYPERTENSION)

51
Q

How do you treat ascites?

A

with spironolactone.

pulmonary oedema = furosemide (loop)

52
Q

What is encephalopathy and what is it caused by?

A

neuropsychiatric syndrome secondary to cirrhosis.

due to ammonia tampering with neurotransmitter trafficking. (treat with lactulose)

53
Q

What are the symptoms of encephalopathy?

A

flapping tremor. confusion, drowsiness.

54
Q

What is pancreatitis and what is it caused by?

A

inflammation of pancreas.
Gall stones. Ethanol. Trauma. Steroids. Mumps. Autoimmune. Scorpion sting. Hyperlipidemia/Hypercalcaemia. ERCP. Drugs (eg. azathioprine)

55
Q

Describe the pain in acute pancreatitis.

A

(Severe) upper abdo pain. Usually beginning in Epi, bores through to back.

56
Q

What are the associated signs/symptoms of acute pancreatitis and what investigations are suitable?

A

nausea and vomitting.
“Grey turners sign” (lumbar redness) + “Cullens sign” (umbilical redness)
increase in serum AMYLASE (and lipase)

57
Q

What are 3 causes of malabsorption?

A

dysfunction of pancreas.
problem in biliary tree
problem in small bowel (lumen and wall)

58
Q

What investigations and treatment is relevant to anaemia?

A

do FBC (check if Hb levels below normal)
Serum ferritin levels.
Give iron/ferrous supplements.
(anaemia may cause angular cheilitis)

59
Q

What is a common cause of iron deficiency anaemia in males over 60? what investigation should be done?

A

Colorectal cancer. All males over 60 with iron deficiency anaemia should receive colonoscopy

Anatomy (make or break marks) (9 decks)

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