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FOCP > GI > Flashcards

GI Flashcards

1
Q

What is a cause of epigastric pain?

A

Peptic ulcer, pancreatitis, gastritis, gallbladder disease, AAA

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2
Q

What are possible causes for left upper quadrant pain?

A

Renal problems, peptic ulcer, gastric or colonic cancer, splenic rupture, subphrenic and polyphrenic abscesses

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3
Q

What can cause right upper quadrant pain?

A

Peptic ulcer, colonic or gastric cancer, hepatitis, cholecystis, renal problems, subphrenic and perinephric abscess

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4
Q

What can cause loin pain?

A

Polynephritis, perinephritic abscess, renal tumour, a in from vertebral column

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5
Q

What can cause left iliac fossa pain?

A

IBS, diverticulitis, volvulus, colon cancer, cancer of un descended testes, zoster, pelvic abscess, hip pathology

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6
Q

What can cause right iliac fossa pain?

A

IBS, chron’s ileities , volvulus, colon cancer, cancer of un descended testes, zoster, pelvic abscess, hip pathology

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7
Q

What can cause generalised abdominal pain?

A

IBS, gastroenteritis, peritonitis, constipation

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8
Q

What can cause central abdominal pain?

A

Mesenteric ischaemia, IBS, AAA, pancreatitis

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9
Q

What can cause pelvic pain?

A

UTI, stones, retention

Ovarian torsion, salpingitis, pregnancy, menstruation, endometriosis, endometritis

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10
Q

What can cause abdominal distension?

A 
Fetus,
Fat
Flatus,
Faeces
Fluid
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11
Q

What can cause faecal incontinence?

A

Idiopathic
Sphincter problems- surgery or tearing
Loss of sensation- ms, dementia, diabetes, spinal cord lesion
Copious diarrhoea,

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12
Q

What is tenesmus and what can cause it?

A

A feeling of incomplete bowl emptying, can be caused by IBS or tumours

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13
Q

What is regurgitation?

A

Effortless entry of gastric or oesophageal contents into mouth without contraction of muscles

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14
Q

What is steatorrhea and what can cause it?

A

Fatty stools, caused by malabsorption of fats and high fat content in stools. Caused by iliac problems, such as Crohn’s and iliel resection, obstructive jaundice and pancreatic disease

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15
Q

What signs of chronic liver disease CN be observed on inspection?

A

Asterix, halitosis, gynaecomastia, purpura, muscle wasting, scratch marks, spider naevi

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16
Q

What is leuconychia and what is it caused by?

A

Whitening of nails caused by hypoalbunism

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17
Q

What is koilonychia and what is it caused by?

A

Spooning of nails due to b12 or iron deficiency

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18
Q

What are Muehrcke’s lines and what causes them?

A

Transverse white lines on nails caused by hupoabuminaemia

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19
Q

What are palmar erythema’s and what are they caused by?

A

Chronic liver disease and pregnancy

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20
Q

What are blue lanulae and what are they caused by?

A

Bluish discolouration of nails caused by Wilson’s disease

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21
Q

What are dupuytren’s contracture and what are they caused by?

A

Thickening and contraction of palmar fascia, caused by alcoholic liver disease

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22
Q

What can hepatic flap be caused by?

A

Hepatic encephalopathy, uremia

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23
Q

What can cause angular stomatitis?

A

Thiamine, iron or b12 deficiencies

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24
Q

What can cause glossitis?

A

Folate, b12 or iron deficiencies

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25
Q

What are keiser-Fleischer rings and what can cause them?

A

Greenish yellow corneal ring, caused by Wilson’s disease

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26
Q

What are causes of Hepatomegaly?

A

RHF, hepatitis, malaria, sickle celled anaemia, leukemia, lymphoma, myeloproliferative diseases, malignancy

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27
Q

What can cause splenomegaly?

A

Malaria, chronic myeloid leukemia, myelofibrosis

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28
Q

What can cause dysphagia and chest pain?

A

Oesophageal spasm

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29
Q

What is dyspepsia?

A

Indigestion

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30
Q

What are the symptoms of gastric pain?

A

Change in weight, asymptomatic, epigastric pain

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31
Q

What are the causes of gastro oesophageal reflux disease?

A

Obesity, over eating, smoking, alcohol, drugs, pregnancy, oesophageal sphincter dysfunction, hiatus hernia

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32
Q

What is GORD?

A

When reflux of stomach into the oesophagus causes problems

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33
Q

What are the complications of GORD?

A

Barret’s oesophagus,
Oesophagitis,
Stricture,
Iron deficiency

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34
Q

What is a sliding hiatus hernia?

A

Gastro-oesophageal junction moves up into chest. LOS becomes less competent, can lead to acid reflux

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35
Q

What is a rolling hiatus hernia?

A

A part of the stomach bulges out, but rarely causes gross acid reflux

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36
Q

What can cause bloody diarrhoea?

A

Campylobacter, shigella, salmonella, ecoli, UC, Crohn’s, ischaemic colitis, pseudo membranous colitis, ameobiasis, colorectal cancer, polyps

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37
Q

What can cause mucousy diarrhoea?

A

IBS, colorectal cancer, polyps

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38
Q

What can cause frank pus diarrhoea?

A

Fistula, abscess, IBD

Absence of white blood cells:ncholera, ecoli, ameobiasis, viruses

39
Q

What can cause explosive diarrhoea?

A

Cholera, yersenia, giardia, rotavirus

40
Q

What are symptoms of large bowel diarrhoea?

A

Pain relieved by defaecation
Watery stools, sometimes blood
Tenesmus
Urgency

41
Q

What are the symptoms of small bowle diarrhoea?

A

Pain not relieved by defecation

42
Q

What can be used to treat diarrhoea?

A

Oral rehydration therapy
Codeine phosphate or loperamide to treat urgency
Antibiotics if needed

43
Q

What can be used to treat constipation?

A

Bulking agents to increase faecal matter
Osmotic laxatives to retain water
Faecal softeners to do that
Stimulant laxatives to increase motility

44
Q

What can cause constipation?

A

Neuromuscular disorders - spinal cord lesion, diabetes, systemic sclerosis
Drugs - morphine
Anorectal disease - prolapse
Obstruction - strictures, crohn’s, UC, diverticulitis

45
Q

What is unconjugated hyperbilirubinaemia and what are possible causes?

A

Bilirubin doesn’t enter blood,
Over production: malaria, hemolysis, ineffective erythropoeisis
Impaired hepatic function: drugs
Neonatal

46
Q

What are the causes of Conjugated hyperbilirubinaemia?

A

Hepatocellular dysfunction: hepatitis, EBV, CMV, leptospirosis, cirrhosis, alcohol, Wilson’s disease, liver metastasis and abscesses, autoimmune hepatitis
Impaired hepatic excretion: biliary cirrhosis, gallstones, pancreatic cancer, cholangitis

47
Q

Fulminant hepatic failure

A

Liver failure due to massive necrosis of the liver

48
Q

What are the causes of liver failure?

A

Viruses: CMV ebv, hepatitis (b and c)
Drugs: paracetamol overdose, alcohol
Vascular: increased portal hypertension, veno occlusive disease
Others: autoimmune hepatitis, primary biliary cirrhosis, Wilson’s disease, cirrhosis, fatty liver

49
Q

What are the clinical presentations of liver failure?

A

Hepatic flap, jaundice, encephalopathy

50
Q

What is liver cirrhosis?

A

Irreparable damage to liver

51
Q

What are the causes of liver cirrhosis?

A 
Alcohol abuse
Fatty lover disease
Chronic HBV and HCV
Primary biliary cirrhosis
Autoimmune hepatitis
52
Q

What is the clinical presentation of liver cirrhosis?

A

Dupytren’s contracture, palmar erythema, spider naevi, spooning of nails, xanthelsma, gynaecomastia, clubbing and Ascites

53
Q

What is hereditary hemochromatosis?

A

A genetic disease that increases iron absorption in the body and causes deposits in the joints and stuff.

Need regular venesection
Reverse vampires

54
Q

What are the indications for liver transplant?

A

Hepatitis b and c
Alcoholic liver disease
Primary biliary
Fatty liver disease

55
Q

What is alpha1 antitrypsin deficiency?

A

It’s a genetic disorder that causes inadequate mucus clearing in the lungs and liver

56
Q

What is the clinical presentation of alpha1 antitrypsin deficiency?

A

Dyspnoea due to bronchiectasis, cholecystic jaundice, cirrhosis.
Presentation usually starts at adolescence

57
Q

What is primary biliary cirrhosis?

A

Damage to bike ducts due to chronic granulomatous inflammation leading to cholecystis which can cause cirrhosis, fibrosis and portal hypertension

58
Q

What is the clinical presentation of primary biliary cirrhosis?

A

Lethargy can precede jaundice

Jaundice, xanthomata, xanthelsma, skin pigmentation, hepatosplenomegaly

59
Q

What are the complications of primary biliary cirrhosis?

A

Coagulapathy, osteoporosis, osteomalacia, poor absorption of fat soluble vitamins

60
Q

What is primary sclerosing cholangitis?

A

Progressive cholestasis with strictures and bile duct inflammation

61
Q

What are the signs and symptoms of primary sclerosing cholangitis?

A

End stage liver failure, cirrhosis, lethargy, pruritis

62
Q

What is Wilson’s disease?

A

Genetic disease of biliary secretion, causing increased copper (and copper deposition) in liver and basal ganglia

63
Q

What are the clinical presentations of Wilson’s disease?

A

Keiser Fleischer rings, blue lines on hand, reduced libido, depression, dysarthria, dysphasia, tremor, arthritis, fulminant liver failure, cirrhosis,

64
Q

What are the signs and symptoms of liver cancer?

A

Fever,malaise, anorexia, weight loss,pain,

Hepatomegaly, other cancers, clubbing,

65
Q

What is ulcerative colitis?

A

It is caused by inflammation of colonic mucosa and it rarely spreads above the ileocaecal valve

66
Q

What are the symptoms and signs of ulcerative colitis?

A

Bloody diarrhoea with mucus, increased bowel frequency

Fever, tachycardia, malaise, weight loss

Clubbing, mouth ulcers, ankylosing spondylitis, conjunctivitis, iritis, uveitis, arthritis

67
Q

What is the surgery used to treat ulcerative colitis?

A

Proctocolectomy with terminal iliectomy. Will require pouch later

68
Q

What is Crohn’s disease?

A

It is a GI disease characterised by granulomatous inflammation anywhere from mouth to anus. Unlike UC, there can be areas without inflammation in between

69
Q

What are the symptoms and signs of Crohn’s disease?

A

Diarrhoea, urgency, fever, anorexia, failure to thrive, weight loss, very smelly stool, malaise

Clubbing, eye problems, skin tags, ulcers, strictures, abdominal distension/tenderness

70
Q

What signs and symptoms can a cancer of the pancreas have?

A

Painless,obstructive jaundice (cholecystic picture in LFTs)

71
Q

What is scurvy and what are the signs?

A

Vit C deficiency

Bleeding gums, nose or hair follicles, caxhexia, listlessness, muscle weakness, oedema, loose teeth and foul breath

72
Q

What is beriberi and it’s usual presentations?

A

HF caused by vit b1 deficiency
Dry beriberi shows neuropathy
Wet beriberi has centralised oedema

73
Q

What is pellagra and it’s clinical presentation?

A

Nicotinic acid deficiency,

Depression, ataxia, fits, dementia, dermatitis, diarrhoea, neuropathy

74
Q

What is xerophthalmia and what does it cause?

A

Vit A deficiency.

Blindness, corneal softening and triangular/oval spots on the eye

75
Q

What are the signs and symptoms of gastrointestinal malabsorption?

A

Diarrhoea, steatorrhea, bloating, lethargy, anaemia, bleeding disorders, metabolic bone disorder

76
Q

What are there presenting symptoms for GI histories?

A

Abdominal pain, distension, dysphasia, haematomesis, dyspepsia, jaundice, weight loss, diarrhoea, constipation, rectal bleeding,

77
Q

What is coeliac disease and what causes it?

A

T cell mediated attack of small bowel that causes glutin intolerance, which in turn, causes villi atrophy and malabsorption

78
Q

What are the symptoms of coeliac disease?

A

Steatorrhea, diarrhoea, abdominal pain, failure to thrive, bloating, osteomalacia, angular stomatitis, ulcers, weight loss

79
Q

What are the causes of chronic pancreatitis?

A

Mostly alcohol

Familial, CF, pancreatic duct obstruction, raised PTH, congenital defects

80
Q

What is the clinical presentation of chronic pancreatitis?

A

Epigastric pain that bores to the back, relieved by sitting forward or hot water bottles, steatorrhea, weight loss, fatigue, bloating, brittle diabetes

81
Q

What are the complications of chronic pancreatitis?

A

Pseudo cyst, pancreatic obstruction, diabetes, local arterial aneurysm, splenic vein thrombosis, pancreatic carcinoma, gastric varices

82
Q

What is Achalasia?

A

Loss of oesophageal myenteric plexus

No peristalsis and LOS does not relax?

83
Q

What is oesophageal spasm?qq

A

Uncoordinated oesophageal spasms

84
Q

What is nut cracker oesophagus?

A

Type of oesophageal spasm

Distal contractions are of excessive amplitude and cause retro sternal chest pain and intermittent dysphagia

85
Q

What would be seen in a patient with a pharyngeal pouch?

A

Cough and a prominent neck lump

86
Q

What are the ALARM symptoms and what should be done with a patient who presents with them?

A

Anorexia, loss of weight, Anaemia, recent onset and Melaena/haematomesis for anyone over 55
Requires urgent referral for endoscopy

87
Q

What is squamous cell and adenocarcinoma of the pancreas associated with?

A

Hoarse voice

88
Q

What is coughing mid swallow associated with?

A

Bulbar palsy

89
Q

What does regurgitation if oral intake suggest

A

Motility disorder like Achalasia

90
Q

What does hypoalbuminaemia cause?

A

Ascites and peripheral oedema

91
Q

What is biliary cirrhosis associated with?

A

Anti-mitochondrial antibodies

92
Q

What is long term steroid use associated with?

A

Ulcers

93
Q

What medications must be avoided before an endoscopy?qq

A

PPIs and H2 antagonists, for at least 2 weeks before

FOCP (12 decks)

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