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Year 3 > GI > Flashcards

GI Flashcards

1
Q

What is often the main cause of gastritis?

A

H. pylori

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2
Q

What does it suggest if neutrophils are present in oesophagitis?

A

It is acute

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3
Q

What are the key features that coeliac disease presents with?

A

Anaemia
Weight loss
Diarhoea

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4
Q

What are the complications of coeliac disease?

A

Anaemia
Oesteoporosis
Dermatitis herpetiformis

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5
Q

What are the key histological features of coeliac disease?

A

Villous atrophy
Crypt hyperplasia
Intra epithelial lymphocytosis
Lamina propria rich in plasma cells

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6
Q

What are the complications associated with diverticulitis?

A

Fistula
Obstruction
Haemorrhage
Perforation

Super infection with CMV/ C.diff

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7
Q

What diseases is Ulcerative colitis associated with?

A

Primary biliary cirhosis

Ankylosing spondolytis

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8
Q

What are the key histological features of UC?

A 
Punctate ulcers
Psuedopolyps
Haemorrhagic colonic mucosa
Basal plasmocytosis
Crypt abscesses
Mucin depletion
Inflammation (diffuse)
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9
Q

What is microscopic colitis?

A

A condition which typically affects middle aged women, with profuse longstanding diarrhoea, with a normal colonoscopy.
There is thickened collagen between the epithelium, with lymphocytic inflammation, associated with autoimmune conditions and NSAID use.

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10
Q

What are the two main types of oesophageal cancer?

A
  1. Squamous cell carcinoma- increased risk in smoking, alcohol, low protein diet, HPV infection
  2. Adenocarcinoma- develops from Barretts metaplasia, chronic GORD, increased risk in alcohol, smoking, obesity, NSAIDs
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11
Q

What are the main causes of dysphagia?

A
  1. Mechanical block eg. malignancy, stricture, extrinsic pressure eg. lung cancer, mediastinal mass, AAA, retrosternal goitre, or pharyngeal pouch
  2. Motility disorders eg. achalasia, oesphahgeal spasm, or bulbar palsy
  3. Oesophagitis
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12
Q

Give examples of anti-emetics.

A

D2 receptors- Metoclopramide, Deompeidone

H1 receptors- Cyclizine

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13
Q

What is the triple therapy for H.pylori infection?

A
  1. PPI eg. omeprazole
  2. Clarithromycin
  3. Amoxicillin/ Metronidazole
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14
Q

What are the symptoms of a duodenal ulcer?

A

Can be asymptomatic, or can have epigastric pain (after eating) and weight loss.

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15
Q

Which drugs can be used in GORD?

A

Antacids eg. Magnesium trisilicate

Alginates eg. Gaviscon

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16
Q

What are the commonest causes of upper GI bleeding?

A 
Oesophageal varices
Mallory-Weiss tears
Peptic ulcers
Malignancy
Oesophagitis
Duodenitis
Drugs- NSAIDs, steroids, anticoagulants
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17
Q

What are the causes of gastric/ oesophageal varices?

A 
Portal hypertension
Thrombosis
Cirrhosis
Schistosomiasis
Right sided heart failure
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18
Q

What are wet and dry beriberi?

A

Beriberi is a severe form of Vitamin B1 (thiamine) deficiency. It involves heart failure with…

Oedema (wet) or
Neuropathy (Dry)

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19
Q

What are the usual symptoms of acute pancreatitis?

A

Epigastric pain which radiates to the back.
Pain is relieved on sitting forward, or a hot water bottle on the back.
Vomitting
Jaundice
Bruising (grey turners/ cullens signs)

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20
Q

What can be the complications of acute pancreatitis?

A 
Pseudocyst
Chronic pancreatitis
Sepsis
Bleeding
Pulmonary oedema/ effusion
Necrosis
Cholecystitis
DIC
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21
Q

What is the Modified Glasgow Score?

A 
To calculate the severity of Acute Pancreatitis:
P- PaO2 LOW
A- Age HIGH
N- WCC HIGH
C- Calcium LOW
R- Urea HIGH
E- LDH HIGH
A- Albumin LOW
S- Glucose HIGH
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22
Q

What are gallstones composed of

A
  1. Bilirubin- large, often solitary. Increased risk with age and obesity.
  2. Pigment- small, irregular.
  3. Mixed stones- salt, pigment and cholesterol.
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23
Q

What are the main presentations of gallstones?

A
  1. Biliary colic- intermittent RUQ pain
  2. Acute cholecystitis- RUQ/ epigastric pain, fever, vomitting, gallbladder mass. Stone in the gallbladder neck. Murphy’s sign positive.
  3. Chronic cholecystitis- vague abdominal pain, flatulence, fat intolerance. chronic inflammation
  4. Ascending cholangitis- RUQ pain, fever and jaundice = Charcot’s Triad. Infection
  5. Gallstone ileus
  6. Pancreatitis
  7. Empyema
  8. Gallbladder necrosis
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24
Q

What is Courvoisier’s Law?

A

Painless jaundice and a palpable gallbladder= unlikely to be gallstones, likely to be pancreatic or cholangiocarcinoma.

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25
Q

What are examples of the causes of epigastric pain?

A 
MI
Pneumonia
GORD
Duodenal/ gastric ulcer
Gastritis
Acute pancreatitis
Acute cholecystitis
Biliary colic
Cancer
Visceral perforation
Trauma
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26
Q

What is Primary Biliary Cholangitis?

A

Autoimmune liver disease
90% are WOMEN aged over 50 years
It is a chronic autoimmune granulomatous inflammation, which leads to cholestasis
May lead to fibrosis, cirrhosis and portal hypertension.

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27
Q

What are the features of PBC?

A 
Often asymptomatic
RAISED ANTI-MITOCHONDRIAL ANTIBODY
Raised ALP levels, mildly raised AST/ALT
Finger clubbing
Pruritis
Lethargy
Jaundice
Xanthelasma, xanthomata
Hepatosplenomegaly
Malabsorption of fat soluble vitamins
28
Q

How does acute cholecystitis present?

A 
RUQ/epigastric pain
Fever
Vomitting
GB mass
Murphy's sign positive
29
Q

How does CHRONIC cholecystitis present?

A

Vague abdo pain
Flatulence
Fat intolerance
Chronic inflammation

30
Q

How does ascending cholangitis present?

A

CHARCOT’S TRIAD:

  1. Fever
  2. RUQ pain
  3. Jaundice
31
Q

How does obstructive jaundice present?

A

Epigastric pain

32
Q

What are the most common causes of SMALL bowel obstruction?

A
  1. Adhesions
  2. Hernias
  3. Crohn’s disease
  4. Malignancy
33
Q

What are the most common causes of LARGE bowel obstruction?

A
  1. Malignancy
  2. Diverticular disease
  3. Colonic volvulus
34
Q

What is colonic volvulus?

A

When the mesentery of the sigmoid colon twists so that the segment of bowel twists
This loop can become ischemic due to compromised blood supply

35
Q

Which triad may present in haemochromatosis?

A
  1. Tanned skin
  2. Cirrhosis
  3. Diabetes
36
Q

Which diabetes medication is associated with weight gain?

A

Glicazide (sulfonylurea)

37
Q

_______________ may present with chronic central abdominal pain, steatorhoea and weight loss.

A

Chronic pancreatitis

38
Q

Which antibiotic can be given for cholecystitis?

A

Co-amoxiclav

39
Q

What are the symptoms of chronic pancreatitis?

A

Steatorrhoea
Weight loss
Bloating

40
Q

How can C. diff infection be treated?

A

Vancomycin

Metronidazole

41
Q

Which skin complaints may be seen in IBD?

A

Erythema nodosum

Pyoderma gangrenosum

42
Q

Which type of GI cancer has a signet ring appearance histologically?

A

Gastric adenocarcinoma

43
Q

If a patient finds it difficult to initiate swallowing, what does this suggest?

A

Bulbar palsy- LMN lesion of CN 9-12

44
Q

If a patient is suffering with intermittent dysphagia, what does this suggest?

A

Oesophageal spasm

45
Q

If a patient with dysphagia has a neck bulge/ gurgle on drinking, what does this suggest?

A

Pharyngeal pouch

46
Q

What is achalasia?

A

Failure of the lower oesophageal sphincter to relax
Due to degeneration of myenteric plexus

Causes dysphagia

47
Q

What can cause a benign oesophageal stricture?

A

GORD

Surgery

48
Q

What is dyspepsia?

A

Indigestion

49
Q

Which type of ulcer is more common: gastric or duodenal?

A

Duodenal

4X more common

50
Q

What can cause a duodenal ulcer?

A 
H. Pylori infection
NSAIDs
Steroids
Smoking
Excess acid secretion
51
Q

The Rockall Score is used for predicting mortality from_____________________

A

Upper GI bleeding

52
Q

What are the likely causes of bloody diarrhoea?

A
  1. Infection- Campylobacter, Shigella, Salmonella, E.coli
  2. Ulcerative collitis
  3. Crohn’s
  4. Colonic cancer
  5. Polyps
53
Q

What can cause steatorrhoea?

A

Chronic pancreatitis

Biliary obstruction

54
Q

Abscorbic acid (Vitamin C) is used to treat ________

A

Scurvy

55
Q

How may gallstone ileus appear on Xray?

A
  1. Air in the common bile duct
  2. Small bowel dilated and fluid filled loops
  3. Gallstone
56
Q

Which patients is PBC most common in?

A

Females

Aged 50 years

57
Q

Which patients is PSC most common in?

A

Males

Aged 20-40 years

58
Q

Which autoimmune liver disease is most associated with UC?

A

PSC

59
Q

What are the signs/ symptoms of PBC?

A 
Often asymptomatic Finger clubbing
Pruritis
Lethargy
Jaundice
Xanthelasma, xanthomata
Hepatosplenomegaly
60
Q

What are the signs/ symptoms of PSC?

A

Pruritis
Lethargy
Cirrhosis

61
Q

What are the 2 types of hiatus hernia?

A
  1. Sliding hiatus hernia (80%) - gastro-oesophageal junction slides up into chest
  2. Rolling hiatus hernia (20%) - gastro-oesophageal junction remains in abdomen
62
Q

What are the commonest causes of small bowel obstruction?

A

Adhesion

Hernias

63
Q

What are the commonest causes of large bowel obstruction?

A 
Colon cancer
Diverticular strictures
Volvulus
Sigmoid volvulus
Constipation
64
Q

How does small bowel obstruction present?

A

Vomitting earlier than large bowel obstruction

Less distension than large bowel obstruction

65
Q

How does large bowel obstruction present?

A

Vomitting later than small bowel obstruction

More distended than small bowel obstruction

Year 3 (22 decks)

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