GI Flashcards

1
Q

Crohn’s disease

A

Type of IBD
Inflammation of digestive tract- mouth to anus

Sx: pain (often R lower quad), diarrhoea, blood in stool, fatigue, weight loss, malnutrition.

Immune related, not autoimmune. Triggered by foreign pathogen- mycobacterium paratuberculosis, pseudomonas - large immune response = destruction
Cousin: ulcerative colitis- large intestine

Risk factor: Genetics - NOD2 frameshift
Make granulomas -> ulcers beyond submucosa layer / transmural
Scattered areas of inflammation - cobblestone
1. Ileum and colon most common
2. Ileum
3. Colon

Tx: anti inflammatorys
Antibiotics - control bacterial levels, control Sx
Immunosuppressants first severe
Surgery to remove
Destination from ulcerative colitis: surgery doesn’t cure crohns, can happen anywhere on GI track

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2
Q

Ulcerative colitis

A
IBD with crohns 
Specifically in large intestine 
Ulcers in lumen - in mucosa and submucosa 
Flares and remission 
Most common type of IBD 
Most common in Young women teens-30’s 

Cause: secondary (stress and diet), autoimmune (cytotoxic T cells), p- ANCA in blood (antibodies that target our neutrophils ), sulphide producing bacteria, all theories.

Pattern: circumferential and continuous, no normal tissue.
Sx: Pain in left lower quad, diarrhoea and blood, dehydration

Diagnosis: colonoscopy plus biopsy
CT, MRI, barium enema, X-ray

Tx: anti inflammatories - sulfasalazine, mesalamine
Immunosuppressors- corticosteroids, azathioprine, cyclosporine
Biological - infliximab, adalimumab
Colectomy- removal large intestine

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3
Q

Commonest cause of travellers diarrhoea

A

ETEC enterotoxigenic escherichia coli

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4
Q

Post course of antibiotics for chest infection

Abdo pain, watery diarrhoea, temperature, other family fine

A
C diff 
Associated with antibiotic use 
Gram positive anaerobe , spore forming 
Causes colitis
Toxin producing- damage lining of bowel 
Diagnosis: stool sample , serious complications if not treated 
Report to public health
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5
Q

Giardiasis

A

Infection of small intestine
Parasite
Drinking contaminated water
Flatulent, bloating, burping

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6
Q

Mallory Weiss tear

A

Tissue tear in lower oesophagus
Present: heamatemesis
Associated with violent coughing or vomiting
Mostly self limiting so supportive Tx.
Endoscopy - rule out other causes of upper GI bleeds
Often right border near gastro oesophageal junction

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7
Q

Oesophageal varices

A

From portal hypertension, complication of cirrhosis
Hepatic venous pressure gradient >12 mmHg = decompensated cirrhosis
Significant mortality and morbidity
Tx : preventative - non selective B blockers

Acute haemorrhage- resus, vasopressin / octreotide IV if suspected

Variceal ligation when confirmed on endoscopy
Balloon tamponade

TIPS - early trans-jugular intrahepatic Porto- systemic stunt - if other Tx fails.

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8
Q

Pain causes

A
BIDI
Blockage 
Inflammation 
Damage, dysfunction 
Ischemia
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9
Q

Colicky central abdo pain migrating to Sharp right iliac fossa pain.

A

Appendicitis
McBurney’s point -1/3 distance from asis to umbilicus
Deep tenderness here.

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10
Q

AAA

A

Pulsating mass the pain radiating to back

Contrast CT gold standard

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11
Q

Gastric ulcers

A
Caused by : NSAIDs and alcohol 
H pylori colonises exposed area 
Converts urea to ammonia and CO2
Tx: clarithromycin and inject adrenaline to stop bleeding 
Gastric : pain on eating
Duodenal: pain relived by eating 
Painful 2-5h after
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12
Q

Iron absorption: duodenum
Folate : jejunum
B12 : ileum

C.diff infection

A

Opportunistic, blood in diarrhoea usually after amoxicillin
1st Tx: metronidazole
2nd vancomycin

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13
Q

Ulcer damage through entire intestinal wall - transmural
Vs
Only through mucosa and submucosa

A

Crohns

UC

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