GI Conditions Flashcards
Aetiology steatosis and steatohepatitis
Alcohol, metabolic syndrome, starvation, steroids
Features of steatohepatitis
Fatigue, malaise, RUQ pain
AST/ALT may be raised, ALT higher in NASH, AST in alcoholic
More likely to progress to cirrhosis
What is cirrhosis?
Hepatic fibrosis, nodular disorganisation, protal hypertension and ultimatley hepatic failure
Aetiology cirrhosis?
Alcohol, chronic hep B/C, NASH, NAFLD
Symptoms and signs cirrhosis
Fatigue, anorexia, nausea, weight loss, ascites, variceal haemorrhage
Management cirrhosis
Zinc supplements, cholestyramie, consider bisphosphonates
Complications cirrhosis
Hypersplenism, Vitamin deficiency, synthetic failure, anaemia, thrombocytopenia, coagulopathy, DIC, encephalopathy
Ascites aetiology
Cirrhosis, GI/ovarian cancer, lymphoma, chronic hf, nephrotic syndrome, pancreatitis
Management ascites
Low salt, spironolactone, paracentesis
Symptoms of primary biliary cirrhosis
Asymptomatic, fatigue, pruritis, RUQ pain
Investigations PBC
High ESR, Bilirubin, hyperlipidaemia, AMA, IgM, ANA
Management PBC
UDCA, DMARDS, liver transplant
Primary sclerosing cholangitis features
Autoimmune inflammatory fibrosis of extra-hepatic bile ducts
Men < 35, underlying IBD
PSC investigations
p-ANCA, IgG, IgM, USS, ERCP, MRCP
Management PSC
Liver transplant only life-prolonging treatment
Avoid alcohol
Features coeliac disease
Autoimmune inflammation triggered by gluten
Symptoms coeliac
Anaemia, abdo discomfort, diarrhoea, mouth ulcers, angular stomatits
Associations for coeliac
Subfertility, miscarriage, low birth weight, dermatitis herpetiformis
Investigations coeliac
anti-tTGA/anti-endomysial antibodies; undetectable after 6m gluten free
Duodenal biopsy gold standard
management coeliac
Gluten free diet, consider vaccinations, bisphosphonates
Complications coeliac
Osteoporosis, malnutrition, hyposplenism, lactose intolerance
Pathogens causing gastroenteritis
Norovirus, campylobacter, E. coli, salmonella, shigella
Risk for GORD
High intra-abdominal pressure, smoking, alcohol, coffee, obesity, hiatus hernia
Alarm symptoms GORD
Dysphagia, weight loss, anaemia, vomiting, age >55, FH, Melaena
Management GORD
PPI for 1-2months
Peptic ulcer causes
H. pylori associated, NSAIDs, smoking, alcohol, steroids, stress, bile reflux
Symptoms peptic ulcers
Epigastric pain, night waking, nausea, belching, bloating
Investigation PU
FBC, H.pylori testing
Management PU
PPI if NSAID induced
Eradication therapy for H. pylori
Features crohn’s disease
Cobblestone colon, skip lesions, granulomas, affects any part of GI tract most commonly ileum, girls aged 15-30, smoking major risk/exacerbating factor
Symptoms crohns disease
diarrhoea (mucus > blood), weight loss, abdominal pain, malaise, anorexia, mouth ulcers, perianal lesions, clubbing, ankylosing spondylitis, renal stone
Investigations crohns disease
ASCA, high CRP in active disease, stool culture, ileocolonoscopy
Treatment crohns disease
smoking cessation, metronidazole if fistulating, PPI if gastric
Prednisolone, IV hydrocortisone, azathiprine, infliximab
Features UC
Pseudopolyps, thin ulcers, crypt abscess, distal disease
Symptoms and signs UC
Bloody diarrhoea, weight loss, abdo pain, tenesmus, urgency, mouth ulcers
Investigations UC
p-ANCA, magnesium, albumin, sigmoidoscopy/colonoscopy
Treatment UC
Mesalazine - maintenance
Surgery
