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