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My Phase 2a Medicine > GI Conditions > Flashcards

GI Conditions Flashcards

1
Q

What micro-organisms can cause GI infections?

A

Viruses, Bacteria, Parasites

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2
Q

What are the common symptoms of a GI infection?

A

Diarrhoea, vomiting, abdominal pain, fever

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3
Q

Name two type of viral GI infections and how they are managed

A

Rotavirus and norovirus

  • water and electrolyte replacement
  • anti-infective agents
  • vaccine
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4
Q

How do bacteria cause damage in the GI?

A
  • mucosal adherence
  • mucosal invasion
  • toxin production
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5
Q

How are bacteria GI infections managed?

A
  • antibiotics

- fluid and electrolyte balance

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6
Q

What is a parasite and name 2 types which cause GI infection.

A

Type of protozoa which lives in another organism

  • Amoebiasis
  • Giadiasis
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7
Q

What are the symptoms and management of a parasitic GI infection?

A

Diarrhoea, abdominal pain, nausea, malabsorption, headaches
Test stools for present of parasite
Anti-protozoal medications

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8
Q

Name 2 types of benign oesophageal tumours.

A 
Gastrointestinal stromal tumours (tumour of the connective tissue anywhere along the GI tract)
Gastric polyp (abnormal growth of tissue on the mucosal membrane)
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9
Q

What are the 2 categories of benign small intestine tumours?

A 
Lipoma = benign tumour of adipose tissue
Adenoma = benign tumour of glandular/secretory tissue
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10
Q

What are some types of benign colonic tumours?

A
  • Sporadic adenomas
  • polyps
  • sessile serrated adenoma (pre-malignant flat lesion)
  • familial adenomatous polyposis (autosomal inherited condition polyp formation in the colon)
  • MYH-associated polyposis (autosomal recessive condition causing polyps of the colorectum)
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11
Q

What are the symptoms of benign colonic tumours?

A
  • rectal bleeding

- diarrhoea

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12
Q

How are benign colonic tumours managed?

A
  • surveillence
  • colonoscopy
  • CT scan
  • surgical removal
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13
Q

What is a hernia?

A

protrusion of an internal organ or part of one through a defect in the cavity wall into an abnormal position

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14
Q

What are the 4 types of hernias?

A
  • irreducible = cannot be pushed back into its normal place
  • obstructed = bowel contents unable to pass
  • strangulated = ischaemia of an organ occurs
  • incarcerated = hernia become trapped due to adhesions
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15
Q

What are the common locations of herniad

A
  • inguinal (through the deep inguinal ring)
  • femoral (through the femoral canal)
  • epigastric (through the line alba)
  • incisional (through an opening formed by surgery)
  • obturator (through the obturator canal in the pelvis)
  • hiatal (through the diaphragm)
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16
Q

What are the symptoms of a hernia?

A
  • pain/discomfort
  • bulge/lump
  • weakness/pressure
  • burning/aching
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17
Q

How are hernias diagnosed?

A
  • physical examination
  • endoscopy
  • barium x-ray
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18
Q

How are hernias treated?

A
  • surgery

- nothing if asymptomatic

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19
Q

What is mesenteric ischaemia?

A

=inadequate blood supply to the small intestine causes damage
can be acute or chronic

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20
Q

What are the causes of acute mesenteric ischaemia?

A
  • thrombosis
  • embolism
  • trauma
  • non-occulisive disease (e.g. vasoconstriction, heart disease)
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21
Q

What are the symptoms of acute mesenteric ischaemia?

A
  • acute severe abdominal pain
  • rapid hypovolaemia
  • no/minimal abdominal signs
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22
Q

How is acute mesenteric ischaemia treated?

A
  • immediate surgery
  • IV fluids
  • antibiotics
  • arteriography
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23
Q

What causes chronic mesenteric ischaemia?

A

atheroma

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24
Q

What are the symptoms of chronic mesenteric ischaemia?

A
  • severe post-prandial pain
  • weight loss
  • upper abdominal pain
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25
Q

How is chronic mesenteric ischaemia treated?

A
  • surgery

- angioplasty

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26
Q

What is peritonitis?

A

infection of the peritoneum (lining of the abdominal cavity)

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27
Q

What are the causes of peritonitis?

A
  • burst stomach ulcer
  • burst appendix
  • pancreatitis
  • surgery
  • cirrhosis
  • perforated bowel
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28
Q

What are the symptoms of peritonitis?

A
  • sudden and severe abdominal pain - if due to perforation
  • slow onset pain - if due to inflammation
  • bloating
  • fever
  • nausea/vomiting
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29
Q

How is peritonitis diagnoses?

A
  • chest x-ray
  • ultrasound/CT
  • serum analysis
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30
Q

How is peritonitis managed?

A
  • IV antibiotics
  • surgery - peritoneal lavage
  • treat underlying cause
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31
Q

What are the complication of peritonitis?

A

Septicaemia = severe infection in the blood

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32
Q

What is appendicitis?

A

lumen of the appendix becomes obstructed by a faecolith (hard mass of faeces), filarial worms of lymphoid hyperplasia causing inflammation

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33
Q

What are the complications of appendicitis?

A
  • perforation
  • ischaemia
  • necrosis
  • oedema
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34
Q

What are the symptoms of appendicitis?

A
  • abdominal pain (centre of abdomen to right of iliac fossa)
  • constipation
  • nausea and vomiting
  • anorexia
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35
Q

What are the signs of appendicitis?

A
  • tachycardia
  • fever
  • tenderness
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36
Q

How is appendicitis diagnosed?

A
  • CT scan

- blood tests

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37
Q

How is appendicitis treated?

A
  • appendicectomy
  • antibiotics
  • laparoscopy
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38
Q

What is ischaemic colitis?

A

=inadequate blood supply causes inflammation and injury to the large intestine

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39
Q

What are the causes of ischaemia colitis?

A
  • low blood flow in the inferior mesenteric artery
  • atherosclerosis
  • hypotension
  • blood clot
  • bowel obstruction
  • surgery
  • medication
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40
Q

What are the symptoms of ischaemic colitis?

A
  • lower left sided abdominal pain
  • bloody diarrhoea
  • nausea
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41
Q

What are the complications of ischaemia colitis?

A
  • bowel inflammation
  • bowel obstruction
  • bowel perforation
  • tissue death
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42
Q

How is ischaemic colitis diagnosed?

A
  • scan
  • stool analysis
  • colonoscopy
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43
Q

How is ischaemic colitis treated?

A
  • antibiotics
  • IV fluids
  • treat cause
  • surgery (remove dead tissue, bypass blocked artery, remove part of colon)
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44
Q

What is intestinal obstruction?

A

small of large intestine becomes totally or partially blocked preventing the passage of fluids and digested food

45
Q

What are the causes of intestinal obstruction?

A 
mechanical
-IBD
-hernias
-tumours
-congenital malformations
-volvulus (twisting)
-adhesions (usually after surgery or inflammation)
functional
-Parkinson's
Hirschspring's disease (lack of nerves to the large intestine)
46
Q

What are the symptoms of intestinal obstruction?

A
  • bloating/swelling
  • abdominal pain
  • decreased appetite
  • nausea/vomiting
  • constipation/diarrhoea
47
Q

How is intestinal obstruction diagnosed?

A
  • scans
  • blood tests
  • colonoscopy
48
Q

How is intestinal obstruction managed?

A 
if partial
-give IV fluids
-no food or drink
surgery
insert tube down tract
49
Q

What are the complications of intestinal obstruction?

A
  • bowel rupture
  • peritonitis
  • dehydration and electrolyte imbalance
50
Q

What is lynch syndrome?

A

autosomal dominant condition causing a very high risk of colon cancer - due to alteration in mismatch repair gene

51
Q

What are the risk factors for colorectal cancer?

A
  • age
  • high red meat/processed meat/sugar/saturated fat diet
  • obesity
  • polyps
  • IBD
52
Q

What are the symptoms for colorectal cancer?

A
  • looser/more frequent stools
  • rectal bleeding
  • anaemia
  • tenesmus (feeling of incomplete defecation)
  • palpable tectal/abdominal mass
53
Q

How is colorectal cancer diagnosed?

A
  • colonoscopy
  • barium enema
  • ultrasound/MRI
  • faecal occult blood test (FOB)
54
Q

How is colorectal cancer treated?

A
  • segmental resection
  • total mesorectal excision
  • post-operative chemo
  • follow up colonoscopy
55
Q

What are the 2 types of small intestine tumours?

A 
Adenocarcinoma = malignant tumour of glandular/secretory epithelium (duodenum or jejunum)
Lymphoma = malignant tumour of adipose tissue (ileum)
56
Q

What are the predisposing factors for malignant tumours of the small intestine?

A
  • inflammatory bowel disease

- immunoproliferative small intestine diseases

57
Q

What are the symptoms of malignant tumours of the small intestine?

A
  • abdominal pain
  • diarrhoea
  • anorexia
  • weight loss
  • anaemia
  • palpable mass
58
Q

How are malignant tumours of the small intestine treated?

A
  • surgery
  • radiotherapy
  • chemotherapy
59
Q

What are carcinoid tumours?

A

tumours developing from neuroendocrine cells (ECF cells-synthesise and secrete histamine)

60
Q

What are the symptoms of carcinoid tumours?

A
  • diarrhoea
  • acute appendicitis
  • abdominal pain
61
Q

How are carcinoid tumours treated?

A
  • somatostatin analogues (decrease hormone production, may shrink tumour)
  • chemotherapy
62
Q

Name 4 types of malignant oesophageal tumours

A
  • squamous cell carcinoma
  • adenocarcinoma
  • gastrointestinal stromal tumours
  • kaposi sarcoma (cancer which causes abnormal patched of tissue in the lining of the oesophagus
63
Q

What is Barret’s oesophagus?

A

Pre-malignant condition when columnar epithelium changes into squamous epithelium at the bottom of the oesophagus due to GORD.

64
Q

What are the symptoms of oesophageal cancer?

A
  • dysphagia
  • pain caused by impaction of food
  • weight loss
  • anorexia
  • lymphadenopathy
65
Q

How is oesophageal cancer diagnosed?

A
  • endoscopy
  • barium swallow
  • CT/MRI/ultrasound/PET
66
Q

How is oesophageal cancer treated?

A
  • surgery
  • pre-operative chemo
  • palliative care
67
Q

What is irritable bowel syndrome (IBS)?

A

abdominal symptoms in the absence of a demonstratable abnormality in digestion absorption or function

68
Q

What are the symptoms of irritable bowel syndrome?

A
  • abdominal pain
  • bloating
  • diarrhoea
  • constipation
  • non-GI symptoms (painful periods, pain after sex, incontinence, back pain, fatigue)
69
Q

How is irritable bowel syndrome diagnosed?

A 
in prev 3 months must be at least 3 days/month of recurrent abdominal pain
plus 2 of
-improvement with defection
-change in stool frequency
-change in stool form
further investigation if
-weight loss
-bleeding
70
Q

How is irritable bowel syndrome managed?

A

lifestyle/diet
-constipation (water, fibre, laxatives, exercise)
-diarrhoea (avoid triggers, anti-diarrhoeal)
-bloating (anti-spasmodics)
-pain (analgesias, muscle relaxants)
cognitive therpay
pre/pro-biotics

71
Q

What is malabsorption?

A

decreased absorption of specific substances

72
Q

What are the causes of malabsorption?

A
  • coeliac disease
  • chronic pancreatitis
  • crohn’s disease (IBD)
  • pancreatic insufficiency
  • decreased bile
  • infection
  • Whipple’s disease (bacterial infection which decreases the bodies ability to absorb nutrients)
73
Q

What are the symptoms of malabsorption?

A
  • weight loss
  • diarrhoea
  • lethargy
  • stearrhoea (smelly stools-due to high fat content)
  • bloating
74
Q

How is malabsorption diagnosed?

A
  • full blood count
  • test for coeliac disease (serology, biopsy)
  • stool sample (bacteria, fat)
  • hydrogen breath test (bacteria)
  • endoscopy
75
Q

How is malabsorption treated?

A

-mineral/vitamin replacement
-treat bacteria infection
gluten free diet (if coeliac)
-creons (replace pancreatic enzymes)

76
Q

What is gastritis?

A

inflammation of the mucosa of the stomach

77
Q

What are the causes of gastritis?

A
  • auto-immune disease
  • H.pylori infection
  • viruses
  • duodenogastric reflux
  • Crohn’s disease
78
Q

How does a H.pylori infection causes gastritis?

A

bacteria produce enzymes which damage the mucosa of the stomach leaving it prone to ulceration and inflammation due to acid damage. The production of ammonia enable the bacteria to survive in the acidic environment and ma also erode the mucosa

79
Q

What are the symptoms of gastritis?

A
  • epigastric pain
  • bloated/feeling full
  • dyspepsia (painful swallowing)
  • nausea/vomiting
80
Q

What are the complications of gastritis?

A
  • ulcers

- metaplasia (cancer pre-cursor)

81
Q

What is the treatment for gastritis?

A
  • antacids
  • PPIs
  • H2 anatagonists
  • antibiotics (if bacterial infection)
  • decrease alcohol/irritant foods
82
Q

What are peptic ulcers?

A

breaks in the mucosa, down the muscularis mucosa, of the stomach or duodenum

83
Q

What are the causes of peptic ulcers?

A
  • H.pylori infection
  • NSAIDs
  • stress
  • delayed gastric emptying
  • cancer
84
Q

How doe NSAIDs cause peptic ulcers?

A

NSAIDs inhibit the production of cox-1 enzymes which decrease prostaglandin secretion which decreases the mucosal defense system

85
Q

What are the symptoms of peptic ulceration?

A
  • asymptomatic
  • epigastric pain (recurrent and burning)
  • nausea and weight loss
86
Q

How are peptic ulcers managed?

A
  • lifestyle modification (decrease smoking/alcohol)
  • antibiotics if H.pylori
  • PPIs
  • H2 antagonists
  • stop causative drugs
87
Q

What is gastro-oesophageal Reflux Disease (GORD)?

A

reflux of stomach contents into the oesophagus causing symptoms and complications

88
Q

What are the causes of GORD?

A
  • lower oesophageal sphincter hypertension (increased contraction - open)
  • oesophageal dysmotility
  • obesity
  • gastric acid hypersecretion
  • delayed gastric emptying
  • drugs
  • pregnancy
  • hiatus hernia
89
Q

What are the symptoms of GORD?

A
  • heart burn (burning/discomfort in the chest, commonly after a meal)
  • belching
  • acid brash (regurgitation of acid)
  • water brash (accumulation of saliva in the mouth)
  • odynophagia (painful swallowing)
  • chronic cough
  • laryngitis
90
Q

What are the complications of GORD?

A
  • Barrett’s oesophagus (oesophagus epithelium changed from squamous to columnar) - precancerous
  • oesophagitis (inflammation of the lining of the oesophagus)
  • ulcers
91
Q

How is GORD treated?

A

-lifestyle modification (weight loss, stop smoking, small regular meals, avoid caffeine/alcohol/fizzy drinks)

92
Q

What are oesophago-gastric varices?

A

dilated submucosal veins in the stomach or oesophagus

93
Q

What are the causes of oesophago-gastric varices?

A
  • liver disease/cirrhosis (blood flow to the liver blocked by scar tissue causing increase in portal vein pressure)
  • thrombosis in portal vein
  • parasitic infection (lead to liver damage)
94
Q

What are the symptoms of oesophago-gastric varices?

A
  • usually asymptomatic
  • vomiting
  • black/bloody stools
  • light headed
95
Q

How are oesophago-gastric varices treated?

A
  • beta-blockers prevent bleeding

- reduce risk of liver disease (decrease alcohol, healthy diet, weight loss)

96
Q

What is coeliac disease?

A

T cell mediated immune response to gluten which leads to atrophy of villi in the small intestine

97
Q

What are the symptoms of coeliac disease?

A
  • diarrhoea
  • abdominal bloating
  • abdominal pain
  • nausea and vomiting
  • aphthous ulcers (recurrent mouth ulcers)
  • weight loss
  • steatorrhoea (stinking stools due to fat in the stools)
98
Q

How is coeliac disease diagnosed?

A
  • small bowel biopsy and histological examination while on gluten diet
  • serology testing for antibodies
99
Q

How is coeliac disease managed?

A

lifelong gluten free diet

100
Q

What are the complications of coeliac disease?

A
  • anaemia
  • osteopenia or osteoprosis
  • hyposplenism (dec spleen function)
101
Q

What is inflammatory bowel disease?

A

group of conditions which involve inflammation of the bowel due an inappropriate immune response resulting in abdominal symptoms with no organic cause

102
Q

What causes inflammatory bowel disease?

A

bacteria, viruses and other antigens trigger an inappropriate immune response causing inflammation

103
Q

What are the two most common types of inflammatory bowel disease?

A

Ulcerative colitis and Crohn’s disease

104
Q

What is ulcerative colitis?

A

inflammation of the colon and/or rectum

105
Q

What are the symptoms of ulcerative colitis?

A
  • diarrhoea (with blood/mucus)
  • lower abdominal discomfort
  • weight loss
  • lethargy
  • malaise
  • frequently needing to empty bowels
  • aphthous ulcers
106
Q

How is ulcerative colitis treated?

A
  • relieve symptoms (anti-diarrhoeal medication, analgesiacs)
  • aminosalicylates (modify inflammatory response)
  • coticosteroids
  • immunosuppressants
  • removal of colon (severe)
107
Q

What is Crohn’s disease?

A

inflammation of any part of the GI tract, most commonly affecting the ileum. May affect single or multiple parts

108
Q

What are the symptoms of Crohn’s disease?

A

constant of intermittent

  • diarrhoea
  • abdominal pain
  • weight loss
  • malaise
  • lethargy
  • nausea/vomiting
109
Q

How is Crohn’s disease treated?

A

no cure

  • glucocorticosteroids
  • immunosuppressant (anti-TNF antibodies)
  • surgery (removal of inflammed part of GI tract)

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