GI Correlation Flashcards
Acholic
White, clay colored stool due to absence of bile in GI tract
Acute abdomen
Any serious acute intraabdominal condition where surgery is considered
Cachexia
Malnutrition and general ill health
Coffee-ground emesis
Blood that is separated within the gastric contents that takes the form of coffee-grounds in the acidic environment
Colic
Acute abdominal pain
Dyspepsia
Postprandial epigastric discomfort
Dysphagia
Difficulty swallowing
Esophagitis
Inflammation of esophagus
ERCP
Endoscopic Retrograde Cholangiopancreatography
Flatus
Fart - air in GI tract expelled through anus
Gastritis
Inflammation of the stomach with histological/endoscopic features
Guarding
Protective response in muscle resulting from pain or fear of movement
Hematemesis
Vomiting blood
Hematochezia
Passage of bright red blood in stools
Icterus
= jaundice; yellowing of sclera in eyes and skin
Melena
Dark, tarry stools
Pneumobilia
Air/gas in the bile ducts/biliary system
Pneumomediastinum
Air/gas in the mediastinum (between organs or cavities)
Pneumoperitoneum
Air/gas in the peritoneal cavity
UGIB
Upper Gastrointestinal Bleed
Ulcer
Local excavation of tissue surface produced by shedding inflamed necrotic tissue
- extends through muscularis mucosae
Ureterolithiasis
Stone from kidney making its way to bladder
Virchow’s node
Palpable mass in LEFT supraclavicular/sternoclavicular fossa
What are some red flag symptoms?
Persistent vomiting and abdominal pain
Dysphagia
Hematemesis
Melena
RUQ pain
Cholecystitis (gallbladder)
LUQ pain
Gastritis (stomach)
RLQ pain
Appendicitis
LLQ pain
Diverticulitis
Describe visceral pain
Stimulation of visceral pain fibers secondary to distention, stretching of hollow organs
- NOT well localized
Describe parietal pain
Stimulation of somatic pain fibers secondary to inflammation of parietal peritoneum
- WELL LOCALIZED
What type of pain is usually more severe?
Parietal pain
If someone presents with nausea and vomiting, what is the most important information to get?
History and appearance of vomit
- Can be due to many causes
Oropharyngeal Dysphasia
Trouble initiating swallowing
- can be due to muscular, neurologic, structural, metabolic disorders
Esophageal Dysphasia is usually due to?
Usually due to mechanical obstruction or motility disorder
Example of a motility disorder for esophageal dysphasia
Achalasia, spasm
Example of a mechanical obstruction for esophageal dysphasia
Schatzki ring, peptic stricture
- Harder to swallow solids than liquids
What are the lab tests for a GI/Abdominal workup?
CBC BMP CMP Urinalysis Pregnancy test Lipase/amylase
CBC
Complete blood count - number of different cells in blood
- “with differential” includes % and counts of immune cells: PMN, lymphocytes, basophils, eosinophils and monocytes
BMP
Basal metabolic panel
- main electrolyte values
CMP
Comprehensive metabolic panel
- main electrolyte values and includes liver function molecules such as albumin and bilirubin
When looking for pancreatitis, what test is ordered?
Lipase/amylase
Types of plain film x-rays that can be ordered for GI pathology
AAS - acute abdominal screening
KUB - kidney, ureter, bladder
AAS plain film is good for?
Initial screening and quick check for free air
Purpose of a barium swallow?
Differentiate between mechanical lesions and motility disorders for esophageal dysphagia
What is a barium study sensitive to?
Detecting subtle esophageal narrowings and lesions
EGD
Endoscopicgastroduodenoscopy (upper endoscopy)
- direct visualization, biopsy of abnormalities and dilation of stricture
Colonoscopy
(lower endoscopy)
- screening, lower GI bleed
What gives the most important info about abdominal pathology?
CT scan - can be with or without contrast
Ultrasound is good for?
Imaging fluid filled structures and trauma situations
ERCP can do what?
Endoscopic Retrograde Cholangiopancreatography
- invasive way to visualize hepatobiliary and pancreatic ducts
MCRP shows?
Bile duct anatomy
HIDA
Hepatobiliary iminodiacetic acid scan
Purpose of HIDA?
Checks for dysfunctional gallbladder
What are the main symptoms with GERD?
Heartburn (pyrosis) and reflux/regurgitation
How do you diagnose GERD?
Usually on symptoms alone or via upper endoscopy
PUD and symptoms
Peptic ulcer disease
- Mostly asymptomatic, maybe pain in epigastric
What are the 2 major risk factors for PUD?
- Helicobacter pylori
2. NSAIDS
What is the most common cause of UGIB?
PUD!!! Peptic ulcer disease
What is the most prevalent chronic bacterial disease known?
Helicobacter pylori
Helicobacter pylori produces _____
urease
Helicobacter pylori produces urease. What does urease do?
It hydrolyzes the urea in the gastric lumen to form ammonia
- Ammonia then neutralizes the gastric acid to form a protective cloud around the organism so it can continue to penetrate the gastric mucosa
Helicobacter pylori is associated with many GI pathologies. List some.
PUD Gastritis Duodenal ulcers Gastric adenocarcinoma MALT lymphoma
What is the mode of transmission for helicobacter pylori?
Unknown
How do you test for helicobacter pylori?
Urea breath test
Fecal antigen test
Have to stop _______ medication 14 days before helicobacter pylori test so there is not a false negative
Proton pump inhibitor
What type of GI bleed is associated with an UGIB?
Melena
What type of GI bleed is associated with a LGIB?
Hematochezia
How can you tell if it is a UGIB or LGIB based on anatomical location?
ABOVE ligament of Treitz = UGIB
BELOW ligament of Treitz = LGIB
Esophageal and gastric varices
Dilated submucosal veins resulting from portal hypertension - high mortality rate
Cholelithiasis
Gall stones
Cholecystitis
Inflammation of gallbladder usually due to stone in cystic duct
Common presentation for cholelithiasis/cholecystitis
Some asymptomatic;
RUQ pain, worst after eating greasy foods
Choledocholithiasis
Gall stone stuck in the common bile duct so neither liver or gallbladder can drain
Ascending cholangitis
Inflammation of biliary tree (in liver)
Gallstone pancreatitis
Stone stuck in pancreatic duct = increased pancreas enzymes
Dysfunctional gallbladder
NO stone, just does not empty too well
Pancreatitis symptoms
Severe epigastric pain, nausea, vomiting, increased pancreatic enzymes in blood
Appendicitis
RLQ pain!!! Starts visceral then localizes
Diverticulitis
LLQ pain!!!
- Erosion/perforation of colon wall
What does achalasia look like on a barium study?
Birds beak - enlarged esophagus but narrowed LES due to its inability to relax
What is a secondary cause of achalasia?
Chagas disease - parasite in mexico, south america
Parasymp. from esophagus to transverse colon
Vagus N.
Parasymp. from descending colon to rectum
Pelvic splanchnic N. (S2-S4)
Symp. innervation of esophagus
T2-T8
Symp. innervation of stomach
T5-T9
Symp. innervation of liver and gallbladder
T6-T9
Symp. innervation of small intestines
T5-T12
Symp. innervation of large intestines (colon)
T9-L1
Symp. innervation of pancreas
T5-T11