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GI Diseases Flashcards

1
Q

What are the risk factors of an AAA?

A

Congenital/connective tissue disorders
Smoking
Increased age

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2
Q

How does an AAA present?

A

Usually asymptomatic

May have back pain/pulsatile mass if ruptured

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3
Q

Treatment of an AAA

A

Immediate surgery if rupture/risk of rupture

If asymptomatic - observation

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4
Q

What is achalasia

A

Lower oesophageal sphincter fails to relax, resulting in distal oesophageal obstruction as food cannot pass into the stomach

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5
Q

Symptoms of achalasia

A 
Progressive dysphagia
Weight loss
Chest pain
Regurgitation
Chest infection
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6
Q

GI investigations

A 
UPPER GI ENDOSCOPY
Colonoscopy
Biopsy
Abdominal ultrasound
Imaging techniques
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7
Q

What is the effect of alpha blockers?

A

Dilation of the blood vessels

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8
Q

What is the effect of beta blockers?

A

Decreases activitiy of the heart by blocking adrenaline etc

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9
Q

What are the causes of acute pancreatitis?

A 
Alcohol abuse
Gallstones
Steroids
Trauma
Viruses
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10
Q

What is the presentation of acute pancreatitis?

A 
Oedema
Fat necrosis
Abdominal pain
Haemorrhage
Nausea
Vomiting
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11
Q

Acute pancreatitis investigations

A 
Amylase
Lipase
FBC
LFT
CT
Ultrasound
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12
Q

Stages of alcoholic liver disease

A

Fatty liver
Alcoholic hepatitis
Cirrhosis

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13
Q

What is alcoholic hepatitis?

A

Inflammation of the liver due to chronic alcoholism

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14
Q

Symptoms of alcoholic hepatitis

A 
Jaundice
Encephalopathy
Infection
Decompensated hepatic function
Raised prothrombin time (as clotting factors not produced by the liver)
Low albumin
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15
Q

How are GI bleeds prevented?

A

PPIs
Reduce NSAIDs
H pylori eradication

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16
Q

What is steatohepatitis?

A

Fatty liver disease + inflammation

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17
Q

Presentation of steatohepatitis

A 
Asymptomatic
Biliary colic
Acute cholecystitis
Empyema
Jaundice
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18
Q

What is the effect of liver disease on alanine amino transferase?

A

Increased

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19
Q

What happens as a result of high levels of bilirubin?

A

Jaundice

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20
Q

Treatment of steatohepatitis

A

Avoidance of alcohol
Weight loss
Exercise

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21
Q

What is cirrhosis?

A

Fibrosis of the liver

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22
Q

Causes of cirrhosis

A 
Alcohol
Autoimmune
Hepatitis B/C
CF
Haemochromatosis
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23
Q

What is the presentation of cirrhosis? (8)

A 
Jaundice
Ascites
Variceal bleeding
Abdominal distension
Malaena
Itching
Leukonychia
Peripheral oedema
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24
Q

Causes of malaena

A 
Cirrhosis
Peptic ulcers
Ulcerative colitis
Crohn's
Any GI bleed
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25
Appendicitis
Acute inflammation of the appendix
26
What is ascending cholangitis?
Inflammation of the bile duct
27
Symptoms of cholangitis
Charcot's triad
28
What is charcot's triad?
Jaundice Fever RUQ pain
29
What is ascites?
Accumulation of protein containing (ascitic) fluid within the abdomen
30
What are varices?
Dilated blood vessels in the oesophagus or stomach caused by portal hypertension
31
Causes of ascites
Portal hypertension | Cirrhosis
32
What does shifting dullness indicate?
Ascites
33
Treatment of ascites
Diuretics Liver transplantation Large volume paracentesis
34
What is Barrett's oesophagus?
Pre-malignant condition caused by oesophageal reflux
35
What is the name of a cancer of the bile duct epithelium?
Cholangiocarcinoma
36
What is cholecystitis?
Infection of the gallbladder
37
What is cholelithiasis?
Presence of gallstones in the gallbladder
38
Causes of cholelithiasis
Obesity
39
What is chronic pancreatitis?
Continuous inflammation of the pancreas | Glandular destruction is irreversible
40
Symptoms of chronic pancreatitis
``` Abdominal pain Weight loss Steatorrhoea Diabetes Jaundice ```
41
Causes of colorectal cancer
Polyps | Genetics
42
Symptoms of colorectal cancer
``` Rectal bleeding Altered bowel habits Iron deficiency anaemia Palpable right lower abdominal mass Weight loss ```
43
What is Crohn's disease?
Patchy inflammation from anus to mouth
44
Presentation of Crohn's
``` Diarrhoea Abdominal pain Weight loss Malaise Lethargy Malabsorption ```
45
What substance is released into the intestines when there is inflammation?
Faecal calprotectin
46
Treatment of Crohn's
Methotrexate Metronidazol 5ASAs Infliximab
47
What is diverticular disease?
Small pouches called diverticula develop in the lining of the bowel and push out through the bowel wall
48
Risk factors of diverticular disease
Genetics Smoking Low fibre diet Obesity
49
Presentation of diverticular disease
Asymptomatic Constipation Fever Left lower quadrant pain
50
Treatment of diverticular disease
Modify diet Fibre supplement Antibiotics
51
What is diverticulitis?
Inflammation of diverticulum
52
Presentation of diverticulitis
Left sided abdominal pain Fever Diarrhoea
53
What is the treatment for diverticulitis?
Analgesia Antibiotic therapy Low residue diet Surgery
54
What is dyspepsia?
Indigestion
55
What are gallstones?
Calcification of cholesterol and pigment
56
What are the symptoms of gastric cancer?
``` Dyspepsia Early satiety Nausea and vomiting Weight loss GI bleeding Iron deficiency anaemia Gastric outlet obstruction ```
57
What is gastritis?
Inflammation of the gastric mucosa
58
Causes of gastritis
H pylori NSAIDs Alcohol Stress
59
What is a GI haemorrhage?
Bleeding in the GI tract
60
Causes of GI haemorrhage
``` Mallory Weiss tear Oesophageal varices Oesophageal cancer Gastritis GORD Peptic ulcer IBD Diverticulitis ```
61
Presentation of GI bleeds
``` Haematemesis Malaena Rectal bleeding Abdominal pain SOB Fatigue ```
62
What is giardiasis?
Infection caused by giardia lamblia
63
Presentation of giardiasis
``` Diarroea Frequent belching Abdominal bloating Malaise Weight loss ```
64
What is metronidazole used for?
Antibiotic and antiprotazoal medication
65
What is GORD?
Gastro-oesophageal reflux disease | Pathological acid and bile exposure in lower oesophageal sphincter
66
Presentation of GORD
Heartburn Cough Water brash Sleep disturbance
67
Treatment of GORD
Alginates H2RA PPI Anti-reflux surgery
68
What are haemorrhoids?
Enlargement of vascular rich connective tissue
69
Causes of haemorrhoids
Increased pressure of blood vessels around anus eg prolonged constipation
70
What is hepatic encephalopathy?
Confusion due to liver disease
71
Causes of hepatic encephalopathy
GI bleed Infection Constipation
72
Presentation of hepatic encephalopathy
Flapping tremor Confusion Foetor hepaticus
73
Treatment of hepatic encephalopathy
Laxatives Neomycin Rifaximin
74
What are neomycin and rifaximin?
Antibiotics
75
Which types of viral hepatitis are caused by exposure to infected blood?
A, C
76
Which types of viral hepatitis are caused by sexual or faecal-oral transmission?
A
77
Which types of viral hepatitis are caused by percutaneous and permucosal routes and sexual transmission?
B
78
Which type of viral hepatitis normally coinfects with HBV?
D
79
``` Asymptomatic Abrupt onset fever Abdominal pain Malaise Dark urine Headache Fatigue Nausea Jaundice ```
Presentation of hepatitis A
80
Jaundice Hepatomegaly Ascites
Presentation of hepatitis B
81
Jaundice Asymptomatic until cirrhotic Ascites
Presentation of hepatitis C
82
What is the commonest form of liver cancer?
Hepatocellular carcinoma
83
Causes of hepatocellular carcinoma
Cirrhosis | Hep B/C
84
Presentation of hepatocellular carcinoma
``` Decompensated cirrhosis Abdominal mass Abdominal pain Weight loss Bleeding from tumour ```
85
What is a Mallory Weiss tear?
A tear in the mucous membrane where the oesophagus meets the stomach
86
What is decompensated cirrhosis?
Development of jaundice, ascites, variceal haemorrhage or hepatic encephalopathy
87
What type of cancer feature in the distal oesophagus?
Adenocarcinoma
88
What type of cancer feature in the proximal and middle 1/3 of the oesophagus?
Squamous cell carcinoma
89
Causes of oesophageal cancer
Barrett's oesophagus Smoking Genetics
90
Presentation of oesophageal cancer
``` Progressive dysphagia Weight loss Odynophagia Chest pain Coughing Vocal cord paralysis Haematemesis ```
91
What is odynophagia?
Painful swallowing
92
Oesophageal cancer metastases
Liver Brain Lungs Bone
93
Oesophageal cancer treatment
Oesophagectomy | Adjuvant/neoadjuvant chemotherapy
94
What are the types of pancreatic carcinoma?
Duct cell Mucinous Adenocarcinoma
95
Symptoms of pancreatic carcinoma
``` Upper abdominal pain Jaundice Weight loss Anorexia Fatigue Diarrhoea Steattorrhoea Nausea and vomiting Ascites Portal hypertension Hepatomegaly Abdominal tenderness Mass on palpation Palpable gallbladder Lymphadenopathy ```
96
Causes of portal hypertension
Cirrhosis | Blood clots in the portal vein
97
Causes of splenomegaly
Portal hypertension | Cancer cell infiltration from haemotological malignancy
98
Which organs are involved in the portal venous system?
Veins coming from the stomach, intestine, spleen, and pancreas merge into the portal vein
99
Portal hypertension presentation
GI bleeding Ascites Encephalopathy
100
What is a hiatus hernia?
Fundus of the stomach moves through the diaphragmatic hiatus
101
Risk factors for a hiatus hernia
Obesity | Ageing
102
Presentation of hiatus hernia
``` Bowel sounds in chest Heartburn Regurgitation Obesity Chest pain ```
103
What is the treatment of a hiatus hernia
Surgery
104
What is IBS?
Irritable bowel syndrome | Functional bowel disorder characterised by frequent abdominal pain
105
What are the symptoms of IBS?
Abdominal pain Altered bowel habits Abdominal bloating Mucus
106
IBS treatment
Probiotics Laxatives Amitriptyline (for anxiety)
107
What is NAFLD?
Non-alcoholic fatty liver disease
108
Causes of NAFLD
Obesity DM Hypertension Genetics
109
What are peptic ulcers?
Open sores in the lining of the stomach
110
Causes of peptic ulcers
H pylori NSAIDs Smoking
111
Presentation of peptic ulcers
``` Epigastric pain Nocturnal pain Back pain Nausea Weight loss Anrexia Haematemesis Melaena ```
112
What are polyps?
Benign or malignant protuberant growths of epithelium or mesenchyme
113
What is primary sclerosing cholangitis?
Inflammation and scarring of the bile ducts
114
Cause of primary sclerosing cholangitis
Autoimmune
115
Presentation of primary sclerosing cholangitis
``` Aymptomatic Jaundice Itching Hepatosplenomegaly Steatorrhoea Malabsorption Dark urine M>F ```
116
Treatment of primary sclerosing cholangitis
Immunosuppressants Vitamin D Calcium Liver transplantation (for end stage liver disease)
117
Complications of primary sclerosing cholangitis
``` Dominant biliary stricture end stage liver disease Cirrhosis Ascites Varices ```
118
What is spontaneous bacterial peritonitis?
Acute bacterial infection of the ascitic fluid
119
What is ulcerative colitis?
Continuous inflammation of the colon
120
Presentation of ulcerative colitis
``` Bloody diarrhoea Abdominal pain Weight loss Tachycardia Fever Low albumin Anaemia ```
121
Treatment of ulcerative colitis
``` 5ASAs Steroids Immunosuppression Anticoagulation Surgery ```
122
Complications of ulcerative colitis
Colonic carcinoma
123
Tropheryma whipplei
Whipple's disease | Multisystemic disease
124
Presentation of Whipple's disease
``` Diarrhoea Arthralgia Weight loss Abdominal pain Fever Steatorrhoea Skin darkening ```
125
What is arthralgia?
Pain in a joint

Year 2 Systems (9 decks)

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