GI diseases simple

Question 1

what is a squamous cell carcinoma

Answer 1

tumor of squamous epithelium

Question 2

what is an adenocarcinoma

Answer 2

tumour of the glands

Question 3

peptic ulcer disease

Answer 3

Peptic ulceration is a breach in the gastrointestinal mucosa as a result of acid and pepsin attack -

refers to an ulcer found in lower oesophagus, stomach and duodenum

often causes by H.Pylori infection

Question 4

gastric ulcer buzzword

Answer 4

• Epigastric pain worse after eating
• Pain eased by lying flat

Question 5

duodenal ulcer buzzword

Answer 5

• Epigastric pain relieved by eating
• Pain worse when lying flat

Question 6

what causes oesophageal varices

Answer 6

secondary to portal hypertension in liver cirrhosis

Question 7

malabsorption

Answer 7

Defective mucosal absorption, caused by defective luminal digestion, mucosal disease or structural disorders

Question 8

what type of cancer is oral cancer

Answer 8

squamous cell carcinoma - 90%

caused by
- smoking is the main avoidable risk factor - linked to 65% of cases in the UK
- Alcohol (metabolised to acetaldehyde)
- Diet (low in Vit A, C and iron)

Question 9

intestinal failure

Answer 9

An inability to maintain adequate nutrition or fluid status via intestines below the minimum necessary for absorption of macronutrients and/or water and electrolytes such thatIV supplementation is requried to maintain health and growth.

Question 10

malnutrition

Answer 10

A state of nutrition in which a deficiency, excess or imbalance of energy, protein and other nutrients causes measurable adverse effects on tissue, body form, function and clinical outcome

Question 11

gastroenteritis

Answer 11

Broad term, but is usually used to refer to an infective illness which causes diarrhoea, vomiting and often abdominal pain

Question 12

Crohn’s disease

Answer 12

(IBD) Chronic inflammatory and ulcerating condition of the GI tract that can affect anywhere from mouth to anus, most commonly the terminal ileum and colon

Question 13

Crohn’s buzzwords

Answer 13

Ileal and/or colonic chronic active mucosal inflammation including cryptitis and crypt abscesses

erythema nodusum (chrons presentation)

‘Cobble-stoning’

Transmural inflammation (all the way through cell)

Question 14

UC

Answer 14

(IBD) Chronic inflammatory disorder confined to colon and rectum

Question 15

UC buzzwords

Answer 15

Pseudo polyps
- Absence of goblet cells
- Crypt distortion and abscess
- Mucosal layer only affected

Question 16

IBS

Answer 16

Refers to a group of symptoms, including abdominal pain and discomfort, bloating, and change in bowel habit, for which no underlying cause or pathology can be identified

• visceral hypersensitivity

Question 17

acute appendicitis

Answer 17

Acute inflammation of the appendix, most common acute abdomen pain

-Typically caused by direct luminal obstruction, usually secondary to a faecolith

Question 18

acute diverticulitis

Answer 18

Evidence of diverticular inflammation (fever, tachycardia) with or without localised symptoms and signs

-Inflammation is caused by micro-perforation of a diverticulum

Question 19

alcoholic liver disease hepatitis

Answer 19

Results from the effects of the long term excessive consumption of alcohol on the liver

1. alcoholic related fatty liver (steatosis)
2. alcoholic hepatitis
3. cirrhosis

Question 20

gallstones

Answer 20

Refers to the formation of hard stones in the gallbladder

‘Fair, fat, fertile, female and forty’

80% of gallstones are mixed - pigment and cholesterol

Question 21

acute cholecystitis

Answer 21

Inflammation of the gallbladder most commonly caused by obstruction of the cystic duct by a gallstone

Tenderness in RUQ +/- MURPHYS SIGN

(place hand firmly at costal margin in RUQ, sign is positive if patient has pain on inspiration)

Question 22

acute pancreatitis

Answer 22

Acute inflammation of the pancreas most commonly caused by gallstones and alcohol excess

• Cullen’s sign - periumbilical bruising
• Grey Turner’s sign - flank bruising

Question 23

pancreatitis acronym

Answer 23

‘I GET SMASHED’

• Idiopathic
• Gallstones - up to 65% of cases
• Ethanol
• Trauma
• Steriods
• Mumps - and other infections e.g. coxsackie B, viral hepatitis
• Autoimmune - IgG4 related disease, polyarteritis nodosa
• Scorpion bite
• Hypercalcaemia; Hyperparathyroidism, Hyperlipidaemia
• ERCP (iatrogenic)
• Drugs e.g. azathioprine

Question 24

Cholangiocarcinoma

Answer 24

Cancer of the bile ducts - Adenocarcinoma

PSC is a risk factor

Painless jaundice = cancer

Question 25

hepatitis A

Answer 25

• Faecal-oral spread
• Linked to poor hygiene/overcrowding
• Some cases imported and some clusters e.g. gay men and PWID but importance has declined in UK

acute infection
travel vaccine available

Question 26

Hepatitis E

Answer 26

leading cause of acute hep
- Faecal-oral transmission in the tropics - contaminated water
- Cases acquired in UK are thought to be zoonoses

Question 27

hepatitis D

Answer 27

Only found with Hepatitis B - exacerbates Hep B infection

Question 28

Hepatitis B

Answer 28

common

• Sex
• Mother to child
• Blood to blood (unscreened transfusions, tattoos)

chronic

Question 29

Hepatitis C

Answer 29

Chronic infection (HCV RNA >6 months)

• No vaccine - minimize exposure
• Strongly associated with hepatocellular carcinoma

Question 30

Liver failure = triad of

Answer 30

encephalopathy, jaundice and coagulopathy