GI Session 11 Flashcards
Why is gallstone colicky pain a misnomer?
There is a fairly constant level of pain which gets worse
Is large bowel colic true colic?
No, has baseline level of pain which then fluctuates
How does colic pain in the small and large bowel compare?
Small = 2-3 mins Large = 10-15 mins
What is anorexia?
Loss of appetite
What can cause anorexia?
Subjectively unpleasant food or surroundings Anxiety Anger/fear Physical disorder Psychological disorder
What should be considered if a pt presents with weight loss?
Intentional?
Unintentional –> sufficient intake? –> yes-fast metabolism or malabsorption?
What is nausea?
Subjective sensation of the need to vomit
What stimulates vomiting?
Labyrinths in ears —> ACh on vomiting centre in medulla
Emetic drugs/dopamine/5-HT on chemoceptor trigger zone
Distension/irritation in chemo- and baroreceptors
Peripheral pain receptors –> histamine on vomiting centre in medulla
Where is the CTZ which is activated in vomiting located?
Base of fourth ventricle outside BBB so it can detect blood contents
What can cause constipation?
Diet Medication (opioids, tricyclics in chronic back pain) Neurological disease Colorectal stricture Dehydration Immobility (decreased transit time so more water reabsorption) Diabetes Functional esp in children
What can diarrhoea be classified as?
Change in frequency or consistency of both
What are the different types of diarrhoea?
Secretory e.g. Cholera Osmotic e.g. Lactose intolerance Abnormal intestinal motility e.g. IBS Exudative e.g. Colitis Malabsorption e.g. Pancreatic enzyme deficiency
What is Odynophagia?
Painful swallow
What are the two broad categories of dysphasia and what do they indicate?
Difficulty with liquids –> difficulty initiating swallow due to neurological causes
Food sticking –> anatomical problem with oesophagus or cardia of stomach
What can cause bleeding from the top of the GI tract?
Acute/chronic peptic ulcer Malory Weiss tear Oesophageal/gastric Varices Erosive oesophagitis Erosive gastric/oesophageal cancer
What causes malaena?
Chronic upper GI bleed –> bacteria break down haem –> black tarry stool
How is malaena differentiated from black tarry stool due to food consumption?
Malaena is foul smelling
Does the R or L colon bleed more commonly?
R
What can cause bleeding at the bottom of the GI tract?
Angiodysplasia Diverticular disease Colonic carcinoma Haemorrhoids/anal fissure IBD esp UC as superficial Massive upper GI bleed
How does bleeding from the bottom of the GI tract present?
Haematochezia - bright red blood from anus
What is Mallory-Weiss tear?
Repeated vomiting –> tear in mucosa where oesophagus and stomach meet. Bleeding usually self limits
What is angiodysplasia?
Multiple lesions of small vascular malformations in the gut
What are the 5 Fs in abdominal distension?
Fat Fluid Faeces Flatus Foetus
What causes flatus?
Aerophagia (swallowing air)
Gas production in gut, especially if digestion is incomplete
