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causes of signs > GI Signs > Flashcards

GI Signs Flashcards

1
Q

Mouth

A

Angular stomatitis- thiamine, B12, Fe deficiency
Ulcers- crohns
Glossitis- Fe, B12, folate deficiency
Dentition
Telangiectasia
Kayser fleicher rings green corneal margin wilsons disease.

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2
Q

Virchows node

A

Upper GI malignancy

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3
Q

Abdo inspection

A

Distension- ascites, ALD, nephrotic syndrome, ovarian CA, HF, TB, pancreatitis.
Scars
Pulsation
Striae
Spider naevi- ALD, pregnancy.
Skin changes
Gynaecomastia- ALD, heroin.
Grey turners sign flank bruising- retroperitoneal bleed eg pancreatitis.
Cullen’s blue around umbillicus- acute pancreatitis

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4
Q

Palpation

A

Rebound tenderness and guarding involuntary muscle contraction- peritoneal inflammation.
Mcburneys point and rovsings sign (palpation LLQ increases RLQ pain)- appendicitis.
Murpheys cholecytsitis.

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5
Q

Hepatomegaly causes

A

Malignancy
Hepatic congestion eg RHF
Anatomical
Infection eg hep, malaria, schistosomiasis, EBV.
Haematological eg leukaemia, lymphoma, SCD, haemolytic anaemia.
Other- fatty liver, amyloidosis.

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6
Q

Splneomegaly causes

A

CML
Myelofibrosis
Malaria
Amyloidosis

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7
Q

Pyelonephritis signs

A 
Tachycardia and tachpnoea
Loin to groin pain
Haematuria
Proteinuria
Hypotension
Palpable kidney
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8
Q

Steroid ADRs

A 
OP
Diabetes
Gastric ulcer
Reduced immunity
Weight gain
Thin skin
Muscle wasting
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9
Q

GU vs DU

A

DU more common
DU pain relief by eat or drink milk. Worse 2-5 hr after eat.
GU pain associated with eating. Nausea and vomiting. Weight loss.
NSAID and Hp associated.
Hp triple therapy PPI, amoxicillin, clarithromycin.

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10
Q

DM drug ADRs

A

Metformin CI in renal failure, causes diarrhoea. Lactic anodises.
Sulphonylureas weight gain, hypoglycaemia.

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11
Q

Pre hepatic jaundice

Haemolysis

A
  • lab- uncojugated hyperbilirubinaemia, reticulocytosis, anaemia, high LDH, low haptoglobin (binds free Hb released by breakdown).
  • causes-
    Inherited- RBC membrane defects, Hb abnormality, metabolic defects.
    Congenital- Gilbert’s syndrome low gluconyl transferase.
    Acquired- immune, mechanical, membrane defects, infection, drugs, burns.
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12
Q

Hepatoccellular jaundice

Cells cant conjugate or eliminate

A
  • lab- Mixed bilirubinaemia, high AST and ALT, maybe high ALP, abnormal clotting.
  • causes-
    Congenital- Gilbert’s.
    Inflammation- virus, autoimmune hepatitis, alcohol, haemochromatosis, wilsons.
    Drugs- paracetamol.
    Cirrhosis- alcohol, chronic hepatitis, metabolic disorder.
    Tumour- HCC, mets.
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13
Q

Post hepatic

Cholestatic- intra or extra hepatic obstruction.

A
  • lab- conjugated hyperbilirubinaemia, dark urine as bilirubin in it, no urobilinogen in urine, high ALP, maybe high AST and ALT.
  • causes-
    Intra- hepatitis, drugs, cirrhosis, primary biliary cirrhosis.
    Extra- gallstone, stricture, pancreatitis, sclerosing cholangitis, CA (pancreas head, ampulla, BD, porta hepatic LNs, mets).
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14
Q

Hepatitis

A

Acute= jaundice, high ALT and AST.
Chronic= low albumin and CFs
Causes- viral, AI, drugs eg isoniazid, hereditary eg a1 antiT deficiency, wilsons.

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15
Q

Cirrhosis

A
  • causes- alcohol, virus, biliary cirrhosis, AI hepatitis, haemochromatosis, wilsons.
  • signs- jaundice, anaemia, bruising, palmar erythema, dupuytrens, flapping tremor. Portal HTN. Spontaneous becaterial peritonitis.
  • tests- high ALT and AST, high ALP, high bilirubin, low albumin, poor clotting, low Na.
  • tx- stop drinking, treat complications, transplant.
  • Specific causes-
    Primary biliary cirrhosis- chronic BD destruction.
    Haemochromatosis- recessive. Iron deposition. Cardiomyopathy, DM, hypogonadism, hepatitis, hyperpigmentation.
    Wilsons- recessive. Copper deposition. Affects basal ganglia= PD symptoms. Tubular degeneration.
    A1 antiT deficiency- recessive. Cirrhosis and empyema.
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16
Q

Portal HTN

A
  • causes- portal vein obstruction. Internal liver flow obstruction eg cirrhosis, sclerosis, schistosomiasis, sarcoidosis.
  • signs- splenomegaly, ascites, spider naevi, caput, oesophageal and rectal varices.
17
Q

Hepatic encephalopathy

Failure of liver to remove NH3

A
  • precipitants- infection, constipation, diuretics, GI bleed, alcohol withdrawal.
  • signs- flapping tremor, LOC, personality change, intellectual impairment.
18
Q

Hepatic tumours

A
  • benign eg haemangioma, liver cell adenoma, liver cyst.
  • primary malignant- HCC
  • secondary- COLORECTAL, neuroendocrine, pancreas, breast, stomach, lung, ovary, kidney.
19
Q

Pancreatitis

A
  • Acute- oedema, haemorrhage, necrosis
    Causes- GET SMASHED- gallstone, ethanol, trauma, steroids, mumps, AI, scorpion, hyperlipidaemia, ERCP, drugs.
    Pathogenesis- duct obstruction and reflux, damage acini, protease, lipase and elastase relaease.
    Signs- severe pain, vomiting, dehydration, shock, ecchymosis, ilieus.
  • Chronic- fibrosis, calcification.
    Causes- alcohol, CF, biliary disease.
    Pathogenesis- presence also destruction, fibrosis, loss acini, duct stenosis.
    Signs- pain, malabsorption, DM, jaundice.
20
Q

Pancreatitis carcinoma

A

90% ductal adenocarcinoma.
Causes- smoking, familial pancreattis, drugs.
Signs- initially none, obstructive jaundice, pain, vomiting, malabsorption, DM.

21
Q

Gilbert’s syndrome

A

Causes unconugated hyperbilirubinoaemia
Decrease UGT1 activity (conjugates bilirubin with glucuronic acid)
Diagnosis- slightly high bilirubin, normal FBC and reticulocytes.

22
Q

Korsakoff syndrome

A

Hypothalamic damage and cerebral atrophy due to vitB1 deficiency eg alcoholics. May accompany wernickes encephalopathy.
Cant make new memories, confabulation, lack insight, apathy.

23
Q

Wernickes encephalopathy

A

VitB1 deficiency (alcoholics) with classic triad- confusion, ataxia, opthalmoplegia.
Focal areas brains damage.
Untreated can progress to korsakoff.

24
Q

Zollinger ellison

A

Gastrin secreting adenoma associated wth peptic ulcers.

Adenoma usually in pancreas, can be stomach or duodenum.

25
Q

Abdo distension

A

Famous five- fat, fluid, faeces, flatus, fetus.
Flatus resonant on percussion, fluid dull (ascites, distended bladder, AAA).
Masses- pelvic eg fibroids, tumour colon/stomach/kidney/pancreas/liver.

26
Q

Steatorrhoea

A

Ileal disease eg crohns
Pancreatic disease
Obstructive jaundice

27
Q

Bowel sounds

A

Listen just below umbilicus.
Absent implies ileus
Enhanced and tinkling in bowel obstruction.

causes of signs (13 decks)

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