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DEN303 - GI > GI Symposium > Flashcards

GI Symposium Flashcards

1
Q

What history would you take from someone with GI symptoms?

A

Duration, solids of liquids, pain (better one eating or not)§, weight loss, dysphagia

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2
Q

What categories does dysphagia fall into?

A
  1. Oropharyngeal
  2. Oesophageal
  3. Gastric
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3
Q

What problem would you expect with oropharyngeal dysphagia?

A

Salivary gland dysfunction - sjogrens
Tongue - amyloid, hypothyroidism
Palatal/ epiglottal and upper oesophageal - MND, parkinsons

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4
Q

What problem would cause oesophageal dysphagia?

A

Benign mucosal disease - peptic stricture
Malignant mucosal disease
Motility disorders

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5
Q

What is a pharyngeal pouch?

A

Defect between constrictor muscles and transverse cricopharyngeus muscles - cause out pouching of mucosa where food can become stuck if becomes large can cause regurgitation
Seen w/ endoscopy or barium swallow

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6
Q

How would you manage dysphagia?

A

Tx underlying cause
Benign: acid reflux suppression and balloon dilation
Malignancy: surgery +- chemo or radio

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7
Q

What symptoms may you see in upper abdominal discomfort?

A

Heartburn, abdominal bloating, chest pain

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8
Q

Give 2 examples of causes of upper abdominal discomfort?

A
  1. GORD

2. Hiatus hernia

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9
Q

What is GORD - why it happens and symptoms?

A
  1. Gastro-oesophageal reflux disease
    Excessive relaxation of lower oesophageal sprinter and raised intra-abdominal pressure

Symptoms : heartburn, epigastric pain, acid reflux, nausea, tooth decay, asthma

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10
Q

Management of GORD

A
  1. Lifestyle - weight loss, smoking cessation, reduce alcohol
  2. PPI - irreversibly block H+/K+ ATPase
  3. H2 antagonist - reduce acid by inhibiting cells produce acid
  4. Fundoplication
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11
Q

What is a hiatus hernia?

A

When stomach moves up towards chest due to problems w/ diaphragm
Manage: surgery

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12
Q

What is oesophageal manometry?

A

Investigation - probe sits at back of gullet and measures pH and pressure (test abnormal amounts of acid)

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13
Q

What hx would you expect of someone with peptic ulceration?

A

Epigastric pain - can radiate to back and worsened by food (improved by eating duodenal)
Weight loss
Vomiting/ haematemesis

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14
Q

Cause peptic ulceration?

A

NSAIDs and helicobacter pylori

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15
Q

Appearance would you expect w/ peptic ulcer?

A

Clean ulcer, visible vessel and adherent clot

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16
Q

Tx peptic ulcer

A
  1. Medication to reduce acid - PPI
  2. Clips
  3. Injection adrenaline
  4. Surgery - if perforation
17
Q

Name some diff types of cancer w/ gastric associations?

A
  1. Gastric carcinoma - epigastric pain, weight loss and vomit
  2. Pancreatic carcinoma - pain that radiated to back, weight loss and poss jaundice
18
Q

Differentiate visceral and periotoneal pain?

A

Visceral pain - inflammation inside organ fewer never endings - dull pain

Peritoneal pain - outside organ - lots of nerves - sharp pain

19
Q

Difference between acute and chronic abdominal pain?

A

Acute: sweating, guarded, increased HR
Chronic: longer than 6 weeks

20
Q

Name some causes of emesis?

A 
Systemic illness - viral/ bacterial
Drugs/ alcohol
Centrally mediated - middle ear disease
Psychiatric disorder - bulimia 
Gastric disease
21
Q

Management of vomiting?

A

Identify underlying cause
Antiemetic/ PPI
CBT - if central

22
Q

Give some examples of small bowel disease?

A

Lactase deficient, coeliac disease, crohn’s disease

23
Q

Give some examples of colonic disease?

A

Ulcerative colitis, Crohn’s disease, carcinoma

24
Q

Difference between small bowel and colonic disease?

A

S.B - pale, floating and diff to flush/ throughout day/ pain - variable timing/ pain not relieved by defaecation

Colonic - blood and mucus/ often morning/ pain related to but relieved by defeacation

25
Q

What is coeliac disease (inc histology and presentation)?

A

Small bowel disease - gluten sensitivity - immunological response to gliadin

Histology: increased lymphocytes, atrophic villi

Presentation: malabsorption symptoms, dermatitis herpetifromis (immunological response to gluten presented in the skin)

26
Q

What is Crohn’s disease?

A

Affect any part GI tract - mouth to rectus
Discontinuous ulceration - cobble stone appearance
Affect all lining of GI tract

Symptoms: pain, fever, diarrhoea, vomiting, weight loss

27
Q

What is ulcerative colitis?

A

Affect rectum and colon
Continuous ulceration
Affect just mucosa

Symptoms: diarrhoea, rectal bleeding, pain

28
Q

What is associated with UC?

A 
Skin - erythema nodosum
Mouth - ulceration 
Joints - arthritis
Eyes - uveitis
Liver - cirrhosis
29
Q

Symptoms, investigation and management of colon cancer?

A

Symptoms: can be none, rectal bleeding, altered bowel habits
Investigation: barium enema, colonoscopy
Manage: evaluate extend of disease - if limited - surgical resection

30
Q

What associated features would you see with chronic liver disease?

A

Clubbing, palmar erythema, spider navei

DEN303 - GI (2 decks)

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