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1st/2nd Year Revision > GI Tract Conditions > Flashcards

GI Tract Conditions Flashcards

1
Q

What is the pathology of achalasia?

A

Lack of oesophageal peristalsis

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2
Q

What are the symptoms of achalasia?

A

Dysphagia
Nausea/vomiting
Weight loss

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3
Q

What investigations would be done if achalasia was suspected?

A

Barium swallow

Endoscopy

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4
Q

How is achalasia treated?

A

Endoscopic balloon dilatation

Surgery

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5
Q

What is the pathology of GORD?

A

Decreased LOS tone

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6
Q

What are the secondary causes of GORD?

A 
Smoking
Pregnancy
Drugs
Alcohol
Obesity
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7
Q

What are the symptoms of GORD?

A

Dyspepsia
Heartburn
Acid regurgitation
Epigastric pain

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8
Q

How is GORD investigated?

A

Endoscopy if dysphagia/ALARM symptoms

24hrs oesophageal pH monitoring

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9
Q

How is GORD treated?

A 
Weight loss
Avoid smoking and alcohol
Antacids
PPI - omeprazole
Surgery - nissan's fundoplication
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10
Q

What is barrett’s oesophagus?

A

When the normal lower squamous epithelium of the oesophagus becomes columnar
Pre-malignant

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11
Q

What causes barrett’s oesophagus

A

Chronic GORD

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12
Q

How is barrett’s oesophagus investigated?

A

Endoscopy and biopsy

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13
Q

How is barrett’s oesophagus treated?

A

Endoscopic ablation

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14
Q

What are the complications of barrett’s oesophagus?

A

Oesophageal adenocarcinoma

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15
Q

What are the risk factors for oesophageal cancer?

A 
Obesity
Smoking
Barrett's oesophagus
GORD
Excessive alcohol
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16
Q

What is the pathology of oesophageal cancer?

A

Middle 1/3 - squamous

Lower 1/3 - adenocarcinoma

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17
Q

What are the symptoms of oesophageal cancer?

A

Progressive dysphagia

Weight loss

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18
Q

How is oesophageal cancer investigated?

A

Endoscopy and biopsy
Barium swallow
CT

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19
Q

How is oesophageal cancer treated?

A

Oesophagectomy

If non-op - chemo, radiotherapy, palliative

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20
Q

What are the causes of peptic ulcers?

A

Helicobacter pylori - 85%
NSAIDs
Smoking
Alcohol

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21
Q

What are the symptoms of peptic ulcers?

A

Epigastric pain
Heartburn
Nausea/vomiting
If the pain gets better after a meal - duodenal ulcer

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22
Q

How are peptic ulcers investigated?

A

<55 and no alarm symptoms - urea breath test

>55/alarm - endoscopy

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23
Q

How are gastric ulcers treated?

A

H.pylori - triple eradication (PPI, amoxicillin, clarithromycin)
PPI
Avoid worsening factors
Gastric ulcers need repeat endoscopy to ensure healing

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24
Q

What are complications of gastric ulcers?

A

Gi bleed

Perforation

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25
Q

What is the pathology of coeliac disease?

A

Gluten sensitivity
T cells respond to gluten
Results in villous atrophy and malabsorption

26
Q

What are the symptoms of coeliac disease?

A 
Diarrhoea
Abdominal pain
Bloating
Lethargy
Anaemia
27
Q

What investigations would be done if coeliac disease was suspected?

A

FBC - anaemia
Coeliac serology - anti-tissue transglutaminase, anti-endomysial antibodies, IgA
Endoscopy
Intestinal biopsy

28
Q

How is coeliac disease treated?

A

Gluten free diet

29
Q

What are the associations with coeliac disease?

A

Other autoimmune diseases - type 1 DM, thyroid disease

30
Q

What are the causes of malabsorption?

A 
Coeliac
Chronic pancreatitis
Crohn's disease
Bacterial overgrowth
Lactose intolerance
31
Q

What are the symptoms of malabsorption?

A 
Diarrhoea
Steatorrhoea
Weight loss
Bloating
Anaemia
32
Q

What investigations would be done if malabsorption was suspected?

A 
FBC, U&amp;Es, LFT, albumin, Ca, folate, B12, vit D
Coagulation
Coeliac serology
Stool microscopy
H breath test
Endoscopy
Small bowel biopsy
33
Q

How is malabsorption treated?

A

Aimed at cause

34
Q

What is the pathology of irritable bowel syndrome?

A

No pathological cause

Functional disorder

35
Q

What are the causes of IBS?

A

Stress
Post-infective
Anxiety
Adverse life events

36
Q

What are the symptoms of IBS?

A

Abdominal discomfort
Relief with defaecation
Alternating bowel habit
Bloating

37
Q

What investigations would be done if IBS was suspected?

A

Routine bloods
Coeliac serology
Sometimes sigmoidoscopy if >45 and persistent symptoms

38
Q

How is IBS treated?

A

Avoid triggers
Antispasmodics - mebeverine
Diarrhoea - codeine phosphate/loperamide

39
Q

What is the pathology of ulcerative colitis?

A

Continuous inflammation of the colonic mucosa starting at the rectum and working its way up

40
Q

What causes UC?

A

Unknown
Genetic predisposition
Non-smokers

41
Q

What are the symptoms of UC?

A 
Diarrhoea
Rectal bleeding
Mucous
Abdominal pain
Weight loss
Fever
Erythema nodosum
42
Q

What investigations would be done if UC was suspected?

A 
Bloods - FBC, increased CRP, increased ERP, increased platelets, decreased albumin, decreased Hb
Stool microscopy and culture
Abdominal x-ray
Faecal caprotectin
Sigmoidoscopy
AXR - rule out toxic megacolon
43
Q

How is UC treated?

A

5-ASA - mesalazine
Steroids
Azathioprine

44
Q

What are the complications of UC?

A

Toxic megacolon
Haemorrhage
Colorectal carcinoma

45
Q

What is the pathology of Crohn’s disease?

A

Affects any part of the GI tract
Transmural - full thickness
Pathy
Cobblestone appearance

46
Q

What causes crohn’s disease?

A

Unknown
Genetic predisposition
Smoking

47
Q

What are the symptoms of crohn’s disease?

A 
Depends on site affected
Diarrhoea
Abdominal pain
Weight loss
Fever
Anaemia
Anal strictures
Erythema nodosum
48
Q

What investigations would be done if crohn’s disease was suspected?

A 
Stool microscopy and culture
Increased CRP, ESR
Decreased Hb, albumin
Colonoscopy with biopsies
B12, folate, vit D, Ca
Faecal calprotectin
Capsule endoscopy
49
Q

How is crohn’s disease treated?

A

Steroids
Azaithoprine
Nutrition

50
Q

What are the complications of crohn’s disease?

A

Sticturing
Bowel obstruction
Perforation

51
Q

What is the pathology of colorectal cancer?

A

Adenocarcinoma

52
Q

What are the predisposing factors for colorectal cancer?

A 
Neoplastic polyps
IBD
Genetic predisposition - FAP, HNPCC
Alcohol
Smoking
Previous cancer
53
Q

What are the symptoms of colorectal cancer?

A

Depends on site
Left - bleeding, mucus, altered bowel habit, obstruction
Right - weight loss, abdominal pain

54
Q

How is colorectal cancer investigated?

A

Sigmoidoscopy
Colonoscopy
CT

55
Q

How is colorectal cancer treated?

A

Laparoscopic surgery
Radiotherapy
Chemotherapy

56
Q

Where does colorectal cancer metastasise to?

A

Liver
Lung
Bone

57
Q

How is colorectal cancer staged?

A

Dukes staging

58
Q

What are ALARM symptoms?

A 
Anaemia
Loss of weight
Anorexia
Recent onset of progressive symptoms
Masses and melaena/haematemesis
Swallowing difficulty
59
Q

What are signs of an upper GI bleed?

A 
Haematemesis
Melaena
Elevated urea
Associations - dyspepsia, reflux
NSAID use
60
Q

What are the signs of a lower GI bleed?

A

Fresh blood/clots
Magenta stools
Normal urea
Typically painless

1st/2nd Year Revision (15 decks)

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