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Stage 3: FOCP > GI week: Hx & Ex > Flashcards

GI week: Hx & Ex Flashcards

1
Q

Cardinal symptoms in GI history

A
  • painful mouth
  • difficulty swallowing
  • heartburn
  • abdominal pain
  • nausea, haematemesis
  • bowels
  • rectal bleeding
  • flatulence
  • jaundice
  • fever
  • weight loss
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2
Q

GI causes of clubbing

A
  • Liver cirrhosis
  • IBD
  • malabsorption
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3
Q

What causes palmar erythema and spider naevi in GI conditions

A

Excess oestrogen due to reduced hepatic breakdown of sex steroids

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4
Q

Causes of leukonychia

A

conditions leading to lack of protein

  • hypoalbunimaemia
  • Kwashiokor (protein malnutrition)
  • Coeliac’s (protein losing enteropathy)
  • Nephrotic syndrome (prolonged proteinuria)
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5
Q

Causes of Dupytrene’s contracture

A
  • Alcohol related chronic liver disease
  • Congenital
  • Diabetes
  • Smoking
  • High cholesterol
  • HIV
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6
Q

What might bilateral parotid swelling indicate

A
  • Chronic alcohol abuse

- Bulimia

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7
Q

Difference between telangiectasia and spider naevi

  • direction of flow
  • blanching characteristics
A

Telangiectasia flow from outside in

Spider naevi flow from inside out

Telangiectasia do not blanch with pressure

Spider naevi blanch with pressure

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8
Q

What GI condition might mouth ulcers indicate

A

Crohn’s

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9
Q

What are iritis and episcleritis associated with

A

IBD (Crohn’s, UC)

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10
Q

What might glossitis and angular stomatitis indicate

A

Iron deficiency anaemia/ B12/ folate deficiency

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11
Q

How to feel difference between expansile and pulsatile aorta on palpation

A

Expansile: fingers pushed apart from each other

Pulsatile: fingers pushed away from abdomen

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12
Q

What 4 features on examination indicate liver failure

A
  1. Fetor hepaticus (stale mousy smell)
  2. Flapping tremor
  3. Varied mental state (from drowsy to coma)
  4. Late neurological features - spasticity and extension of arms and legs. Extensor plantar responses
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13
Q

Peptic ulcer and duodenal ulcer

  • in which do you lose/ gain weight
A

Lose weight with peptic ulcer

Gain weight with duodenal ulcer

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14
Q

What do the following GI pains suggest:

  • worse during eating
  • better with eating
  • just after eating
  • a little more time after eating
A

Worse during eating: stomach problem

Better during eating: duodenum

Just after eating: reflux

A little more time after eating: problem further down in bowels

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15
Q

What might cause dysphagia with solids

A

Strictures from reflux or cancer

stuck in oesophagus

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16
Q

What might cause dysphagia with fluids

A

Neurological problem with musces

stuck in pharyngeus

17
Q

What condition might the following symptoms indicate

  • pain radiating to genitalia
  • patient was dehydrated
A

Renal colic

18
Q

Causes of hepatomegaly

A
  • chronic liver disease
  • cancer
  • RHF
  • blood disorders (lymphoma, leukaemia, myelofibrosis, polycythaemia)
19
Q

Causes of splenomegaly

A
  • blood disorders (myeloid leukaemia, myelofibrosis)
  • portal hypertension
  • infection (malaria)
  • rheumatoid conditions: RA, SLE
20
Q

Causes of hepatosplenomegaly

A
  • lymphoma
  • myeloproliferative disease
  • cirrhosis
  • portal hypertension
21
Q

Which abdominal organs are retroperitoneal

A

SAD PUCKER

Suprarenal (adrenal) glands
Aorta, IVC
Duodenum
Pancreas
Ureteres
Colon
Kidneys
Esophagus
Rectum
22
Q

Embryologically, which parts of the GI tract are the

  • foregut
  • midgut
  • hindgut
A

Foregut: oesophagus -> 2nd part duodenum

Midgut: 2nd part duodenum -> proximal 2/3 transverse colon

Hindgut: Distal 1/3 transverse colon -> rectum

23
Q

Describe the Grey Turners sign.

What is it a feature of?

A

Bruising of flanks (sign of retroperitoneal haemorrhage)

Indicates acute pancreatitis (leading to necrosis)

24
Q

Describe the Cullens sign.

What is it a feature of?

A

Superficial oedema and bruising around umbilicus (in subcutaneous fatty tissue)

May indicate:

  • acute pancreatitis
  • ruptured AAA
  • ruptured ectopic pregnancy
25
Q

Causes of koilonychia

A

Iron deficiency anaemia

26
Q

3 signs of peritonitis

A
  1. rebound tenderness
  2. percussion tenderness
  3. guarding
27
Q

Which side do ileostomy and colostomy tend to appear on

A

Ileostomy: R side
Colostomy: L side

28
Q

Where might pain from biliary colic radiate to?

A

Below R scapula

29
Q

Describe Murphy’s sign

A

for cholecystitis

Push in RUQ, pain on inspiration disrupting breath

30
Q

Describe Rovsing’s sign

A

for appendicitis

Push LIF but they feel pain in RIF

31
Q

Describe McBurney’s point

A

for appendicitis

RIF pain

32
Q

Over what age is renal colic rare

A

> 65

33
Q

In patients >65 presenting with symptoms similar to renal colic, what must be excluded

A

AAA

34
Q

What is the criteria for surgical repair of an AAA

A

> 5.5cm must be repaired

below 5.5cm, risks of surgery outweigh the benefits

35
Q

Differentiating epigastric pain caused by GORD vs peptic ulcer disease

A

GORD pain would be worse when bending forward. Not so with PUD.

Lack of acid reflux makes PUD less likely

Stage 3: FOCP (47 decks)

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