GI Y1 Flashcards
Supine
Laying on the back
Prone
Laying on the the front
Sagittal plane
symmetric , Cut the body into left and right
Coronal plane
cut the body into anterior and anterior
Axial (transfers) plane
cut the body into superior and inferior (top and bottom)
Oppsite words
Superior (cranial or rostral)
Oppsite words
Superior (cranial or rostral)
Oppsite words
Superior (cranial or rostral)
Anterior
Medial
Proximal
Superficial
Inferior (caudal)
Posterior
Lateral
Distal
Deep
embryo anatomy
Flexion
Extension
decrease the angel between parts
Increase angle between parts
Flexion
Extension
decrease the angel between parts
Increase angle between parts
When Metoclopramide should be avoided?
Metoclopramide is a medication commonly used to treat gastroesophageal reflux disease (GERD) symptoms, nausea, and vomiting. However, it should be avoided in cases of bowel obstruction because it can exacerbate the obstruction and cause further complications.
Bowel obstruction is a condition where the passage of intestinal contents is blocked, either partially or completely.
Sigmoid Volvulus
- Old patients
- high fibre diet
- chronic constipation
- AXR - show coffee bean sign
Intrahepatic causes of Juandiace
Gilberts syndrome
Alcoholic liver disease
Primary biliary cirrhosis
Autoimmune hepatitis
Post hepatic causes Juandiace
Choledocholithiasis
Achalasia (name of defected neurons )
The progressive degeneration of myenteric neurons
Preventing food from being effectively moved through Esophages
Daysphagia progressively (improves when moving the head back)
Trypanosoma cruzi -> chagas disease
PARALYTIC Leus
similar to sigmoid volvulus but no coffee beans sign
Globus hysterics
Young women
Previous history of anxiety
Feeling lump in the throat
Acute Cholecystitis (which duct, sign )
complication of gallstone
Gallstones obstruct the cystic duct and stop the emptying of the gallbladder
RUQ pain
Positive Murphy’s sign (feeling the inflamed gallbladder )
Acut Pancreatic
acute epigastric pain
Radiate to the back due to the involvement of retroperitoneum
High level of Amylase
Appendicitis
Rebound tenderness and guarding
Central pain radiates to the right iliac fossa
Tachycardia
Positive McBurney’s point
Rosving’s sign - pressing on LIF causes pain in RIF.
Rosving’s sign - pressing on LIF causes pain in RIF.
Treatment :
Appendectomy
analyiscs
antibiotic
Ulcerative colitis
Get worst after quitting smoking
AMA
anti mitochondrial antibody is the most specific test for primary biliary cholangitis (PBS)
primary biliary cholangitis (PBS)
AMA
MRCP
it caused by autoimmune destruction of both intra and extra-hepatic bile duct
Wilsons Disease
- Chronic hepatitis
Neurogenic degeneration (aggressive behaviour)
autosomal recessive
treatment :
Penicillamine or trientene (copper chelating agents )
Clostridium difficicle gastroenteritis
History of PO antibodies (e.g for chest infection)
as antibodies can disrupt the normal gut flora leading to the overgrowth of C.difficicle
Alpha 1- antitrypsin can be caused by — genetic
autosomal recessive
Coeliac disease
Autoimmune reaction to gluten
+ anti-tissue transglutaminase (anti TTG)
+ anti endomysial (antiEMA)
Malabsorption
Small bowel specifically jejunum
Atrophy of intestinal villi (coeliac small intestinal mucosa + crypt hypertrophy)
LINK TO TYPE 1 DIABETES
Dermatitis herpetiformis
When patients have IgA deficiency and is suspected to have coeliac disease what can of test can be done
anti TTG and anti EMA for IgG version
what is Charcot’s triad
Charcot’s triad is a set of three symptoms that are typically associated with acute cholangitis
1. right upper quadrant pain
2. fever - rigor (shaking )
3. painful jaundice (raised bilirubin)
Haemorrhoide
fresh blood on toliet paparer
Direct ingual hernia
cough will causes it to reappear after reduction
point toward the groin
Indirect inguinal
will not reappear after the reduction
point towards the groin
Femoral hernia
more common in females
Point down the leg
How to treat the following:
1. low BP + Haemtemesis
2. actively bleeding peptic ulcer
3. Uncontrol oesophageal visceral
- Iv fluid
- Heater probe coagulation + adrenaline injection
- TIPs
GORD
Heartburn
water brush
regurgitation of excessive saliva with acid
Odynphagia
MANAGEMENT
Endoscopy
stop smoking
loss weight
prop the head up of bed
H2 antagonist
PPI for 8 weeks
Barrets oesophagus
PPI optimisation
tumour maker of colorectal cancer
CEA
Crohons disease
palpable lesion on the shin ->IBS
Slim there maybe have been wight lost
tumour marker Hepatocellular carcinoma
alpha fetoprotein
why is azathioprine given with caution
is bone marrow suppression thus a weak immune system.
given for patients with ulcercolitis
what is Terlipression
is given in variceal bleeding for patients with cirrhosis
its vasoconstriction of splanchnic circulation decreases portal pressure and reduces the risk of bleeding from varices
Peptic ulcer includes 7 days of tripe therapy what are these drugs
PPI+ Amoxicillin + clarithromycin
OR if the patient allergic to penicillin
PPI+ Amoxicillin + Metronidase
COlumnar
Squamous cells epithelium
Irritable bowel syndrome
females
discomfort is only better when having a bowel movement
Paneth cells
The Paneth cells are found at the base of the
crypts of Lieberkühn and have a role in defence and regulating bacterial flora
Hepatitis A
- Faecal-oral spread
- Acute hepatitis, no chronic infection
- Serology :Hepatitis A antibody (anti-HAV): This test detects antibodies to the HAV virus, which is spread through contaminated food or water.
- Management: Vaccine
Hepatitis E
- Faecal-oral transmission in the tropics
Tropical genotype associated with severe disease in pregnant women - Some immunocompromised humans can get chronic infection
- No vaccine yet available
Hepatitis D
- Only found with Hepatitis B - exacerbates Hep B infection
- Serology: Hepatitis D antibody (anti-HDV)
Hepatitis B
- Transmission (bodily fluids)
Sex
Mother to child
Blood to blood (unscreened transfusions, tattoos) - Serology:
Hepatitis B surface antigen (HBsAg)
Antibodies to hepatitis B surface antigen (anti-HBs)
Antibodies to hepatitis B core antigen (anti-HBc)
Clinical features
Chronic disease is more likely to result if first exposure is in childhood
Spontaneous cure is not uncommon, even after years of infection - Management: Vaccinations
Antibodies to hepatitis B core antigen (anti-HBc) - ‘C’ for Caught -
this means the person has developed antibodies due to a previous infection
Hepatitis C
- Same as Hep B
- Strongly associated with hepatocellular carcinoma
- Once chronic infection is established, spontaneous cure is not seen
- Management
chronic hep B - suppressive antiviral drug (more widely used) OR peginterferon alone (sustained cure possible in minority of cases)
Chronic hep C - choice of antiviral regime based on many factors; aim is >90% SVR
Cirrhotic patients at those at risk of complications treated as priority
what bacteria causes Severe Vomiting
S.aureus - <24hrs onset
what causes Watery Diarrhoea
Clostridium difficile (C. diff)- use of antibiotics 💊
(think the 4 C’S!)
other casues of watery diarrhoea
- Bacillus cereus => fast onset - reheated rice 🍚
- Listeria - unpasteurised milk products 🐄
- Vibrio cholerae - Travel Abroad (SE asia) ✈️🌏
- E. coli - Traveller’s Diarrhoea
- Giardiasis (parasite)🐛💦
Bloody Diarrhoea
E. coli 0157 🩸
Campylobacter jejuni - BBQ, Travellers diarrhoea 🍖/✈️🌏
Salmonella - eggs and poultry 🍳🐔
Amoebiasis (parasite)🐛🩸
* E. coli 0157 - from farmyard animals/ petting zoos. has shiga toxins (ENDOTOXIN!)causing bloody diarrhoea
Can lead to haemolytic uraemic syndrome.
Use of antibiotics causes toxins to be released from dying cells so DO NOT use antibiotics if you suspect HUS.
E coli - short history bloody diarrhoea // travelling + diarrhoea // haemolytic uraemic syndrome + thrombocytopaenia = E COLI (subtype 0157)
Viral gastroenteritis
Onset: 24hrs
Norovirus - winter vomiting bug
(raw chicken/turkey)🎅
Parasites
Amoebiasis - bloody diarrhoea - tropical areas
Giardiasis - Faecal-oral transmission - pets , farm animals or human
treatment for
Ecoli 0157-
C.diff -
- Supportive measures
- Oral vancomycin and hygiene measures
(remember to wash hands w/ soap! C.diff has spores which alcohol cant break!)
Gastric ulcer
- Dyspepsia
- Epigastric pain worse after eating
- Pain eased by antacids and lying flat
- Rupture will present as haematemesis (vomiting blood)
Duodenal ulcer
- Dyspepsia
- Epigastric pain relieved by eating
- Pain worse when lying flat - may wake patient during the night
- Rupture will present as rectal bleeding/melaena (blood in stool)
Croup is caused by…
B- parainfluenza
the first line antibiotic treatment for a C. difficile infection?
A- Oral Vancomycin
A patient presents with bloody diarrhoea and is confirmed via stool culture to be infected with E.coli 0157. What is the best management below?
fluid only
Bacillus cereus
Reheated rice
Barretts oesophagus is the metaplasia of epithelial cells of the lower oesophagus from
stratified squamous to simple columnar epithelium
Coeliac disease is strongly associated with genetic
is strongly associated with HLA-DQ2 (95% of patients) and HLA-DQ8 (80%).
Diverticulosis
condition in which diverticula are present in the intestine without signs of inflammation.
Upper midline abdominal incisions will involve the division of the
linea alba
How is Aspergillus fumigatus treated? lung infection
Amphotericin B
Hepatocellular carcinoma is associated
Hepatitis C
Oesophageal cancer
is associated with alcohol excess and smoking.
Inguinal hernia is above the inguinal ligament, Femoral hernia is below the inguinal ligament
