GIT Flashcards
It is difficulty in swallowing which is due to a local lesion or is part of a generalized disease.
DYSPHAGIA
Complications of acute viral hepatitis
Acute fulminant H ، Chronic carrier state ، Cholestatic H with obstructive jaundice ، Post - H svndrome ، relapsing H .
It is defined anatomically as a diffuse process of fibrosis and compensatory nodule formation followed by hepato-cellular necrosis which is of irreversible nature.
Liver cirrhosis
Most common form of peptic ulcers. Usually located in the
duodenal bulb.
Duodenal ulcer
Much less common than duodenal ulcer in absence of NSAIDs. Commonly located along lesser curvature of the antrum. and in the antepyloric area
Gastric ulcer
Complication of liver cirrhosis
l - Portal hypertension
ll - Liver cell Failures
lll- hepatic encophalopathy
Yellow discolouration of skin and mucous membrane due to increase in serum bilirubin above 2 mg ( normal value up to 1,0 mg )
Jaundice
Complication of peptic ulcer
- Haemorrhage
- Perforation
- Obstruction of the gastric outlet
- Malignancy in gastric ulcer
Deep jaundice , Dark brown urine , Pale white stools , Itching , Failure to digest fat and fat soluble vitamines , Abdominal pain , Conjugated bilirubin
obstructive jaundice
Moderate jaundice with conjugated and unconjugated bilirubin
hepatocellular jaundice
Jaundice lemon yellow , Normal urine color , Dark stools , Splenomegaly , Normal liver functions
haemolytic jaundice
Risk factors of peptic ulcer
NSAID use , smoking , family history of peptic ulcer , gastrinoma .
Aetiology of peptic ulcer
H- pylori infection
Ulcerogenic drugs
Hypersecretory syndrome
burning epigastric pain 1-3 hrs after meals , nocturnal pain , relieved by food , antacids , antiseratory agents
Duodenal ulcer - hunger pain
Weight loss , Chronic , epigastric pain , with pre-cancers lesions , relieved by anti-acids forward complications are gastric malignancy or obstruction , gastroscopy and biopsy are required .
Gastric ulcers
Upper endoscopy , H pylori testing , CBC rule out anemia ,
Investigations of peptic ulcer
Triple therapy for peptic ulcer
2 antibiotics + PPI for 14 days then PPI for 3-4 weeks ( all twice daily )
PPI = omeprazole 20 mg + clarithromycin 500 mg & metronidazole 500 mg as antibiotics
Investigation of esophageal disorders
Upper endoscopy.
Barium swallow and meal.
Manometry
presence of intestinal metaplastic columnar epithelium which has
replaced squamous epithelium as a consequence of acid reflux, it predisposes to malignancy.
Barrett’s esophagus
Inflammation of the lower oesophagus produced by persistent
episodes of refluxes Patients may be asymptomatic.
Reflux esophagitis
patient with reflux who has persistent symptoms.
Gastro-oesophageal reflux
disease (GORD)
reflux of gastric contents which can occur normal with no symptoms.
Gastro-oesophageal reflux
an anatomical abnormality in which part of stomach protrudes through the diaphragm and up into the chest.
Hiatus hernia
[ plummer vinson syndrome which consists of chronic iron deficiency anemia , difficulty swallowing ]
Oesophageal web
