GIT Flashcards
Complications of villous adenoma
Hypokalemia
Protein is also deranged
Complications of opioid use
Constipation
According to NICE CKS, we should try interventions for constipation in this order.
1. High fibre diet
2. Stimulatant laxative (senna)
3. Osmotic laxative (laculose/macrogol)
4. Add on a prokinetic agent such as metoclopramide, domperidone, or erythromycin
5. Consider the use of a dantron-containing laxative
6. Seek specialist advice if the patient is still experiencing constipation
Test to confirm eradication of helicobacter pylori in PUD
C13 urea breath test (stable, non-radioactive isotope)
Virchow’s node
Lump in the left supraclavicular region is known as a Virchow’s node. It is indicative
of carcinoma of the stomach. weight loss and decreased appetite support the
diagnosis of gastric cancer.
Oesophageal spasm
Chest pain associated with ingestion of liquids or solids
TTF-1
Protein used as a clinical marker of lung adenocarcinoma
Abdominal pain radiating to the back
Pancreatitis
Aetiology
The vast majority of cases in the UK are caused by gallstones and alcohol.
A popular mnemonic to remember is GET SMASHED
• Gallstones
• Ethanol
• Trauma
• Steroids
• Mumps (other viruses include Coxsackie B)
• Autoimmune (e.g. polyarteritis nodosa), Ascaris infection
• Scorpion venom
• Hypertriglyceridaemia, Hyperchylomicronaemia, Hypercalcaemia, Hypothermia
• ERCP
• Drugs (azathioprine, mesalazine*, didanosine, bendroflumethiazide,furosemide,
pentamidine, steroids, sodium valproate)
Clinical features
• Gradual or sudden severe epigastric or central abdominal pain (radiates toback,
sitting forward may relieve it)
• Vomiting is prominent
• Tachycardia
• Fever,
• Jaundice
• Shock
• Rigid abdomen with local or general tenderness
• Periumbilical bruising (Cullen’s sign)
Investigation
• Raised serum amylase (>1000U/mL or around 3-fold upper limit of normal).However,
lipase levels are more sensitive and more specific.
• CT scan with contrast enhancement may be diagnostic where clinical andbiochemical
results are equivocal on admission
Most common cause of traveler’s diarrhea
E. coli. It will usually
cause a mild self-limiting diarrhoea for less than 72 hours.
Proctalgia fugax
Severe recurrent rectal pain (may be described as shooting) in the absence of any organic disease. Attacks may occur
atnight, after bowel actions, or following ejaculation. Anxiety is said to be an
associated feature.
Primary biliary cirrhosis
The classic presentation is itching in a middle-aged woman.
Often asymptomatic and diagnosed after finding alkaline phosphatase on routine
LFT.Lethargy, sleepiness, and pruritus may precede jaundice.
There is an association with Sjögren syndrome.
Antimitochondrial antibodies (AMA) are the hallmark for this disease
To help remember: Think of the M rule for Primary biliary cirrhosis
• IgM
• anti-Mitochondrial antibodies
• Middle aged females
Pathologic change in Barrett’s esophagus
Replacement of squamous epithelium to columnar epithelium with goblet cells
