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4th Yr - CMS 1 > GIT 2 > Flashcards

GIT 2 Flashcards

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Introductory Sommelier Exam (CMS) flashcards
1
Q

How many adults suffer from haemorrhoids ?

A

4%

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2
Q

what can haemorrhoids cause?

A

pain
bleeding
problems when going to toilet
tenesmus

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3
Q

why do ppl get haemorrhoids?

A

increase in abdominal pressure eg. pregnancy and straining (low fibre diet)

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4
Q

what type of sensation do we feel in anus ?

A

somatic

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5
Q

what sensation do we feel in rectum?

A

non somatic

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6
Q

what type of nerve supply do organs have?

A

visceral nerve supply

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7
Q

what do pts feel if there is inflammation in the rectum?

A
  • bit of discomfort
  • tenesmus
  • but no pain
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8
Q

when do pts feel pain in rectum?

A
  • skin of anus and the dentate line which is the junction between the rectum and anus
  • if s3 nerve damaged (sciatica) leads to numbness of muscle and incontinency
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9
Q

what are the 2 types of piles?

A

internal - rectal mucosa above dentate line - pain free (gives tenesmus) discomfort but no pain
external - painful as they have somatic sensation, itch (bacteria), bleeding, discharge, fresh red blood in paper to toilet water, ulceration, difficulty with continence

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10
Q

how do piles arrise?

A

from the anal cushion

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11
Q

what is the anal cushion?

A

Lots of blood vessels (sometimes swell causing haemorrhoids)
Contributes to continence - helps to identify Solid vs liquid vs gas

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12
Q

what are the 2 types of sphincters we have in our anus?

A

internal and external anal sphincter

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13
Q

what is an external sphincter

A
  • voluntary muscle
  • striated muscle
  • keep tight naturally
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13
Q

what Is an internal anal sphincter?

A
  • involuntary muscle apart of autonomic nervous system
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14
Q

how do we manage haemorrhoids?

A

Symptomatic: relieve itching (anti inflam cream)
Hygiene
High fibre diet, fluid intake, keep stool soft
May require surgery.
- internal, prolapsed sphincter= elastic band, necrotic and die
- cryotherapy

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15
Q

how can we tell where the problem of blood in bowel motions is coming from?

A

colour of stool and blood distribution

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16
Q

blood in motions: stomach and upper GI

A

Digested partially, black colour stool
Melena stools (thick, sticky black poo)

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17
Q

Blood in bowel motions: colon

A

Blood mixed in with stool
- as contents get pushed through the colon hence mixing

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18
Q

Blood in bowel motions: sigmoid/rectum

A

blood coating stool

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19
Q

blood in bowel motions: rectum/anus

A

blood on toilet
paper or toilet water

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20
Q

what type of sensation is angina an eg of?

A

viceral

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21
Q

what type of sensation is gastrienetritis an eg of?

A

viceral

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22
Q

what type of sensation does the GIT have?

A

visceral

22
Q

what is the parietal peritoneum ?

A

lining of the abdominal cavity

23
Q

what sensation does the parietal peritoneum feel?

A

somatic
- can feel pain but still don’t know exactly where or which organ is the source of innervation

24
Q

define visceral sensation

A

Nerves that supply the organs and blood vessels
Generalised

25
Q

define somatic sensation

A

Pain in the muscles, bones or soft tissues
Localised

26
Q

when do we get visceral sensation of the gut ?

A

when there is inflammation, infection or obstruction (colicky pain)

27
Q

how do we categorise abdominal location

A
28
Q

abdominal pain q’s to ask

A
  • Where is it?
  • When is it?
  • Associated nausea and vomiting
  • When did you last move your bowels?
  • When did you last pee?
  • When was your last menstrual period?
29
Q

what is the appendix

A
  • lower right quadrant
  • 5-10cm long
  • arises from first section of colon
30
Q

what are end arteries?

A

terminal artery - the only supply of oxygenated blood to a part of a tissue eg. brain, finger and appendix
No collateral blood flow or venous drainage
Inflammation may compromise blood flow
Becomes increasingly inflamed, necrotic

31
Q

what are some signs and symptoms of appendicitis ?

A
  • initially poorly localised abdominal pain
  • constipation diarrhoea
  • anorexia malaise
32
Q

what happens when appendicitis advances ?

A

-leakage of bugs into parietal periotneiam causes pain around anpendix therefore tender when u press down as there are somatic peritoneal nociceptors which are innervated due to inflammation

33
Q

what is the tx for appendicitis?

A

surgery to remove necrotic appendix

34
Q

what are the 3 types of gastrointestinal infections ?

A

viral, parasitic and bacterial

35
Q

what is a viral gastroenteritis ?

A
  • noravirus
  • vomiting bug
  • highly transmissible
36
Q

what are the symptoms of viral gastroenteritis ?

A

nausea / vomiting
diarrhoea
malaise
fever

no management - just fluids and rest, handwashing

37
Q

how does bacterial gastroenteritis
occur?

A

From contaminated food:
Raw/incompletely cooked food
Dairy
Poorly stored food
Unwashed salad.
Salmonella Campylobacter E.Coli
Bacterial superinfection

38
Q

what are the symptoms of B.G

A

Nausea/vomiting
Diarrhoea and bleeding
Adbominal pain
Fever
Dehydration Fluid and electrolyte balance

39
Q

who are at a high risk of B.G?

A

Pregancy
Infants
Immunocompromised
Elderly

40
Q

what is a bacterial superinfection?

A

When pt gets prescribed antibiotics, can give pt a bacterial superinfection, which kills off other stomach bacteria and give C. Dificile an opportunity to grow can lead to death

may need stool culture to detect and give the right antibiotics to treat

Caused by prescription of amoxicillin, clindomycin, and metronidazole

41
Q

what are GIT parasites?

A
  • children get them more
  • developing countries
  • tx is praziquantel
42
Q

what are the signs of GIT parasites?

A

Worms or parts of worm in poo
Itchy anus, especially at night
Diarrhoea/vomiting/abdominal pain

43
Q

what is the prevalence of colorectal cancer ?

A

1 case per 1000 in uk
> 50 yrs
family history
history of colorectal polyps

44
Q

risk factors for C.C

A

Diet
- red meat and dairy high risk
- fish, nuts, fresh veg low risk

Smoking
Alcohol

45
Q

how does polyps progress into cancer

A
46
Q

what is the survival rate of c.c? and why?

A
  • 50%
  • Due to late presentation
  • Often asymptomatic until late Abdominal pain, diarrhoea, constipation, anaemia
47
Q

c.c tx

A

surgery
radiotherapy
chemotherapy

48
Q

how do we stage c.c and grade?

A

TNM (T1 (earliest)-T4(latest))

Tumour Thickness
Node involvement
Distant metastases

49
Q

c.c survival and stage

A
50
Q

how do we screen for c.c?

A

Asymptomatic disease
Faecal occult blood: detects blood in poo(old) - not the best test as if u consume food with animal blood u can get a false positive
Faecal immunochemical test: detects human blood in poo

51
Q

what happens if the test is positive for c.c?

A

colonoscopy
- pts who have family that have polyps also get tested

52
Q

signs of bowel cancer?

A

Change in bowel habit (2/3 weeks)
Abdominal pain (2/3 weeks)
Anaemia Blood or mucus in poo
Weight loss
Refer to GP for 2 week wait referral

53
Q

how do we reduce the risk factors for bowel cancer ?

A
  • Smoking cessation
  • Alcohol reduction
  • Ask about diet
  • Encourage patient to participate in all screening programmes
  • ASK about symptoms
  • Refer to GP

4th Yr - CMS 1 (27 decks)

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