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ICM Block 1 > GIT 2 > Flashcards

GIT 2 Flashcards

1
Q

a. T-cell mediated autoimmune disease
b. Triggered by prolamin (protein present in gluten)
c. Small bowel, villous atrophy and malabsorption

A

celiac

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2
Q

d. Hx: female, age, fatty diarrhea, abdo pain, bloating, nausea, vomiting, weight loss, mouth ulcers

A

celiac

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3
Q

i. Bloods: CBC, folate, calcium, vitamin D, Antibodies (α-gliadin, transglutaminase, anti-endomysial

A

celiac

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4
Q

a. Malabsorption disease found in tropical areas
b. abnormal flattening of villi and inflammation
c. Hx: fatty diarrhea, weight loss

A

tropical sprue

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5
Q

a. Tropheryma whippelii infection
i. Gram positive bacillus
ii. Contaminated soil/animals/sewage

A

whipples

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6
Q

b. Hx: Men, middle age, peripheral joint pain and inflammation, weight loss, fatty diarrhea, abdominal pain, fever
c. Exam: skin hyperpigmentation

A

whipples

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7
Q

d. Comp: Endocarditis, dementia (reversible), ophthalmoplegia

A

whipples

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8
Q

a. Chronic, progressive inflammation- Fibrosis, calcification, dilated pancreatic duct

A

chronic pancreatitis

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9
Q

Hx:

i. Epigastric pain ‘bores’ through to the back, relieved by sitting forwards, bloating, fatty diarrhea, weight loss
ii. PMH – diabetes
iii. SH – alcohol

A

chronic pancreatitis

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10
Q

Causes: alcohol and gallstones

A

chronic pancreatitis

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11
Q

d. Invest: CT – pancreatic inflammation, calcifications

A

chronic pancreatitis

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12
Q

a. Asymptomatic

b. May precede colorectal cancer – benign hyperplasia

A

colorectal polyps

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13
Q

i. Genetic cancer syndrome: colorectal, endometrial, ovarian, gastric
ii. Mainly right sided
iii. Younger – 40s

A

HNPCC

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14
Q

a. Adenocarcinoma
b. 50-75 yo
i. Age, altered bowel habit, bleeding (fresh/melaena), mucus, weight loss, abdo pain, obstruction
ii. PMH: bowel polyps, IBD, HNPCC, low fiber diet
iii. SH: smoking

A

CRC

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15
Q

Weight loss, malaise, tiredness, abdo pain, tends to present later and bleeding

A

right CRC

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16
Q

Bleeding, mucus, altered bowel habit, tenesmus (mass effect)

A

left CRC

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17
Q

Presence of diverticular outpouchings of bowel; asymptomatic

A

diverticulosis

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18
Q

location of diverticular dz

A

sigmoid

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19
Q

Acute inflammation of diverticular outpouchings

i. Hx: Altered bowel habit, abdominal pain relieved by defecation, nausea, fever, generally unwell, blood/pus

A

diverticulitis

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20
Q

a. Acute interruption of blood flow: arterial thrombosis (MC) & venous thrombosis
b. Usually small bowel

A

acute mesenteric ischemic

21
Q

c. Classic triad
i. Acute severe abdominal pain: central or RIF, constant
ii. No abdominal signs on examination (no tenderness)
iii. Rapid hypovolemia leading to circulatory shock

A

acute mesenteric ischemic

22
Q

d. Invest:
i. AXR: ‘gasless’ bowel
ii. Consider arteriography
iii. Surgery: diagnosis confirmed by necrotic bowel

A

acute mesenteric ischemic

23
Q

e. Comp: Septic peritonitis, overwhelming sepsis, death

A

acute mesenteric ischemic

24
Q

a. Large bowel; transient, non-occlusive ischemia
b. Hx:
- Sudden cramping, mild, left lower abdominal pain, tenesmus, rectal passage of blood – fresh/old/bloody diarrhea
- Symptom resolution within 2-3 days; healing 1-2 weeks
c. Thumb printing on AXR – not receiving oxygen
d. Metabolic acidosis

A

acute ischemic colitis

25
Q

a. Adhesion – adults
b. Crohns strictures
c. Volvulus: cecal, sigmoid
d. Hx:
i. Acute vomiting, colicky pain, constipation, distention
ii. Vomit: feculent: fermented bowel contents or small bowel contents
e. Sound: hyper tink @ beginning; nothing at the end

A

bowel obstruction

26
Q

a. Prolapse of abdominal contents through weakness in abdominal wall
b. Inguinal, Femoral, periumbilical, incisional, Spigelian (lateral edge of rectus sheath- below and lateral to umbilicus

A

hernias

27
Q

a. Less than 30
b. Infection and inflammation of appendix wall
c. Hx: Periumbilical pain – moves to RIF, anorexia, vomiting, increased pain with coughing/movement
d. Exam: Low grade fever, tachycardic, lying still, guarding, rebound, tenderness RIF, Rovsing’s sign (rebound tenderness)

A

acute appendicitis

28
Q

a. RNA virus, fecal oral spread, 2-6 wk incubation
b. Hx: fever, malaise, nausea, jaundice
c. Invest: Hep A IgM

A

hep A

29
Q

a. DNA virus; spread: blood, sexual, vertical; 1-6-month incubation
b. Hx: same as hep A plus itching, joint pain, RUQ pain
c. Exam: Jaundice, RUQ tenderness, hepatomegaly, splenomegaly
d. Invest: HBsAg (early), HBeAg (infectivity), HBcAg (previous infection)
e. Comp: cirrhosis; PAN

A

hep B

30
Q

a. RNA virus, spread: blood sexual

b. Comp: hepatocellular carcinoma

A

hep C

31
Q

a. Hx: anorexia, diarrhea, vomiting, jaundice, easy bruising
b. Exam: jaundice, hepatomegaly, ascites
c. Invest: Blood – LFTs, clotting, urea

A

alcoholic hepatitis

32
Q

a. Type 1: adults/children, anti SMA in 80%, ANA in 1%
b. Exam: jaundice, hepatomegaly
c. Invest: liver biopsy – mononuclear infiltrate
d. Young female

A

alcoholic hepatitis

33
Q

a. Genetic: toxic copper accumulation
b. Hx:
i. Liver: Chronic hepatitis, cirrhosis,
ii. Eye: Kayser-Fleischer rings
iii. CNS: Movement, coordination, cognitive or mood disorders (weird gait/bad balance)
c. Invest: urine – increased copper excretion

A

chronic liver dz - wilson’s

34
Q

a. Young pt
b. Hyperpigmentation
c. Bronze diabetes
d. Invest: serum ferritin
e. Comp: cirrhosis, cardiac failure, hypogonadism

A

hemochromatosis

35
Q

a. Exam: Leukonychia, Terry’s nails, clubbing, palmar erythema, Dupytren’s contracture, spider naevi, hepatomegaly, ascites

A

cirrhosis

36
Q

a. Stones formed from bile
i. Pigment stones – small, friable, irregular
ii. Cholesterol – large, often just one
iii. Mixed

A

gallstones

37
Q

females, forty, fat, fertile

A

gallstones

38
Q

Leads to

i. Infection – cholecystitis, ascending cholangitis
ii. Obstruction – colic, pancreatitis, obstructive jaundice

A

gallstones

39
Q

Hx: RUQ pain radiating to the back, vomiting; +/- obstructive jaundice (pale stools, dark urine), fatty meal
Exam: Jaundice, RUQ/epigastric tenderness

A

gallstones

40
Q

i. Hx: continuous epigastric/RUQ pain, vomiting, fever
ii. Exam: Raised temperature, peritonism, tender gall bladder mass, Murphy’s sign
iii. Invest: USS – thick walled gall bladder, sludge, stone

A

cholecystitis

41
Q

i. Ascending infection from bile stasis – leads to biliary sepsis
ii. Hx: Charcot’s triad: fever, RUQ pain, pale stools/dark urine

A

ascending cholangitis

42
Q

a. Inflammatory disorder of gallbladder - Assoc with IBD
b. Hx: Asymptomatic (incidental), fluctuating, jaundice, itching, abdominal pain, fatigue
c. Exam: Jaundice, hepatomegaly, caput medusae

A

primary sclerosis cholangitis

43
Q

primary sclerosis cholangitis investigations

A

i. Autoantibodies: ANA, ANCA+
ERCP – beaded appearance – multiple strictures
Liver biopsy

44
Q

a. Chronic inflammation
i. Damage to interlobular bile ducts (portion in liver)
ii. Cholestasis, portal hypertension
iii. Associated with: RA, Sjogren’s, systemic sclerosis

A

primary biliary cirrhosis

45
Q

b. Invest: liver biopsy – granulomas around bile ducts

c. Comp: Osteoporosis (vit D), coagulopathy (vit K), portal hypertension

A

primary biliary cirrhosis

46
Q

a. Slow growing
b. Poor prognosis – 5-month survival
c. Hx: fever, abdominal pain, malaise, jaundice, weight loss, itching
d. Exam: weight loss, jaundice, ascites, hepatomegaly

A

cholangiosarcoma

47
Q

alcohol and gallstones
i. SEVERE epigastric pain, radiating to back, relieved by sitting forwards, precipitating event (e.g. alcohol binge/scorpion bite), jaundice

A

acute pancreatitis

48
Q

b. Exam: Unwell, fever, raised HR, jaundice, guarding, Cullen’s sign, Grey-Turner’s sign
c. Invest: CBC, amylase, lipase, ABG
d. Comp: renal failure, pancreatic necrosis, abscess, pseudocyst

A

acute pancreatitis

49
Q

i. Female, > 60 yo, smoking, alcohol, diabetes
ii. Metastasize early – mean survival 6 months
iii. Hx: painless jaundice
iv. Exam: jaundice, Courvoisier’s sign
1. Cancer of the head of the pancreas, palpable painless gallbladder

A

pancreatic cancer

ICM Block 1 (2 decks)

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