GIT Flashcards
Which scenario is most concerning? Answers: a. Young female complaining about difficulty swallowing, with the sensation that food gets stuck b. Middle aged man who had a choking episode with a background of smoking c.Elderly lady losing weight as she has difficulty swallowing for the last few months. Started with solids then progressed to liquids. d. Asymptomatic young man with a family history of gastric cancer
c.Elderly lady losing weight as she has difficulty swallowing for the last few months. Started with solids then progressed to liquids. . The red flags in this scenario are - older age, progressive symptoms, difficulty swallowing getting worse, weight loss
Pyloric stenosis can be diagnosed by
an US can demonstrate the thickened muscle wall.
Which of the following identifies the correct most likely diagnosis based on typical history? Selected Answer: a. Appendicitis - right lower quadrant pain that moves to the left b. Biliary colic - pain starts at 3am in the morning c. Spontaneous bacterial peritonitis - known chronic kidney disease and sudden onset severe abdominal pain d. Coeliac disease - fatty diarrhoea/bowel motions that are difficult to flush
Biliary colic - pain starts at 3am in the morning Incorrect A and explanations: -
Coeliac disease - Diarrhea. Loose, watery stool is one of the first symptoms that many people experience before being diagnosed with celiac disease
Pancreatitis leads to lack of digestive enzymes to help digest fat, leading to steatorrhoea (fatty diarrhoea). Oil floats in water so these bowel motions are difficult to flush -
Appendicitis - Typically in appendicitis the pain starts with vague periumbilical pain that then localises to the right lower quadrant/right iliac fossa -
Spontaneous bacterial peritonitis - This condition occurs in people with ascites from portal hypertension secondary to liver cirrhosis
Right upper quadrant pain + fever + jaundice suggests Answers: a. Pancreatic cancer b. Gall stones c. Ascending cholangitis, which requires urgent medical intervention d. Ascending cholangitis, which is a self limiting viral condition
Incorrect answers and explanation - Ascending cholangitis, which is a self limiting viral condition This clinical triad is highly suggestive of ascending cholangitis, which is a medical emergency - Pancreatic cancer This would typically cause painless jaundice, and typically no fever - Gall stones Can be asymptomatic. However if they get stuck in the biliary tree, that would cause pain, and ongoing obstruction can lead to infection and fever and jaundice
Which of the following statements is true about malaena? Answers: a. Suggests bleeding from the upper gastrointestinal tract b. Is caused from taking iron supplements c. Diagnostic sign of intussusception d. The source of malaena can be found on ultrasound
Suggests bleeding from the upper gastrointestinal tract That is correct; it’s typical tarry black appearance is a result of the blood having been digested and come in contact with stomach acid
All hernias need to be surgically fixed
Surgical treatment is only required if the hernia is symptomatic (causes recurrent pain). Emergency surgery is required if the hernia becomes incarcerated
Recurrent perianal abscesses are suggestive of underlying inflammatory bowel disease
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How would you differentiate between chest pain that is cardiac versus that of oesophageal spasm?
Oesophageal spasm is typically triggered by a cold drink. There may be a background of underlying reflux. Cardiac chest pain typically has associated symptoms like: nausea, vomitting, profuse sweating, shortness of breath, palpitations, dizzyness, radiation down left arm/to jaw. The patient may have cardiovascular risk factors also.
What are some red flags for severe dehydration in an young child/infant?
Vomitting/diarrhoe > 4 times a day, lasting > 24 hours, sunken fontanelle, dry mucous membranes, dry nappies, lethargy, reduced skin turgor, delayed capillary refill, tachycardia, weight loss >10%
