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GIT Flashcards

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1
Q

Complications of Dysphagia x4

A
  1. Aspiration
  2. Pneumonia
  3. Weight loss
  4. Malnutrition
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2
Q

Causes of Gastritis

A

COMMON

  1. NSAIDs
  2. Alcohol
  3. Stress

LESS COMMON

  1. Radiation
  2. Viral infection
  3. Vascular injury
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3
Q

Symptoms and signs of Gastritis x6

A
  1. Dyspepsia
  2. Nausea
  3. Vomiting
  4. Anorexia
  5. Hematemesis
  6. Melena
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4
Q

Complications of Gastritis x3

A
  1. Ulcers or GI bleeding
  2. Chronic atrophic gastritis
  3. B12 deficiency
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5
Q

Causes of PUD x4

A
  1. NSAIDs (Aspirin, ibuprofen)
  2. Zollinger Ellison Syndrome (gastrinoma)
  3. Helicobacter pylori infection
  4. Hyperacidity
  5. Duodenal-gastric reflux
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6
Q

Symptoms of PUD (Gastric ulcer) x8

A
  1. Bloating
  2. Nausea
  3. Vomiting
  4. Abd pain
  5. Anorexia
  6. Recent weight loss
  7. Loss of appetite
  8. Pain worsens with eating
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7
Q

Signs of PUD (Gastric ulcer)

A
  1. Pallor
  2. Epigastric tenderness
  3. Hyperactive bowel sounds
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8
Q

Symptoms of PUD (Duodenal ulcer)

A
  1. Abd pain
  2. Weight gain
  3. Pain that is relieved by food or antiacids for 2-3 hours after ingestion
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9
Q

Signs of PUD (Duodenal ulcer)

A
  1. Epigastric pain
  2. Pallor
  3. Tenderness on the abdomen
  4. Hyperactive bowel sounds
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10
Q

Risk factors of PUD

A

Increased acid can result from:

a) Stress
b) Alcohol
c) Caffeine
d) Smoking
e) Spicy foods

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11
Q

Investigations of PUD

A
  1. Endoscopy
    a) rapid urease test (CLO test) can be performed to check for H. pylori
    b) Biopsy to exclude malignancy
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12
Q

Complications of PUD

A
  1. Hemorrhage
  2. Stomach cancer
  3. Penetration
  4. Free perforation
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13
Q

DDx of PUD

A
  1. Gastroenteritis
  2. Gastritis
  3. Pancreatitis
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14
Q

Causes of Gastroenteritis

A

VIRUS

  1. Norovirus
  2. Rotavirus
  3. Astrovirus
  4. Adenovirus

BACTERIAL

  1. Salmonella
  2. Shigella
  3. Campylobacter
  4. E.Coli
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15
Q

Symptoms of Gastroenteritis

A
  1. Nausea
  2. Vomiting
  3. Diarrhea
  4. Anorexia
  5. Abd cramps
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16
Q

Post-Gastroenteritis Complications

A
  1. Lactose intolerance
  2. Irritable bowel syndrome
  3. Reactive arthritis
  4. Guillain–Barré syndrome
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17
Q

Patho steps bacterial gastroenteritis

A
  1. Mucosal adherence
  2. Mucosal invasion
  3. Toxin production
18
Q

Hepatitis types and causes

A

TYPE CAUSE TRANSMISSION

  1. Hep. A by Viral Fecal oral route
  2. Hep. B by Infections Sex & infective body fluids
  3. Hep. C by drugs & alcohol Infective bdy fluids
  4. Hep. D by auto-immune Hep. B
  5. Hep. E by seronegative F O route
19
Q

Causes of Hepatitis

A
  1. Alcoholic hepatitis
  2. Non-alcoholic fatty liver disease
  3. Viral hepatitis
  4. Autoimmune hepatitis
  5. Drug-induced hepatitis (e.g. paracetamol overdose
20
Q

Presentation of Hepatitis

A
  1. Abdominal pain
  2. Fatigue
  3. Pruritis (itching)
  4. Muscle and joint aches
  5. Nausea and vomiting
  6. Jaundice
  7. Fever (viral hepatitis)
21
Q

Causes of Chronic Liver Disease

A
  1. HBV and HCV
  2. Wilson’s disease
  3. Alcoholism
  4. Drug-induced disease
  5. Auto-immune Hepatitis
22
Q

Risk factors of Chronic Liver Disease

A
  1. Obesity
  2. Exessive use of Alcohol
  3. Unprotected sex
  4. Sharing of needles
23
Q

Signs and symptoms CLD OR Liver Cirrhosis

A
  1. Jaundice – caused by raised bilirubin
  2. Hepatomegaly – however, the liver can shrink as it becomes more cirrhotic
  3. Splenomegaly – due to portal hypertension
  4. Spider Naevi – these are telangiectasia with a central arteriole and small vessels radiating away
  5. Palmar Erythema – caused by hyperdynamic circulation
  6. Gynecomastia and testicular atrophy in males due to endocrine dysfunction
  7. Bruising – due to abnormal clotting
  8. Ascites
  9. Caput Medusae – distended paraumbilical veins due to portal hypertension
  10. Asterixis – “flapping tremor” in decompensated liver disease
24
Q

Investigations of Liver Cirrhosis or CLD

A
  1. Liver biopsy
  2. Blood- cirrhosis all of the markers (ALT, AST, ALP, and bilirubin) …. Increased LFT
  3. Nodularity of the surface of the liver

a) A “corkscrew” appearance to the arteries with increased flow as they compensate for reduced portal flow
b) Enlarged portal vein with reduced flow
c) Ascites
d) Splenomegaly

25
Q

Cholecystitis

A

Inflammation of the gallbladder

26
Q

Causes of Cholecystitis

A
  1. Cholelithiasis (most common)
  2. Acute acalculous cholecystitis (without stones)
    * Inadequate or absent blood flow to the gallbladder
    * Abnormal metabolism of cholesterol and bile salts
    * Tumor
    * Bile duct blockage (due to shrinking & scarring)
    * Infection
27
Q

Symptoms of cholecystitis

A
  1. Nausea
  2. Vomiting
  3. Fever
  4. RUQ pain
28
Q

Signs of cholecystitis

A
    • Murphy’s sign
  2. Right subcostal tenderness (rebound tenderness)
  3. involuntary guarding of RUQ
  4. Low-grade fever
  5. Jaundice
  6. Hyperactive bowel sounds
29
Q

Complications of cholecystitis

A
  1. Gangrene
  2. Peritonitis
  3. Perforation
  4. Gallbladder fistula formation
  5. Empyema
30
Q

Investigations of Cholecystitis

A
  1. FBC- Increased WCC
    - Increased Amylase/ lipase
    - ↑CRP, EUC, LFT
    - ↑Bilirubin
  2. Ultrasound- Detects gallstones and is used to elicit Murphy’s sign
31
Q

Causes of pancreatitis

A
  1. Gallstones
  2. Alcohol
  3. Genetic abnormalities of the pancreas
32
Q

Pancreatitis overview

A
  1. Inflammation of the pancreas
  2. Pancreatic enzymes (amylase/lipase) attack the pancreatic tissue
  3. Cause epigastric pain radiating to the back
  4. Diagnosed clinically / by rise in amylase (>3 x normal) / CT scan
  5. Amylase may not rise in an acute exacerbation of chronic pancreatitis because the pancreas has lost it’s ability to produce the enzyme
33
Q

Complications of Pancreatitis

A
  1. Pancreatitis necrosis
  2. Infection in necrotic areas
  3. Pseudocysts
  4. Chronic pancreatitis
34
Q

Causes of Intestinal Obstruction

A

MECHANICAL

  1. Adhesion
  2. Tumor
  3. Strangulated hernia
  4. Intussusception
  5. Volvulus
35
Q

8 signs of intestinal obstruction

A
  1. Visible peristalsis
  2. Abnormal bowel sounds (High pitched early then later become absent)
  3. Abdominal tenderness
  4. Abdominal distension
  5. Empty rectum on examination
  6. Muscle guarding
  7. Hernia (Cecal volvulus)
  8. Dilated loops of bowel
36
Q

Name and explain 3 Investigations of intestinal obstruction

A
  1. Abdominal xray- This may show dilated loops of bowel proximal to the obstruction and collapsed loops of bowel distal to the obstruction and COFFEE BEAN SIGN
  2. Rectal exam- Absent stool or empty rectum
  3. Abdominal CT scan- is being used more often in suspected small-bowel obstruction (The small bowel is dilated and filled with air and fluid)
37
Q

Medicine management for cholecystitis

A

Amoxicillin/calvulanic acid, oral, 875/125mg 12hrly

if unable to tolerate oral
Augmentin, IV, 1.2mg 8 hourly

38
Q

General measures for cholecystitis

A
  1. Admit the patient
  2. GI rest- nil by mouth until recovered
  3. Low-fat diet
  4. Large bore IV for fluids
  5. Drain care- Cholecystectomy “C-tube”, placed through abdominal wall & into the gallbladder.
  6. Cholecystectomy
39
Q

Medicine treatment for PUD

A 
H.pylori +ve
Proton pump inhibitor, e.g.:
Adults- Lansoprazole, oral, 30mg 12 hourly 
    -Duodenal ulcer: for 7 days
    -Gastric ulcer: for 28 days

AND

H.pylori eradication:
-Amoxicillin, oral, 1g 12 hourly

OR
for severe penicillin allergy
-Azithromycin, oral, 500mg daily for 3 days.

AND
Metronidazole,oral, 400mg 12 hourly for 14 days

IF
H.pylori -ve
-These are usually a consequence of NSAID use.
-Stop NSAID until the ulcer has healed.
-If the patient is unable to stop NSAID, refer to a
specialist.

PPI, e.g.:
Lansoprazole, oral, 60 mg daily
-Duodenal ulcer: for 14 days
- Gastric ulcer: for 28 days

40
Q

General Measures of PUD

A
  • Advise patient to avoid ulcerogenic medications, e.g. NSAIDs.
  • Advise patient to stop smoking and drinking alcohol.
  • Dietary advice by a dietician
41
Q

Essential history in Gastroenteritis

A

Essential history must be obtained while simultaneously assessing vital signs and hydration.

  • Is the child vomiting; how much?
  • When was the last oral intake?
  • Stools: blood, mucus, amount, consistency, frequency;
  • Diet: malnutrition risk;
  • Other systems: especially heart/lung disease
  • Use of oral rehydration solution;
  • Length of history (if > 10 days of loose stools, manage for ‘persistent’ or ‘chronic’ diarrhea).

GIT E.E (1 decks)

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