GIT Investigations Flashcards
What are the 2 most important investigations with any patient?
History
Examination
What bedside investigations should be done?
BMI Pulse ECG Capillary glucose Urinalyssis
What does capillary glucose investigate?
Diabetes
High blood glucose
What score must be carried out for malabsorptive patients?
MUST
Why should an ECG be carried out for abdominal patients?
Distinguish between upper abdomen or chest pain
What is stool analysed for?
FOBT
Stool culture
Faecal calcprotectin
Faecal Elastase
What is FOB?
Blood in the bowels
When is stool culture particularly important?
For diarrhoea
When is faecal calcprotectin important?
Inflammatory signs e.g IBD
When is faecal elastase important to test for?
Investigations of pancreatic insufficiency/malabsorption
What LFT should be carried out?
Bilirubin Aminotransferases ALT/ALT Alkaline Phosphatase/ALP Gamma GT Albumin Prothrombin time Creatinine Platelet count
What are aminotransferases?
Enzymes used in breaking down proteins
ALT
AST
What result suggests problem with aminotransferases?
Elevated aminotransferases
Excess levels are leaked into blood stream when hepatocytes are damaged
What is alkaline phosphatase?
Enzyme present in cells lining biliary ducts
What results suggest pathology with alkaline phosphatase?
Elevated levels
What is Gamma GT?
Non-specific liver enzyme
When is Gamma GT elevated?
In alcohol abuse
What do low levels of albumin suggest?
Chronic liver disease
What can elevated CRP suggest?
Inflammation
Generally high in Crohns disease
Why should WBC be checked for?
Inflammation
In blood analysis what should be checked fro in hepatic screens?
HBC and HCV serology Autoantibodies Immunoglobulins Ferritin Alpha 1 antitrypsin Alpha fetoprotein
What does alpha fetoprotein suggest?
Cancer bio marker
What is a urea breath test used to test for?
H/pylori
What does an UGIE examine?
Oesophagus to duodenum
Why is fasting required for UGIE?
To ensure no food gets in the way of camera view
What does UGIE allow for?
Biopsy and therapeutic intervention
Give example of therapeutic intervention that can be carried out with UGIE
Oesophageal stenting
Pyloric stenting
Give an example of diagnostic technique that can be carried out with UGIE
Biopsy
What are some risks from UGIE?
Aspiration
Perforation
Haemorrhage
What does colonoscopy investigate?
Rectum to caecum
What does colonoscopy allow for?
Biopsy and polypectomy
What is polypectomy?
Removal of polyps
What are the risk fo colonoscopy?
Perforation
Hameorrhage
Renal impairment
What is ERCP?
Endoscopic retrograde cholangio-pancreatography
What does ERCP allow visualisation of?
Ampulla
Biliary system
Pancreatic ducts
What are the risks of ERCP?
Pancreatitis Haemorrhage Perforation Infection Mortality
What is endoscopic ultrasound used for?
Diagnosis and staging
What does EUS allow for?
Diagnosis
Staging
Biopsy
Cyst Drainage
Where are RBC broken down?
Spleen
What does increased creatinine suggest?
Renal impairment
Decreased eGFR
Where is albumin made?
Liver
Why can hypoalbuminaemia lead to oedema?
As oncotic pressure extravascular space>intravascular space
Which antibodies are measured in coeliac serology?
Tissue transglutaminase
What is oesophageal pH manometry used to detect?
Motility of GIT
Level of acid exposure
Records acid levels
In which cancers if alpha fetoprotein normally found?
Liver
Non-sematomous
What is ERCP a major risk factor for?
Pancreatitis
Why is a colonoscopy and endoscopy diagnostic?
Because biopsies can be taken
