Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Revision Year 2 > GIT Pathologies > Flashcards

GIT Pathologies Flashcards

1
Q

Hepatic Adenoma

Risk Factors

Symptoms

Investigations

Treatment

A

Women, Oral Contraceptive Pill

Asymptomatic, If Large = Abd Pain, Haemorrhage

LFTs, USS, CT, MRI, Liver Biopsy

Embolisation (injects substances to try to block or reduce the blood flow to cancer cells), Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hepatocellular Carcinoma (HCC)

Risk Factors

Symptoms

Investigations

Treatment

A

a1-antitrypsin deficiency, Men, Cirrhosis,
Viral / Autoimmune Hepatitis

Weight Loss, Anorexia, Abd Pain, Ascites, Polycythemia
Tender Hepatomegaly, Fever, Lymphadenopathy, Cachexia, Jaundice

ALT, AST, Increased apha-fetoprotein, CRP, ESR

Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Steatosis

A

Increased Synthesis and uptake of fatty acids from the blood. Fat Droplets form in Hepatocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Non Alchoholic Steatohepatitis

A

Once cell death is initiated Inflammation starts taking place. Fatique, Malaise, Ascites, Hepartomegaly, Jaundice, Pain
Increase in ALT > AST in contrast to alcoholic steatohepatitis which causes the opposite AST>ALT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Acute Pancreatitis

Symptoms

Investigations

Leading Causes

A

Sudden Inflammation and damage of Pancreas due to Autodigestion (zymogens prematurely converted)
usually reversible

Grey Turners Sign ((bruising along the bellybutton)
Cullens Sign (bruising along the flank)

Nausea, Vomiting, High Epigastric pain radiating back

Increase in Serum Amylase (>specific) and Lipase
CT Inflammation, Necrosis, Pseudocysts

Alcohol Abuse + Gallstones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Alcohol

A

Stimulates Cytokine release and ROS formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Acute Pancreatitis Causes

A 
Idiopathic
Gallstones
Ethanol
Steroids
Mumps Virus
Autoimmune Disease
Scorpion
Hypertryglyceridemia / Hypercalcemia 
ERCP - Endoscopic Retrogate Cholangiopancreatography 
Drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Chronic Pancreatitis

Symptoms

Investigations

Treatment

A

Persistent Inflammation
Changes to Structure (Fibrosis, Atrophy, Calcification)
Duct Dilatation, Acinar Cell Atrophy

Endoscopic Retrograde Colangiopancreatography

High Epigastric pain radiating back
Malabsorption, Loss Weight, Steatorrhoea, DM

Insulin replacement therapy, Pancreatic Enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Gallstones Causes

A

Female
Fat - Obesity
Fertile - Pregancy
Forty 40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ascending Cholangitis

A

Bacteria from gut work their way up the bile duct which is obstructed by a gallstone after stricture is caused by cancer or ERCP.

Charcots Triad - RUQ Pain, Fever, Jaundice
Cx - Septic Shock = Hypotension + Confusion

Cholecystectomy, Widen Ducts with Stent,
ERCP - remove obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Cholecystitis

A

Chronic Inflammation of Cystic Ducts, Gallstones block duct, e.coli grow in gallbladder after stasis

Pain in RUQ radiating to scapula
Pain after eating meal
Peritonitis - rebound tenderness

Positive Murphys Sign (Stop breathing while pressing the gallbladder on inhalation)

ERCP, USS, HIDA Scan (Cholecintigraphy)

Bile duct can also be obstructed leading to Jaundice but more likely to cause ascending cholangitis

Cholescintigraphy Ix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Primary Sclerosing Cholangitis

A

Autoimmune Disease (IBD)

Onion Skin Fibrosis seen in microscopy
Beaded appearance of bile ducts

Genetic Link
HLA-B8, HLA-DR3, Human Leukocyte Ag

Ix IgM, p-ANCA, ALP, GGT

Cx Portal Hypertention, Pruritus,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hypetrophic Pyloric Stenosis

A

Gastric Outlet Obstruction in Infants
Non Bilous Projectile Vomiting
Paplable olive-shaped mass in epigastric region
USS shows thickened and lengthened pylorus
Tx Pyloromyotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Annular Pancreas

A

Abnormal rotation of ventral pancreatic buds causing duodenal narrowing and vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pancreas Divisum

A

Abnormal fusion of ventral and dorsal pancreatic buds

chronic abdominal pain and pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Esophageal Atrisia

A

Bilous Vomiting and abdominal distension
Duodenum: Double Bubble on Xray
Jejunal: Disruption of mesenteric veins - ishcaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Courvoisier sign

A

Enlarged Gallbladder with painless Jaundice

Obstruction of common bile duct due to tumour in head of the pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hernias

A

Protrusion of peritoneum through and opening. Contents might be at risk of ischaemia.
Tenderness, erythema and Fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Achalasia

A

Failure of LOS to relax leading to progressive dysphagia to solids and liquids and possible solid obstruction. (Degenerative changes
Barium Swallow shows dilated oesophagus with an area of distal stenosis
Oesophageal Manometry shows decreased peristalsis
Video Fluoroscopy of Swallow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

GORD

Causes and Complications

A

Heartburn, Hoarseness, Dysphagia, Regurgitation
Associated with Asthma
Leads to Barret Oesophagus (stratified squamous epithelium turns simple columnar with goblet cells)
Increased risk of adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Cancer Prevalence

A

Upper 2/3 rds Squamous Cell Carcinoma
Alcohol, Strictures, Smoking, Achalasia

Lower 1/3 rd Adenocarcinoma
Barret, Obesity, GORD, Smoking, Achalasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Acute Gastritis Causes

A

NSAIDs,

Brain Injury increasing vagal stimulation and therefore Ach and H+ production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Chronic Gastritis Cuases

A

Mucosal Inflammation leading to atrophy and intestinal metaplasia. H.Pylori Increase risk of peptic ulcer and
Autoimmune Abs to parietal cells and Intrinsic factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Gastric Adenocarcinoma

A

Acanthosis Nigricans
Nausea, Vomiting, Dysphagia, Haematemesis, Malaena
Virchow node involvement of left supraclavicular node
H.Pylori, Nitrosamines, Tobacco
Mucus Secreting Cells

Gastroscopy, Barium meal
Endoscopic USS, CT Thorax/Abd, FDG-PET

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Gastric Ulcer

A

Malignant
NSAIDs associated
Pain Increases with eating so looses weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Duodenal Ulcer

A

Benign
H.Pylori, Zollinger Elisson Syndrome associated
Pain decreases with eating so gain weight
Hypertrophic Brunners Glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Ulcer Complications

A

Haemorrhage, (G, D)
Obstruction - Pyloric or Duodenal Obs
Perforation (D) - free air under diaphragm with referred pain to the shoulder via irritation of phrenic nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Celiac Disease

A

Autoimmune intolerance to gliadin - 1% population
Malabsorption and Steatorrhoea– failure to thrive as a child; iron deficiency anaemia, fatigue,
GI symptoms – loose stool, abdominal pain

Risk Factors: HLA-DQ2, HLA-DQ8
Cx: Dermatitis Herpetiformis

Ix: Anti Tissue Transglutaminase, anti-Endomysial, gliadin peptide Abs, Villous Atrophy,
D-xylose test to see if mucosal absorption is affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Lactose Intolerance

A

Osmotic Diarrhoea with decreased stool pH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Whipple Disease

A 
Tropheryma Whipplei
Foamy Macrophages
Cardiac Symptoms
Arthralgias
Neurological Symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

MacBurneys point

A

1/3 rd of a distance from right anterior superior iliac spine to umbilicus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Rovsings Sign

A

palpation of the left iliac fossa causing pain to be felt in the right iliac fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Differential Diagnosis safe choices

A

Idiopathic, Drugs,

34
Q

Biliary Pain

A

Epigastrium + sometimes RUQ

Cholestasis features - pale stools, dark urine, jaundice

35
Q

Persistent Right upper quadrant discomfort

A

Hepatic Distension due to RHF or hepatic disease

36
Q

Pancreatic Pain

A

Epigastric and radiates to the the back

Fatty Foods and alcohol are common precipitates

37
Q

Foregut Pain

A

Gastroduodenal Pain in Epigastrium
Eating will relieve Acidic, Dyspeptic symptoms
Exacerbate Obstructive/Irritative causes

38
Q

Midgut Pain

A

Small Intestine
Colicky, Periumbilically
Bloating, Nausea, Vomiting

39
Q

Hindgut Pain

A

Colicky

Change in Bowel Habits and Rectal Bleading

40
Q

Peritonic Pain

A

Highly Localised - sensory innervation

41
Q

Jaundice Causes

A

PreHepatic - Haemolysis (excess Hb Destruction)

Hepatic - Hepatitis (LFTs abnormal, ALT)

PostHepatic - (Pancreas,
Cancer, Biliary Stones (AST - tissue injury indicative)

42
Q

Gilbert’s Syndrome

A

Unconjugated Hyperbilirubinaemia

Jaundice after Exercise

43
Q

Jaundice Ix

A

BT’s, LFT’s, Viral hepatitis Serology
IgG, IgA, IgM
MRCP - Magn Resonance CholangioPancreatography, Liver Ultrasonography, EUS (Endoscopic Ultrasound),
Endoscopic Retrogade Cholangiopancreatographhy

44
Q

Ascites
Exudate
Transudate

A

> 30, Pancreatitis

<25, Liver Disease, HF

45
Q

Causes of Increased portal venous pressure

A 
Cirrhosis
Vascular Obstruction (Portal Vein Thromb, Budd Chiari)
46
Q

Pathogenesis in Colorectal Cancer

A

APC (Adenomatous polyposis coli) gene loss
- Decreased intracellular adhesion
- Increased Proliferation
KRAS mutation - Unregulated Intracellular Signalling
- Adenoma
Loss of p53, DCC (Tumour Suppressor Genes)
- Tumorigenesis
- Carcinoma

47
Q

Colorectal Cancer

RF, Presentation, Ix

A

Hereditary Non Polyposis colorectal cancer
Family History

Iron Deficiency
Colicky Pain
Hematochezia

Flexible Sigmoidoscopy
Feacal Occult Blood Testing FOBT
Feacal Immunochemical Testing FIT
Apple Core Lesion on Barium Enema
CEA tumour biomarker recurrence screening
48
Q

exophytic mass

infiltrating mass

A

“ball-shaped” mass - compresses
ascending colon

“bean-shape’’ of kidney maintained - invades
descening colon

49
Q

Bacterial Peritonitis

A

Gram -ve Klebsiella, E.coli
Gram +ve Streptococcus
Paracentesis with ascitic fluid
ANC - absolute neutrophil count

50
Q

Alcoholic Liver Disease Ix

Viral Hepatitis

Liver Disease Ix

A

AST > ALT ? 1:1? , gamma glutamyl transferase

AST>ALT 2:1

ALT > AST, Decreased Albumin and Platelets,
Increased Bilirubin and Prothrombin time

51
Q

Hepatic Encephalopathy

A

Increase NH3 production (GI Bleed, constipation, infection)
Dereased NH3 removal (Diuretics, TIPS, renal failure)
Treatment: Lactulose, Neomycin

52
Q

Budd Chiari Sydrome

A

Thrombosis or Compression of hepatic veins
Hepatic Outflow Obstruction

Triad: Abdominal pain, ascites, and hepatomegaly

53
Q

Wilson Disease

Gilberts Syndrome

Hemochromatosis

A

AR, Increased Copper

Decreased UDP-glucuronosyltransferase conjucation
Increased Bilirubin
Increased Iron

54
Q

IgM

IgG

IgA

A

IgM is an indicator of a current infection,

IgG indicates a recent or past exposure to the illness

IgA - mucosal surfaces, serum immunoglobulin,

55
Q

Biliary Colic

A

Stone in cystic duct - RUQ Pain, nausea, vomiting

56
Q

Choledocholithiasis

A

Gallstone in common bile duct (Increased ALP, GGT)

57
Q

Pancreatitic Insufficiency Manifestations

A

Steatorrhea,
Fat Soluble Vitamin (ADEK) Deficiency
Diabetes Mellitus

Acute Pancr. Amylase and Lipase are elevenated

58
Q

Pancreatic Adenocarcinoma

A

Abd Pain radiating to the back
Weight Loss
Migratory Thrombophlebitis (redness and tenderness on palpation of extremities - Trousseau Syndrome)
Courvoisier Sign (Obstructive Jaundice with palpable non tender gallbladder)

Tx Whipple Procedure, Chemo, Radiotherapy

59
Q

Whipple Procedure

A

Pancreaticoduodenectomy
removes the head of the pancreas,
first part of the small intestine (duodenum),
the gallbladder and the bile duct.

60
Q

Histamine-2 Blockers

A

-dine eg. Ranitidine
Decrease H+ secretion from parietal cells
PU, Gastritis, Mild Esophageal Reflux

61
Q

PPI

A

-zole eg. Omeprazole
Irreversibly Inhibit H+/K+ ATPase
PU, Gastritis, Esophageal Reflux, ZE Syndrome

62
Q

Laxatives for Constipation

Adverse Effect

A

Bulk Forming - Methylcellulose - Promotes Peristalsis
- Bloating

Osmotic - Mg Hydroxide - Draws Water into GI lumen

Stimulants - Colonic Contraction (Enteric Nerve Stimul)

AE: Diarrhoea

63
Q

Gastroscopy Cx

A 
Iron Deficiency
Vit B12 / Vit D Deficiency
Dumping syndrome
Alkaline reflux Oesophagitis
Anastomotic Stricture
64
Q

Dumping syndrome

A

Weakness,
abdominal discomfort,
abnormally rapid bowel evacuation,
occurring after meals

65
Q

Acanthosis nigricans

A

Brown to black, poorly defined, velvety hyperpigmentation of the skin.
usually found in body folds

66
Q

Achalasia Treatment

A

Endoscopic injection of botulinum toxin

Hydrostatic balloon under imaging to dilate LOS

67
Q 
18 month history
Heartburn
Water brash
Belching
Pain on Swallowing
A

Hiatus Hernia with reflux oesophagitis (sliding hearnia is also usually associated)

Oesophageal pH monitoring

Antacids (Al/Mg Hydroxide)
PPIs

68
Q

H.Pylori Tx

A

PPI (Omeprazole)
Clarythromycin
Amoxycillin

69
Q

hematemesis

A

Coffee ground (coagulated blood) vomiting

70
Q

Budd Chiari Syndrome

A

Hepatomegaly
Ascitis
Abd Pain

71
Q

Conjugated

Uncojugated Bilirubin

A 
Coca Cola Urine (Post Hepatic/Hepatic)
Urine Normal (Haemolysis)
72
Q

Osmotic Laxatives
Stimulants
Bulking Agents

A

Lactulose
Senna (Motility)
Methylcellulose (Drink Water)

73
Q

Tarry Black Stool

A

Malena - Upper GI Bleed

74
Q

Commonest UGI Bleed

A

PU

Mallory Weiss

75
Q

Acute Abdomen:Investigation

A

FBC, U+E, LFT
Radiology: plain,US, axial (CT) ?other
Laparoscopy vs. laparotomy

Resuscitation
Restore circulating fluid volume
Ensure tissue perfusion
Enhance tissue oxygenation
Treat sepsis
Decompress gut
Ensure adequate pain relief
76
Q

High risk features of Rectal Bleeding

A

Persistent change in bowel habit (>6 weeks)
Persistent rectal bleeding without anal symptoms
Right sided abdominal mass
Palpable rectal mass
Unexplained iron deficiency anaemia

77
Q

Bowel anastomosis

Success Criteria
Complications

A

Tension free
Well perfused
Well oxygenated
Clean surgical site

Complications
Anaesthetic related
Bleeding
Sepsis
Anastomotic breakdown
Small bowel obstruction
Wound hernia
78
Q

Immunological Functions of

Epithelial layer

Mucus layer

Innate immune responses

Antigen presenting cells

Soluble mediators of immunity

A

Specialized tight junctions that regulate permeability

Physical barrier keeping microbes from host cells

Sensing of bacteria + anti-microbial peptides + IgA

Dendritic cells and macrophage

Chemokines and cytokines

79
Q

IBD

A

dysbiosis in microbial communities

Anti-TNF biologics - vedolizumab

80
Q

Haematemesis

Brown vomit,

Melaena

Magenta stools

Haematochezia

Dyspepsia

A

Vomiting of blood due to active haemorrhage from the oesophagus, stomach or duodenum

poor correlation with significant GI bleeding in isolation, often reflection of systemic illness

Black tar-like loose stools per rectum,
Considered as partially digested blood

Red-purple stools, typically from right colon or distal small bowel

Passage of fresh or altered blood per rectum – may be from upper GI cause as “fast transit” or lower GI

Epigastric discomfort, may be exacerbated by eating, “indigestion”

Revision Year 2 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions