GORD and gall bladdrt Flashcards
which muscles contract during no eating
two sphincters
when does the lower oesophageal sphincter relax
swallowing
pre disposing factors for GORD
obesity
sclerosis
hiatus hernia
symptoms of GORD
heartburn
cough
nocturnal asthma
when to give an OGD
over 55 with alarm symptoms
alarm symptoms which equire ODG
weight loss, dysphagia, haematemesis, anaemia
difference between magnesium and aluminium antacids
Magnesium-containing antacids cause diarrhoea aluminium-containing may cause constipation
how do dopamine antagonist prokinetic agents help
speed peristalsis
examples of dopamine antagonist prokinetic agents
metoclopramide
H2-receptor antagonists examples
cimetidine, ranitidine
PPI reduce
gastric acid secretion
what can barrets turn into
oesophageal adenocarcinoma
most common type of gall stone
cholesterol
what is cholesterol held by so it cant cause stones
bile salts
bile salt + cholesterol =
micelles
gall stones risk factors
age, female, family history
Obesity metabolic syndrome
Rapid weight loss, Ileal disease or resection, Multiparity
Diet, Diabetes mellitus, octreotide, Liver cirrhosis
why does ileal disease cause gall stones
bile salt loss
other type of gall stone
pigment stone
whats in pigment stones
bilirubin polymers and calcium bilirubinate
which people get pigment stones
people with chronic haemolysis
what is biliary pain
pain associated with the temporary obstruction of the cystic duct or CBD
where might gall stone pain radiate
right shoulder and the right subscapular region
other symptom with gall stones
vomitting
what serum levels are high in gall stones
ALP
billirubin
inflammation of the gall bladder
cholecystitis
what happens to get cholecystitis
impaction of a stone in the cystic duct or neck of
the gall bladder
acalculous cholecystitis
cholecystitis without a stone
sign with cholecystitis
murphys
what is murphys sign
more pain on inspiration
what scan to do for cholecystitis
US
what will an US show for cholecystitis
thickened walls and distended
management of cholecystitis
nil by mouth, intravenous fluids, pain
relief and intravenous antibiotics
what antibiotic might you give for cholecystitis
cefotaxime
when might the gall bladder appear small and shrunken
chronic cholecystitis
what will you be intollerant to with cholecystitis
fatty food
Acute cholangitis
infection of the biliary tree
Acute cholangitis symptoms
fever, jaundice and right upper quadrant pain
rigors
dark urine, pale stool, itchy skin
investigations for Acute cholangitis
WWC Blood cultures are positive Liver biochemistry US MRCP can further assess the site and cause of obstruction ERCP
WCC for Acute cholangitis
leucocytosis
Acute cholangitis liver biochem
raised serum bilirubin and and alkaline phosphatase.
Acute cholangitis US shows
dilated CBD
Acute cholangitis ERCP is an investigation but can also
allow biliary drainage
Acute cholangitis antibiotic
third-generation cephalosporin
third-generation cephalosporin example
cefotaxime
choledocholithiasis
Common bile duct stones
