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Western Med > Illness script - week 6 > Flashcards

Illness script - week 6 Flashcards

1
Q

GIT disorders

31% _____ and 29% _____ are the most common causes to a GP for acute _____ pain

A

GIT disorders

31% appendicitis and 29% colics are the most common causes to a GP for acute abdomen pain

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2
Q

GIT disorders

hospital presentations most commonly for abdomen pain are _____ (34%), _____ (34%), and _____ (10%)

A

GIT disorders

Hospital presentations most commonly for abdomen pain are non-specific (34%), appendicitis (34%), and cholecystitis (10%)

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3
Q

Probability diagnosis of GIT

1) acute _____ and _____
2) _____
3) _____ _____ _____
4) _____ and _____ colic

A

Probability diagnosis of GIT

1) Acute gastroenteritis and appendicitis
2) Dysmenorrhoea
3) Irritable bowel syndrome
4) Biliary and renal colic

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4
Q

Pitfalls of abdominal pain

1) acute _____
2) _____ _____
3) _____ causes
4) _____
5) _____ _____
6) _____ _____

A

pitfalls of abdominal pain

1) acute appendicitis
2) myofascial tear
3) pulmonary causes
4) pneumonia
5) pulmonary embolism
6) faecal impaction

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5
Q

abdominal diagnostic testing

1) Blood: _____, _____ _____ _____ (ERS), _____ _____ (CRP)
2) Stools: _____ blood, _____ _____ and _____
3) ______
4) Radiology: _____ scan, _____, _____
5) Endoscopy: _____, _____ with _____

A

abdominal diagnostic testing

1) Blood: haemoglobin, Erythrocyte sedimentation rate (ERS), C-reactive protein (CRP)
2) Stools: occult blood, microscopic analysis and culture
3) Urine
4) Radiology: CT scan, MRI, Ultrasound
5) Endoscopy: colonoscopy, gastroscopy with biopsy

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6
Q

endoscopy diagnostic

Sigmodoidoscopy: helps exlude local _____, searching for abnormalities in _____, _____ and _____; __% usually occurs in the first __cm of the bowel

A

endoscopy diagnostic

Sigmoidoscopy: helps exclude local disease, searching for abnormalities in blood mucus and neoplasia; 60% usually occurs in the first 60 cm of the bowel

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7
Q

Appendicitis

The rodimentary part of the colon, it’s role in immunity becomes inflamed and is in risk of perforating leading to peritonitis

A

appendicitis

The _____ part of the colon, it’s role in immunity becomes inflamed and is in risk of perforating leading to _____

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8
Q

Appendicitis

life-time risk is 1 in __ for people in america, 1/__ of appendicitis presents to hospital with a _____ _____

A

appendicitis

life-time risk is 1 in 15 for people in america, 1/3 of appendicitis presents to hospital with a perforated appendix

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9
Q

Signs and symptoms of appendicitis

1) general _____ pain that is localised to the _____ _____ _____
2) _____
3) _____ and _____

A

signs and symptoms of appendicitis

1) general abdominal pain that is localised to the right iliac fossa
2) anorexia
3) Diarrhea and constipation

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10
Q

Diagnosing appendicitis

1) _____ _____ _____
2) _____ (last resort)
3) _____ or _____ scan

A

diagnosing appendicitis

1) Full blood count
2) Laporoscopy (last resort)
3) Ultrasound or CT scan

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11
Q

Treatment of appendicitis

1) Antibiotics: if it is _____ _____
2) _____ and antibiotics: if _____

A

treatment of appendicitis

1) Antibiotics: if it is low grade
2) Surgery and antibiotics: if perforated

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12
Q

Colic

Presents as rhythmical patterns of _____ ______

Biliary colic has smaller variations in ______

Ureteric colic and intestinal colic are more during _____ of _____

A

colic

Presents as rhythmical patterns of painful contractions

Biliary colic has smaller variations in wavelength

Ureteric colic and intestinal colic are more during periods of rest

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13
Q

Colic

Intensely painful: can be faked for _____ seeking behaviour

_____ on palpations

_____ or _____ scans used to find any obstructions

A

colic

Intensely painful: can be faked for opioid seeking behaviour

Tender on palpations

Ultrasound or CT scans used to find any obstructions

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14
Q

Cholelithiasis

_____ are hard, _____-like structures that obstructs the _____ _____

_____ are formed by presence of _____ _____ which is a mix of _____, ______ deposits and _____ crystals in the galbladder or biliary ducts

A

cholelithiasis

Gallstones are hard, pebble-like structures that obstructs the cystic duct

Gallstones are formed by presence of biliary sludge which is a mix of glycoproteins, calcium deposits and cholesterol crystals in the gallbladder or biliary ducts

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15
Q

Cholelithiasis

More common in adults __-__% between __-__ years old

Ages <40 Males to females __:__
Over >40 Males to females __:__

Relationship between _____ and high diet of _____ _____

A

cholelithiasis

More common in adults 10-15% between 18-65 years old

Ages <40 Male to females 1:3
Over >40 Males to females 1:1

Relationship between disease and high diet of refined sugar

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16
Q

cholecystitis

almost always associated with obstruction of gallbladder or cystic duct by a gall stone, the obstruction may be from mucus, parasitic worm or bile tumour

the initial inflammation is _____ induced and leads to _____ damage which releases _____ and _____

A

cholecystitis

almost always associated with obstruction of gallballder or cystic duct by a gallstone, the obstruction may be from mucus, parasitic worm or bile tumour

the initial inflammation is chemically induced and leads to mucosal damage which releases phosphollipase and lysolecithia

17
Q

Dsypepsia

_____ _____ _____ most common cause

__% of population experienced at some point, but not all are caused by _____ _____

__% develops into _____ _____ _____, __ - __% of chronic _____ users have peptic ulceration

A

Dsypepsia

Gastoesophagal reflux disease most common cause

80% of population experienced at some point, but not all are caused by hiatal hernia

10% Develops into peptic ulcer disease, 10-20% of chronic NSAIDs users have peptic ulceration

18
Q

Gastroesophageal reflux disease

when _____ _____ is exposed to gastric contents for prolonged periods

factors such as delayed _____, increased _____-_____ pressure or abnormal lower _____ _____ function can lead to GORD

A

gastroesophagel reflux disease

when oesophageal mucus is exposed to gastric contents for prolonged periods

factors such as delayed emptying, increased intra-abdominal pressure or abnormal lower esophageal sphincter function can lead to GORD

19
Q

GORD

Can develop into _____ oesophagus a pre-malignant lesion that can lead to _____ _____

A

GORD

Can develop Barret oesophagus a pre-malignant lesion that can lead to oesophageal adenocarcinoma

20
Q

Treating GORD

1) _____: for rapid relief but is ineffective for long term treatment
2) _____-_____ _____ (PPI): 4 weeks
3) _____-_____ _____: 8 weeks

A

Treating GORD

1) Antacids: for rapid relief but is ineffective for long term treatment
2) Proton-pump inhibitior (PPI): 4 weeks
3) H2-receptor antagonists: 8 weeks

21
Q

Peptic ulcer

Strong associated with _____; _____ like to borrow in _____ which stimulates the chronic _____ by stimulating local inflammatory repsonse

A

peptic ulcer

Strongly associated with H.pylori; H.pylori like to borrow in mucosa which stimulates the chronic gastritis by stimulating local inflammatory response

22
Q

Peptic ulcer

_____ can impair muscosal defence which inhibits the _____ and __ (_____, _____); they are _____ that protect the function of gut _____

__% of the population is affected

A

peptic ulcer

NSAIDs can impair mucosal defence which inhibitis the COX1 and 2 (voltaren, ibuprofen); they are enzymes that protect the function of gut mucosa

2% of the population is affected

23
Q

Treating peptic ulcer

1) _____ _____ with heater probe and low _____ injection
2) IV _____/_____ or _____
3) _____ is also an option

A

treating peptic ulcer

1) endoscopic haemostasis with heater probe and low adrenaline injection
2) IV omeprazole/esomeprazole or pantroprazole
3) Surgery is also an option

24
Q

Histamine H2 receptor antagonists

_____, _____ and _____: these medications are less likely to affect _____ of other medications; they can be administered without food and patients are advised to avoid _____ _____ and _____

A

Histamine H2 receptor antagonists

Ranitidine, nizatidine and feimotidine: these medications are less likely to affect metabolism of other medications; they can be administered without food and patients are advised to avoid spicy foods and caffeine

25
Q

Proton-pump inhibitor (PPI)

Inhibits _____ _____ _____, it is more potent than _____ _____ _____ and managing conditions associated with _____

_____ is the most common medication

A

Proton-pump inhibitor (PPI)

Inhibits gastric acid secretion, it is more potent than H2 receptor antagonist and managing conditions associated with hyperacidity

Omeprazole is the most common medication

26
Q

Recurrent abdominal pain

3 distinct _____ over __ months, occurs in __% of school children

__-__% are diagnosed by organic causes, the other are psychological and emotional

A

recurrent abdominal pain

3 distinct episodes over 3 months, occurs in 10% of school children

5-10% are diagnosed by organic causes, the other are psychological and emotional

27
Q

Inflammatory bowel disease (IBD)

abnormal host response to an _____ trigger, causes the gut _____ and release of inflammatory mediators that cause _____ _____

A

Inflammatory bowel disease (IBD)

abnormal host response to an environment trigger, causes the gut inflammation and release of inflammatory mediators that cause tissue damage

28
Q

IBD

Ulcerative colitis: __/100,000
Chrohn’s disease: __/100,000

A

IBD

Ulcerative colitis: 9.8/100,000
Chrohn’s disease: 6.3/100,000

29
Q

Chrohn’s disease

More common in terminal _____ and right side of _____; the entire walls thicken and deep _____ create linear _____

This may ulcerate and form fistulas with _____, _____ and bowel

A

Chrohn’s disease

More common in terminal ileum and right side of colon; the entire walls thicken and deep ulcers create linear fissures

This may ulcerate and form fistulas with bladder, uterus and bowel

30
Q

Ulcerative colitis (UC)

involves _____ and _____ colon or even _____ colon; inflammation is confluent and affects the _____

A

ulcerative colitis (UC)

involves rectum and signoid colon or even whole colon; inflammation is confluent and affects the mucosa

31
Q

Treating IBD

1) _____, _____, _____ for treating UC
2) _____: for acute flares
3) _____ drugs for severe attacks: _____, _____
4) _____ agents: _____

A

treating IBD

1) Sulfasalazine, olsalazine, mesalazine for treating UC
2) Corticosteroid: for acute flares
3) Immunomodifying drugs for severe attacks: azathiopine, cyclosponn
4) Biological agents: infliximab

32
Q

Irritable bowel syndrome (IBS)

__-__% worldwide: most common functional GI disorder caused by _____ and _____ (__% triggered by food)

_____-_____ breath test

A

Irritable bowel syndrome (IBS)

7-21% worldwide: most common functional GI disorder caused by malabsorption and FODMAPs (90% triggered by food)

Hydro-methane breath test

33
Q

Treating IBS

1) Regular _____ pattern
2) No _____, _____, _____ and _____
3) High _____, low _____ and a lot of _____
4) Avoid _____

A

treating IBS

1) Regular eating pattern
2) No smoking, alcohol, laxatives and codeine
3) High fibre, low carbs and a lot of water
4) Avoid FODMAPs

34
Q

Diverticulitis

long-life and _____ deficient diet; small stools require higher _____-_____ pressure resulting in herniation of the _____

A

diverticulitis

long-life and fibre deficient diet; small stools require higher intra-colic pressure resulting in herniation of the mucosa

35
Q

diverticulitis

<40 years old: __%
>80 years old: __%
~__% of patients have at least 1 _____

A

diverticulitis

<40 years old: 10%
>80 years old: 70%
~20% of patients have at least 1 recurrence

36
Q

Colon cancer

Common GIT _____, second most common cause of _____ in western society; Males >50 years old (__%)

Mortability rate is __%, _____ prognosis if diagnosed early

A

colon cancer

Common GIT malignancy, second most common cause of death in western society; Males >50 years old (90%)

Mortality rate is 60%, good prognosis if diagnosed early

37
Q

Duke stages

~__ year survival
A-cancer: limited to _____ and _____ __%
B-cancer: extends into _____ or _____ __%
C-cancer: involves regional _____ _____ __%
D-distant _____ 7%

A

Duke stages

~5 year survival
A-cancer: limited to mucosa and submucosa 88%
B-cancer: extends into muscularis or terosa 70%
C-cancer: involves regional lymph nodes 43%
D-distant mestastses 7%

38
Q

diagnosing colon cancer

1) _____ _____ _____ _____ (FOBT): if results are positive, _____ or _____
2) _____ scan
3) _____ every __ years after 50 years old

A

diagnosing colon cancer

1) Full occult blood test (FOBT): if results are positive, colonscopy or sigmoidoscopy
2) PET scan
3) FOBT every 2 years after 50 years old

Western Med (7 decks)

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