itis of the GI tract

Question 1

pathology of appendicitis

Answer 1

obstruction
bacterial invasion
necrosis

Question 2

signs of appendicitis

Answer 2

anorexia
pyrexia
pain radiating from umbilicus to McBurney’s point
bowel habit change

Question 3

complications of appendicitis

Answer 3

perforation

peritonitis

Question 4

diagnosis of appendicitis

Answer 4

CT

Question 5

treatment of appendicitis

Answer 5

fluid resuscitation

laparoscopic appendicectomy

Question 6

risk factors for diverticulitis

Answer 6

low fibre diet - leads to pressure changes in sigmoid colon

Question 7

pathology of diverticulitis

Answer 7

abrasion or perforation of herniated mucosa

inflammation and granulation tissue

Question 8

symptoms of diverticulitis

Answer 8

altered bowel habit

abdominal pain

Question 9

complications of diverticulitis

Answer 9

fistula into vagina, bladder, or small bowel

per-colic abscess

Question 10

diagnosis of diverticulitis

Answer 10

barium enema

endoscopy

Question 11

treatment of diverticulitis

Answer 11

surgery

antibiotics

Question 12

risk factors for acute gastritis

Answer 12

drugs (e.g. NSAIDs)

excessive alcohol consumption

Question 13

causes of acute gastritis

Answer 13

chemical injury
Helicobacter infection
inhibition of prostaglandin synthesis
Diminished mucous secretion

Question 14

pathology of acute gastritis

Answer 14

surface epithelial degeneration leads to regenerative hyperplasia of pit-lining epithelium
vasodilation/congestion
neutrophil polymorph response

Question 15

symptoms of acute gastritis

Answer 15

indigestion
gnawing or burning stomach pain
nausea and vomiting
feeling full after eating

Question 16

diagnosis of acute gastritis

Answer 16

blood test (check for H.pylori)
endoscopy
gastric tissue biopsy

Question 17

treatment of gastritis

Answer 17

antacids (magnesium triscillicate mixture)
H2 blockers (ranitidine)
PPIs (omeprazole)
antibiotics (amoxicillin, tetracycline)

Question 18

risk factors for chronic gastritis

Answer 18

B12 deficiency

Helicobacter infection

Question 19

pathology of chronic gastritis

Answer 19

can be autoimmune process or vitamin B12 deficiency 
lymphocyte and plasma cell response
glandular atrophy 
laminar propria fibrosis
intestinal metaplasia

Question 20

signs of chronic gastritis

Answer 20

hypochlorhydria
pernicious anaemia
nausea
indigestion

Question 21

diagnosis of chronic gastritis

Answer 21

occult blood test
FBC
endoscopy
gastric biopsy

Question 22

risk factors for ischaemic colitis

Answer 22

hypotension

thrombosis

Question 23

pathology of ischaemic colitis

Answer 23

restriction of blood flow to colon due to low systemic bp, restriction, or occlusion

Question 24

signs of ischaemic colitis

Answer 24

abdominal tenderness/pain
low bp 
tachycardia
lower GI bleeding
fever

Question 25

complications of ischaemic colitis

Answer 25

peritonitis

sepsis

Question 26

diagnosis of ischaemic colitis

Answer 26

test bowel blood O2 sats by light spectroscopy (via endoscopy)
endoscopy with biopsy

Question 27

treatment of ischaemic colitis

Answer 27

IV fluids to treat dehydration

antibiotics

Question 28

what causes peritonitis?

Answer 28

anything that shouldn't be in the peritoneal cavity 
inflamed organ 
pus
air
faeces
blood

Question 29

where is visceral peritoneum pain localised to?

Answer 29

nerve roots

Question 30

where is parietal peritoneum pain localised to?

Answer 30

where the problem is

Question 31

complications of peritonitis

Answer 31

sepsis
multi-organ failure
cardiovascular events
respiratory complications (due to pressure on diaphragm)
hypovolaemic shock and renal failure (disturbed electrolyte balance)
abscess

Question 32

diagnosis of peritonitis

Answer 32

CT

Question 33

treatment of peritonitis

Answer 33

IV fluids and catheter
broad spectrum antibiotics
surgery - wash out peritoneal cavity and remove dead/inflamed tissue

Question 34

mortality rate of peritonitis

Answer 34

15%

Question 35

what is peritonism?

Answer 35

tensing of muscles to prevent movement of peritoneum

Question 36

how many hospital admissions a year in the UK for peritonitis?

Answer 36

370,000

Question 37

risk factors for peritonitis

Answer 37

male
ruptured sexual organs
ectopic pregnancy 
trauma
surgery 
ascites

Question 38

signs of peritonitis

Answer 38

sudden acute onset of abdominal pain 
pain exacerbated by movement
pain is generalised and becomes localised
shock 
fever
washboard rigidity
fever
sinus tachycardia 
nausea and vomiting
abdominal swelling

Question 39

treatment of peritonitis

Answer 39

IV fluids
IV antibiotics
wash out abdominal cavity with 6L warm saline and take out dead or inflamed tissue
physiotherapy to help patients take deep breaths
nutritional support (to stop patient getting an ileus)