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GIHEP > L6: Gastroenterology - A Symptoms Based Approach > Flashcards

L6: Gastroenterology - A Symptoms Based Approach Flashcards

1
Q

According to the bristol stool chart, which types are considered to be “normal”?

A

Type 3 or 4

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2
Q

What is the definition of diarrhea?

A

increased frequency and liquidity of faecal evacuation (frequency > 3 a day)

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3
Q

What is considered acute diarrhea?

A

less than 7 days

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4
Q

What is considered persistent diarrhea?

A

occurs for between 14 to 21 days

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5
Q

What is considered chronic diarrhea?

A

occurs for more than 1 month

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6
Q

List some of the characteristics of small bowel diarrhea

A
  • watery
  • large volume
  • cramping, bloating, gas
  • weight loss
  • no blood
  • rarely fever
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7
Q

List some of the characteristics of large bowel diarrhea

A
  • frequent
  • small volume
  • blood present
  • mucus
  • fever common
  • rarely weight loss
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8
Q

How many stools/day would be considered a trait of severe diarrhea?

A

6 stools/24 hours

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9
Q

What is steatorrhea? Why does it occur? How does it appear?

A

fat in the stool; due to fat malaborption

- appears as pale stools

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10
Q

What is tenesmus? What may be some causes of this?

A

Tenesmus: sensation that rectum is full; need to go to the washroom

may result from proctitis or a rectal issue
- can also be a tumour!

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11
Q

Why may tenesmus be concerning? (i.e. why should it be investigated?)

A

There may be a tumour present near/around the rectum that is causing the feeling of fullness and need to go to the washroom

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12
Q

PPIs may increase the risk for what type of diarrhea?

A

C. difficile - associated diarrhea

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13
Q

What are the effects of opioids in the GIT and what can it cause?

A
  • opioids inhibit gastric emptying and inhibit peristalsis in the GIT
  • leads to hardening of stool and constipation

opioids a/w with OVERFLOW DIARRHEA

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14
Q

Which bacteria cause bloody diarrhea?

A

campylobacteria, shigella, salmonella

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15
Q

Which bacteria cause non-bloody diarrhea?

A

norovirus, c. difficile, cholera

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16
Q

If stool is described as yellow, loose and difficult to wash away - what is this describing?

A

Steatorrhea (fat in the stool)

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17
Q

What is a medication that may cause diarrhea? (hint: PPI and what else?)

A

Metformin

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18
Q

What is malabsorption? (definition)

A

impaired absorption of digested food caused by alterations of the intestinal mucosa

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19
Q

What are the 4 categories of malabsorption?

A
  1. Intestinal
  2. Pancreatic
  3. Biliary
  4. Other
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20
Q

Malabsorption is characterized by what 3 things?

A
  1. Diarrhea
  2. Steatorrhea
  3. Weight Loss
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21
Q

What are some examples of intestinal malabsorption (or intestinal causes of malabsorption)?

A

coeliac disease
crohn’s disease
giardiasis
whipple’s disease

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22
Q

What are some examples pancreatic malabsorption (or pancreatic causes of malabsorption)?

A

Main One = chronic pancreatitis
cystic fibrosis
pancreatic cancer

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23
Q

What are some examples of biliary malabsorption (or biliary causes of malabsorption)?

A

biliary obstruction

primary biliary cirrhosis

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24
Q

What can hypercalcaemia cause?

A

constipation

25
Q

What are haemorrhoids?

A

they are swollen and inflamed veins in the rectum or anus

26
Q

What are anal fissures?

A

small tears in the anus

27
Q

List the complications of constipation

A
  • haemorrhoids
  • anal fissures
  • rectal prolapse
  • fecal impaction
28
Q

What is the connection between the brain-gut axis and constipation?

A

patients become constipated due to ignoring the urge to have a bowel movement/for psychological reasons

  • treated w/ biofeedback
29
Q

Laxatives are used to treat what condition?

A

constipation

30
Q

What are some non-medicinal treatments for constipation?

A
  • changes in diet/nutrition
  • exercise and lifestyle changes
  • biofeedback
31
Q

What are some medicinal treatments for constipation?

A
  • Bulk Forming Agents
  • Osmotic Laxatives
  • Stimulant/Irritant Laxatives
  • Stool Softeners
  • Cholinergic Agonists
32
Q

What are the 5 F’s of abdominal distension and bloating? (5 possible causes)

A 
Fluid
Faeces
Flatus
Foetus
Fat
33
Q

List some of the symptoms of oesophageal disease

A 
heartburn
regurgitation
chest pain
dysphagia 
odynophagia 
globus sensation
water brash
34
Q

What is odynophagia?

A

painful swallowing

35
Q

What symptoms of oesophageal disease should raise a red flag?

A

dysphagia

odynophagia

36
Q

What is globus sensation/globus pharyngeus?

A

tightness in the throat/sensation of a constant lump in throat without any difficulty of swallowing

  • mainly psychological
37
Q

What are the “mechanical” causes of dysphagia?

A

oesophageal cancer
peptic stricture
achalasia
inflammatory (oesophagitis)

38
Q

What are the clinical features/symptoms of achalasia?

A

dysphagia, regurgitation and CHEST PAIN*

39
Q

What is achalasia? What imaging is used and how does it appear?

A

narrowing of the LES

barium swallow used - Bird Beak appearance

40
Q

What is a possible treatment of achalasia?

A

botox injection

41
Q

What is a possible complication of oesophagitis?

A

narrowing of eosophagus causing a stricture

42
Q

What is a possible complication of diverticulae in the eosophagus?

A

food may get stuck in the pouches

43
Q

What is the Schatski ring? How would it present?

A

thin, web like constriction located @ squamocolumnar mucosal junction or near border of LES

dysphagia to solids is the only symptom

44
Q

What is eosinophilic oesophagitis? What is the treatment for it?

A

huge amount of eosinophils in oesophagus; can get dysphagia
a/w asthma and eczema
treated w/ PPI

45
Q

What is eosinophilic oesophagitis associated with?

A

asthma and eczema

46
Q

Clubbing of the fingers is associated with which conditions?

A

IBD, cirrhosis, coeliac disease

47
Q

Leuconychia is associated with what condition?

A

hypoalbuminaemia

48
Q

What is koilonychia associated with?

A

iron deficiency anaemia

49
Q

What is dupytren’s contracture associated with?

A

excess alcohol

50
Q

What is palmar crease pallor associated with?

A

anaemia

51
Q

What is angular stomatitis? What is it associated with?

A

causes swelling around sides of mouth; a/w iron or b12 deficiency

52
Q

Aphthous ulcers are associated with what?

A

Crohn’s or Coeliac disease

53
Q

What is Felty’s Syndrome? What triad is it a/w?

A
  • a rare subtype of rheumatoid arthritis

- characterized by arthritis, splenomegaly*, and neutropenia

54
Q

What gastrointestinal condition can NSAIDs cause?

A

colitis

55
Q

A Schatski Ring may only present with 1 symptom which is…

A

dysphagia to solids

56
Q

What is a hepatic flap a/w?

A

hepatic encephalopathy or uraemia

57
Q

What is conjunctival pallor a/w?

A

anaemia

58
Q

What is scleral icetrus a/w?

A

liver disease/jaundice

59
Q

What is xanthelasma a/w?

A

hyperlipidaemia + PBC

GIHEP (24 decks)

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