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Year 3 Gastro > Liver and Renal > Flashcards

Liver and Renal Flashcards

1
Q

What are some signs of chronic liver disease on examination?

A 
Asterexsis
Brusing
Clubbing
Dupytrens
Erythema (palmar)
Fetor hepticus (breath smell) 
Gynaecomastia
Itching (pruritus)
Jaundice
Spider Nevae
Caput medusae
Raised JVP
AV fistulae (renal theraply)
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2
Q

What do you look for in the mouth?

A 
Pigmentation
Gum hypertrophy (medication post renal transplant can cause this)
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3
Q

What would a right subcostal scar be from?

A

BIliary surgery

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4
Q

Mercedes-benz scar?

A

Liver transplant

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5
Q

Midline lapartomy scar?

A

GI or major abdo surgery

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6
Q

Mcburneys incision?

A

Appendicetomy

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7
Q

J-shaped incision?

A

Renal transplant

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8
Q

Low transverse?

A

Gynae procedure

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9
Q

Inguinal incision?

A

Inguinal hernia repair and vascular access

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10
Q

Loin incision?

A

Nephrectomy

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11
Q

What are the causes of hepatomegaly?

A 
Cancer
Cirrhosis
Cardiac
- Congestive heart failure
- Constrictive pericarditis

Infiltration

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12
Q

Summarise the causes of liver disesase

A 
Alcohol
Auto-immune
Drugs
Viral
Biliary disease
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13
Q

What are the causes of splenomegaly?

A

2H and 2I

portal Hypertension
Haematological

Infection
Inflammation

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14
Q

What infections can cause splenomegaly?

A 
EBV
Infectious mononucleosis
TB
Malaria
Infective endocarditis
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15
Q

What are gastro presentations?

A 
Abdo pain
Abdo distention
Change of bowel habit
GI bleed
Jaundice 
Ascites
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16
Q

What is constant pain indicative of?

A

Inflammation

and -itis disease

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17
Q

What are some causes of epigastric pain?

What from the history can help differentiate?

A

Peptic ulcer (?NSAID use)
GORD (better with antaacids)
Gastritis (retrosternal, ETOH)
Malignancy

Acute pancreatitis (gallstones, high amylase)

Pain from above - cardiac

18
Q

What are features of chronic pancreatitis?

A 
Pain
Wt loss
loss of exocrine and endocrine function
normal amylase 
faecal elastase
19
Q

What are causes of RUQ pain?

A

Gallbladder:
Cholecystitis
Cholangitis
Gallstones

Liver:
Abscess

From above: basal pneumonia

Form left: peptic ulcer or pancreatitis

From right: pyelonephritis

20
Q

What are causes of RIF pain?

A

Gynae:
Ovarian cyst rupture, twist, bleed
Ectopic pregnancy

GI
Appendicitis
Mesenteric adentis
Colitis
Malignancy
21
Q

What are causes of suprapubic pain?

A

Cystisis

Urinary retention

22
Q

What are causes of LIF pain?

A

GI
Diverticulitis
Colitis (IBD)
Malignancy

Gynae:
Ovarian cyst rupture, twist, bleed
Ectopic pregnancy

23
Q

What are some causes of diffuse abdo pain?

A 
Obstruction
Infection - peritonitis, gastroenteritis
IBD
Mesenteric ischaemia
Medical causes:
DKA
Addisons
Hypercalcaemia
Porphria
Lead poisoning
24
Q

What is porphyria?

A

Group of disorders caused by abnormalities in haem production
Can present with acute abdomen

25
Q

What can cause abdominal distension?

A

Fluid

Flatus

Fat, faeces, fetus

26
Q

What should you ask about when thinking about obstruction?

A 
N and V
Not opened bowel?
High pitched tinkling bowel sounds
Previous surgery - adhesions
Tender irreducible hernia in the groin
27
Q

What are the causes of transudate ascites?

A

High protein

- Cirrhosis

28
Q

What causes pale stool?

A

Low stercobilinogen

29
Q

What causes the different types of jaundice?

A

Pre-hepatic - haemolysis or defective bilirubin conjugation

Hepatic

Post-hepatic - biliary

30
Q

What causes the different types of jaundice?

A

Pre-hepatic - haemolysis or defective bilirubin conjugation

Hepatic - hepatitis

Post-hepatic - biliary (pain), pancreatic cancer (painless)

31
Q

When do you get dark urine?

A

Conjugated bilirubin leaks and makes it way into urine in hepatitis

Does not enter bowel so pale stools. Obstruction to flow.

32
Q

Why does bloody diarrhoea happen?

A

Loss of epithelial integreity

33
Q

What are the infective causes of bloody diarrhoea?

A

Infective colitis

  • Campylobacter
  • Haemorrhagic e. coli
  • Entamoeba histo
  • S
  • S
34
Q

What is thumb print sign?

A

Thickening of bowel

Thick haustral folds

35
Q

What is the lead pipe sign?

A

UC

36
Q

What is toxic megacolon?

A

Dilated colon more than 6cm with systemic signs

37
Q

How is a acute GI bleed managed?

A 
ABC
IV access
Fluids
G+S, X match
OGD
38
Q

How is a variceal bleed from chronic liver disease treated?

A

ABs

Terlipressin

39
Q

What is the mangement of acute abdomen?

A 
NBM
Fluids
Analgesic
Anti-emetics
Antibiotics
Monitor vitals
40
Q

What investigations for jaundiced patients?

A

FBC, LFTs, CRP

Abdo USS after fast

41
Q

What is the management for ascites?

A 
Diuretics
NA restriction
Fluid restriction
Monitor weight daily
Therapeutic paracentesis

Year 3 Gastro (39 decks)

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