Mind maps qs Flashcards
Causes of Upper Gastrointestinal bleeding
Oesophageal varices Gastritis Peptic ulcers Mallory-Weiss tear Malignancy
Causes of Lower GI bleeds
Haemorrhoids Polyps Angiodysplasia Infectious diarrhoea Malignancy Inflammatory Bowel Disease (2 types)
2 types of IBD
Crohns disease
Ulcerative colitis
Regions of abdomen
Right hypochondriac (top right abdomen) Epigastric Left hypochondriac Right lumbar Umbilical Left lumbar Right iliac Hypogastric/suprapubic Left iliac (bottom left abdomen)
Causes of abdominal pain in right hypochondriac region
Pancreatitis
Ulcer (gastric)
Gallstones
Biliary colic
Causes of abdominal pain in epigastric region
Heartburn Pancreatitis Epigastric hernia Gallstones Ulcer (gastric)
Causes of abdominal pain in left hypochondriac region
Pancreatitis
Ulcer (gastric or duodenal)
Causes of abdominal pain in right lumbar region
Kidney stones
Urinary tract infection
Constipation
Causes of abdominal pain in umbilical region
Gastric ulcer Early stages of appendicitis Aortic aneurysm Ruptured aortic aneurysm Pancreatitis IBD
Causes of abdominal pain in left lumber region
Kidney stones Urinary tract infection Constipation Inflammatory Bowel Disease (IBD) Diverticular disease
Causes of abdominal pain in right iliac region
Appendicitis
Ectopic pregnancy
Ovarian torsion
Inguinal or femoral hernias
Causes of abdominal pain in hypogastric/suprapubic region
Urinary tract infection
Appendicitis
IBD
Diverticular disease
Causes of abdominal pain in left iliac region
Diverticula disease IBD Ectopic pregnancy Ovarian torsion Inguinal or femoral hernias
Causes of GI malabsorption
These Definitely Cause Absorption Problems: Tropical sprue Disaccharidase deficiency Coeliac disease and Crohn's disease A-beta-lipoproteinaemia Pancreatic insufficiency
Which part of GI tract is affected by tropical sprue
Idiopathic
Can affect all of small intestine
Treatment of GI malabsorption as result of tropical sprue
Folic acid
Tetracycline
Cause of Coeliac disease
Autoantibodies to gliadin
Proximal small intestine mainly affected
Treatment of coeliac disease
Gluten-free diet
What is A-beta-lipoproteinaemia
Autosomal recessive disorder
Results in the inability to synthesise chylomicrons
Treatment of GI malabsorption as result of A-beta-lipoproteinaemia
Vitamin E
Cause of Whipple’s disease
Tropheryma whipplei (gram-positive bacterium)
Treatment of Whipple’s disease
Antibiotics for 1-2 years
Cause of disaccharidase deficiency
a deficiency in enzymes required for digestion and absorption e.g. beta-glycosidase complex
Treatment of disaccharidase deficiency
Restricted diet
Cause/pathology of pancreatic insufficiency
Diseases such as cystic fibrosis, cancer and pancreatitis
Results in the deficiency of vitamins A, D, E, K (fat soluble vitamins)
Treatment of pancreatic insufficiency
Pancrelipase
Causes of GI inflammation
Gastritis
Irritable Bowel Syndrome
Appendicitis
Inflammatory Bowel Disease (Ulcerative colitis and Crohn’s disease)
What is gastritis
Inflammation of the stomach lining
May be acute or chronic
Cause of acute gastritis
Stress Uraemia Alcohol NSAIDs Burns: Curling's ulcer
Types of chronic gastritis and their causes
Type A:
Autoimmune - autoantibodies are present to parietal cells
Presents with pernicious anaemia
Occurs in the fundus or body of the stomach
Type B (more common):
Associated with Helicobacter pylori infection
Investigations for H.pylori infection (gastritis)
Bloods - anaemia and H.pylori
Urinalysis
Blood test - measures antibodies to H.pylori
Carbon isotope - urea breath test
Endoscopy with biopsy of stomach lining
Stool microscopy and culture (may detect trace amounts of H.pylori)
Treatment of gastritis
Triple therapy to eradicate H.pylori
Step wise approach to treating gastritis:
Mild or Moderate/severe
Treatment of mild gastritis
antacids or H2 receptor antagonists
Treatment of moderate/severe gastritis
PPI
Triple therapy to eradicate H.pylori
Proton pump inhibitor and
Clarithromycin and
Metronidazole or Amoxicillin
Gastritis complications
Peptic ulcers
Anaemia (from bleeding ulcers)
Stricture formation
Mucosa-associated lymphoid tissue (MALT) lymphoma
What is appendicitis
Inflammation of appendix that presents with pain that can originate in the umbilical area before migrating to the right iliac fossa
Investigations of appendicitis
Diagnosis is clinical:
Bloods - FBCs, U and Es, CRP
Ultrasound
Pregnancy test in females of child bearing age to rule out ectopic pregnancy
Treatment of appendicitis
Surgical excision
Complications of appendicitis
Peritonitis
