Minor cases 1,2 & 3 Flashcards
Patient admitted with uncontrolled vomiting, diarrhoea, rigors, fever and positive test for HIV.
What is the immediate management priority? (4)
- Immediate antiviral therapy regardless of CD4 count (reduce risk of progression)
- Antipyretics treat fever
- Rehydration therapy, IV fluids treat diarrhoea and vomiting
- Antiemetics reduce nausea
Patient admitted with uncontrolled vomiting, diarrhoea, rigors, fever and positive test for HIV after trip to Brazil.
What diseases should be queried? (4)
- Gastroenteritis - due to vomiting, diarrhoea, fever
- Infection due to raised temperature
- Chronic diarrhoea > IBS, amalbsorbtion, medication side effect
- E. coli given travel history
Patient admitted with uncontrolled vomiting, diarrhoea, rigors, fever and positive test for HIV after trip to Brazil.
Has low CD4 count
How does low CD4 count result in increased susceptibility to infection? (3)
- Reduced CD4 T cells reduces activation of B cells and CD8 T cells
- Low count is a sign of HIV/AIDS
What is the pathogenesis of Barrett’s oesophagus? (2)
Metaplastic simple columnar cells replaces the simple squamous cells in the mucosa
Can occur by transdifferentiation:
- Mature squamous cells reverse into cells with progenitor like plasticity and then change to columnar
What are the risk factors for Barrett’s oesophagus? (4)
- Family history
- Male
- Chronic acid reflux
- Overweight
What disease is Barrett’s oesophagus a risk factor for?
Adenocarcinoma
What are the causes of oesophagitis?
- Acid reflux
- Medications e.g. aspirin/NSAIDs
- Infections that weaken immune system
- Allergies to food
- Radiation > mucosal damage
- Autoimmune disease
What are the two most common types of oesophageal carcinoma?
- Adenocarcinoma
- Squamous cell carcinoma
What does this histological slide from the gastroesophageal junction show? (3)
- Specialised epithelium with villiform architecture
- Foveolar gastric type cells which are present in GERD and Barrett’s oes patients
- Intestinal goblet cells
What is the guaiac test?
Looks for hidden (occult) blood in stool
What does this photo show? What is the diagnosis?
-Ulcer centrally with radiating gastric folds with grey base
- Peptic ulcer
What are the common causes of acute and chronic gastritis? (5)
Acute:
- Physiological stress - trauma/surgery
- Chronic NSAID use
- H pylori
Chronic:
- Autoimmune disease
- H. pylori infection
What gastric diseases have been associated with H. pylori infection? (4)
- Chronic gastritis
- Peptic ulcer disease
- Gastric cancers
- Mucosa-associated lymphoid tissue lymphoma
What is atrophic gastritis? (3)
- Chronic inflammation and thinning of gastric lining
- Metaplasia of gastric glandular cells to mimic intestinal cells
- Small intestinal goblet cells or enterocytes with brush border like appearance
What are risk factors for peptic ulcer? (4)
- Pernicious anaemia - immune cells attacking parietal cells
- H. pylori
- Decreased fruit and veg intake
- Smoking
