Miscellaneous terms and diseases Flashcards
Spontaneous bacterial peritonitis
- Definition
- Signs and symptoms
- Causes
- Pathophysiology
- Diagnosis
- Treatment
Bacterial infection in peritoneum
- Especially of ascitic fluid
- Complication of ascites/ liver cirrhosis
Signs and symptoms
- Pyrexia
- Nausea vomitting
- Abdominal pain
- Worsening ascites
Causes (cirrhosis, nephrotic syndrome)
- E.Coli
- Klebsiella
Pathophysiology
- Bacterial translocation from bowel to ascitic fluid
Diagnosis
- Paracentesis of fluid is cultured.
Treatment/ Prevention
- Antibiotics to treat
- AB to prevent if ascites protein is lower
Achalasia
- Definition
- Signs and symptoms
- Treatment
Inability of lower oesophageal sphincter to relax
- Due to imbalance of excitatory and inhibitory neurotransmission.
Signs and symptoms
- DYSPHAGIA- solids then liquids
- Regurgitation of undigested food
- Retrosternal pressure
- Choking
Complication
- Aspiration
Treatment
- Pharmacological: nitrates/ calcium channel blocker
- Surgery: pneumatic dilation
- Botox injection
- Gastronomy
Benign oesophageal stricture
Narrowing/ tightening of the oesphagus
- Due to scar formation or a benign obstruction.
Causes
- GORD
- Oesophagitis
- Oesophageal surgery
-
Gilbert’s syndrome
- Description
- Genetics
- Presenatation
Inherited liver disorder
- Mainly autosomal recessive, can be dominant.
Mutation
- UGT1A1 gene= bilirubin uridine diphosphate glucuronosyltransferase
Causes increase in unconjugated bilirubin in blood
Presentation
- Elevated bilirubin
- Transient jaundice after physiological stress (exercise, fasting)
- Does not require regular treatment/ monitoring and does not progress to chronic liver disease.
Primary biliary sclerosis
- Description
- Presentation
- Diagnosis
Autoimmune condition that affects the small biliary ducts (interlobular)
- Granulomatous inflammation
- Can progress to cirrhosis
Presents
- Mildly elevated bilirubin
- Elevated ALP
- Lethargy, sleepiness, and pruritus
Diagnosis
- Assocated mainly in younger females
- Anti-mitochondrial antibodies (AMA)
Primary scleorosing cholangitis
- Description
- Presentation + associations
- Diagnosis
Autoimmune destruction of large bile ducts.
-75
Presentation
- Cholestatic: elevated bilirubin, ALP
- Jaundice
- Pruritis, fatigue
- 75% are male, 75% have IBD
Diagnosis
- Liver biopsy: fibrous, obliterative cholangitis
- Usually clinical diagnosis: AMA negative
______ is an example of a bulk forming laxative that is indicated…
Ispaghula first line for short-term constipation in those with adequate fluid intake
________ and _______ are laxatives indicated in opioid induced constipation
Stimulant and osmotic
_________ laxatives are contraindicated in opioid induced constipation
Bulk-forming
_______ is the first line osmotic laxative indicated in short-term constipation
Macrogol
________ is indicated in chronic constipation where 2 laxatives have failed for at least 6 months
Prucalopride
