Passmed Questions Flashcards
(26 cards)
Biliary Colic
RUQ
Caused by gallstones lodged in the bile duct.
Provoked by eating a fatty meal.
Has no fever + inflammation
Acute Cholecystitis
RUQ
Inflammation / infection of the gall bladder secondary t gall stones.
Murphy’s sigh positive
Ascending Cholangitis
RUQ
Ascending cholangitis is a bacterial infection of the biliary tree. MOST common predisposing gallstone.
Charcot’s triad of RUQ pain, fever and jaundice
Acute pancreatitis
Epigastric - can radiate to the back.
Due to alcohol / gallstones.
Pain is often very severe.
examination may reveal tenderness, ileus + low grade fever.
Peptic Ulcer Disease
Epigastric History of NSAID / alcohol excess. Most common duodenal ulcer (relieved by food). Gastric ulcer worsens by eating. Features: Haemorrhage, melena.
Appendicitis
Right iliac fossa.
Pain central abdomen before localising to right iliac fossa.
Features: anorexia, Tachycardia, low grade pyrexia, tenderness in RIF.
Acute Diverticulitis
LLQ
Colicky pain in LLQ
Features: Diarrhoea, sometimes bloody.
Fever, raised inflammation, WCC.
Intestinal Obstruction
Central.
History of malignancy (intraluminal obstruction)
Features: Vomiting
Ruptured abdominal aortic aneurysm
Central abdominal pain radiating to the back.
Features: sudden collapse, severe central abdominal pain with developing SHOCK.
Shock: hypotension, tachycardic and history of CVD.
Mesenteric Ischeamia
Central Abdominal pain.
History of AF / CVD
Features: Diahoea, rectal bleeding and metabolic acidosis (seen in dying tissues).
Cause of acute pancreatitis
Gall stones Ethanol Trauma Steroids Mumps Autoimmune Scorpion venom Hypertriglyceridaemia, Hyperchylomicronaemia, Hypercalcaemia, Hypothermia ERCP Drugs ( macolides, diuretics, steriods, sodium)
On palpation: palpate over the LIF pain bounces to the RIF
Rovsing’s sign
Affects between 6 -18 months of age. Boys are effected more than girls.
Intussusception, one portion of bowel into the lumen, commonly around ileo-caecal region.
Common in females and pregnant women
Femoral Hernias
Familial Adenomatous polyposis
Mutation of APC gene
Feature: colonic adenomas
Peutz-Jeghers
STK11 mutation on chromosome 19.
Features: Multiple benign intestinal hamartomas
Plummer-Vinson Syndrome
Triad of: dysphagia, glossitis, Fe deficiency anaemia.
Mallory Weiss syndrome
Severe vomiting, → painful mucosal lacerations at the gastroesophageal junction resulting in haematemesis. Common in alcoholics
Gilbert’s Syndrome
Autosomal recessive
Due to deficiency of UDP glucuronosyltransferase.
This enzyme conjugates bilirubin in the liver.
Results in build-up of unconjugated bilirubin which cannot be excreted.
What must be present for the diagnosis of Barrett’s oesophagus
Goblet cells
Pancreatic cancer
Tumour are adenocarcinoma which typically occur at the head.
Associates with BRCA2 gene.
Chronic pancreatitis:
Inflammatory condition effecting exocrine + endocrine function.
80% of cases is due to alcohol.
Other issues: Hereditary Haemochromatosis / ducts obstruction due to tumour.
Crohns Disease
inflammatory bowel disease, commonly affects the terminal ileum and colon, also mouth to anus.
Inflammation involves all layers down to Serosa = more prone to stricture, fistulas and adhesions.
Ulcerative colitis, what to look for ?
Mucosal inflammation, crypt abscess, shallow ulceration, and marked pseudopolyps.