phase 2 GI Flashcards
Which of the regions of the stomach is closest t oesophagealgastric junction
cardia
risk factors of haemhoroids
- obesity
- chronic constipation (causing straining)
- coughing
symptoms of haemarhoids
- fresh red blood and mucous in the
stool - an itchy anus
- soreness around the anus
- Bright red bleeding
- pain on passing stools
- Mucus discharge,
most appropriate description of Barrett’s oesophagus?
Metaplasia of the squamous epithelium of the lower third of the oesophagus to columnar epithelium
gold standard test for ceolaics
Endoscopy with duodenal biopsy
bowel cancer screening home-test kit name
Faecal immunochemical tests (FIT),
do PPIs cause peptic ulcers?
no they are treatment for it
causes:
NSAIDs
Helicobacter pyloric infection
Haemodynamic shock
Stress
is sudden onset dysphagia of solids and liquids a red flag for oesophageal cancer
no - The dysphasia is gradual in onset, sudden onset dysphasia of solids and liquids from
the start indicated benign disease
main types of diarrohea
secretory, osmotic, exudative, inflammatory, dysentery
symptoms of small bowel obstruction
Vomiting, nausea, constipation, abdominal distention. Intermittent abdominal pain .
What abdominal radiograph findings would confirm small bowel obstruction
Dilated jejunum and/or ileum, Absence of gas in bowel distal to the obstruction.
Name a complication of small bowel obstruction which would lead to emergency surgery
Bowel Ischaemia, or strangulation
differentials for gastritis?
Peptic ulcer disease, GORD, non-ulcer dyspepsia, gastric lymphoma, gastric carcinoma
Briefly describe the pathophysiology of haemorrhoids
Haemorrhoids are swelling and inflammation of veins in the rectum and anus
describe internal haemorrhoidd
arise internally, are painless covered in mucus, they can also
prolapse.
describe external haemorrhoids
Form at the anal opening, painful, covered with skin.
Give 2 non-surgical and one surgical treatment of haemorrhoids (
- stool softener
- high fibre diet
- band ligation
NICE IBD symptoms
- abdominal pain or discomfort that is either relieved by defecation or associated with altered bowel
frequency or stool form - Altered stool passage (straining, urgency, incomplete evacuation)
- Abdominal bloating (more common in women than men), distension, tension or hardness
- Symptoms made worse by eating
- Passage of mucus
non-pharmacological treatments for GORD
- Weight loss (if obese)
- Healthy eating
- Smoking cessation
- Eat smaller meals
- Eat evening meal 3-4 hours before going to bed
- Reduce alcohol consumption
- Raise the head of the bed / use more pillows
serology for coeliacs
Labs often look for either IgA-tTG or IgA-EMA then, if the result is vaguely positive, will look for the
other.
Some coeliac patients are IgA deficient, in which case, IgG versions of the above would be tested for
risk factors for colorectal carcinomas.
Increasing age/old age/elderly
Alcohol
Smoking
Obesity
Low fibre diet
Saturated animal fat and red meat consumption
Colorectal polyps
Family history of GI cancer
Past medical history of cancer
Presence of colorectal polyps
Ulcerative colitis and Crohn’s disease
Genetic predisposition
potential complications of diverticulitis
- Large bowel perforation
- fistula formation
- large bowel obstruction
- bleeding
- mucosal inflammation
risk factors for oesophageal cancer
Alcohol
* Smoking tobacco
* Obesity
* GORD
* Achalasia
first line drug used to treat haematemesis from ruptured oesophageal varices?
IV Terlipressin acts as a vasodilator to control variceal bleeding.
If terlipressin is contraindicated (for example in IHD) then IV somatostatin should be
used
differential diagnoses for acute appendicitis
- Crohn’s disease
- Ectopic pregnancy
- UTI
- Diverticulitis
- Perforated ulcer
- Food poisoning
extra tests for acute appendicitis
- WCC (blood test) – will show increased neutrophils
- CRP (blood test) – will be elevated as it is a marker of inflammation
- ESR (blood test) – will be elevated as it is a marker of inflammation
- Ultrasound – can detect an inflamed appendix and an appendix mass, confirmation with a
CT scan would then be done - Pregnancy test – to exclude an ectopic pregnancy
- Urinalysis – to exclude a UT
3 signs which may be elicited on abdominal examination of small bowel obstruction
Abdominal distension (1) Hyperresonant bowel (1) Tinkling bowel sounds (1
What may be seen on an abdominal x ray of a patient with a sigmoid volvulus
coffee bean sign
drug class of choice used for acute flares of UC
5 – Amino-Salicylates (e.g. sulfasalazine, mesalazine)
