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Gastroenterology > Presentations in GI > Flashcards

Presentations in GI Flashcards

1
Q

GI causes of epigastric pain

A

Duodenal/gastric ulcers, oesophagitis, ruptured AAA

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2
Q

Non-GI causes of epigastric pain

A

Pericarditis, MI, ASC, diabetic ketoacidosis

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3
Q

Causes of central abdominal pain

A

Bowel obstruction, early appendicitis, acute gastritis, acute pancreatitis, ruptured AAA, ischaemic bowel disease

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4
Q

GI causes of left upper quadrant pain

A

Splenic rupture, splenic artery aneurysm, sub-phrenic abscess, pathology from epigastric region - ulcer, acute pancreatitis, oesophagitis

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5
Q

Non-GI causes of left upper quadrant pain

A

Pneumonia, ACS, diabetic ketoacidosis

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6
Q

Differentials of left upper quadrant mass

A

Splenomegaly, Gi malignancy, ectopic kidney, transplanted kidney, incisional hernia, sebaceous cyst, lipoma

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7
Q

Normal pathopysiology of bilirubin

A

Bilirubin is the breakdown product of RBCs, it is a yellow/orange bile pigment which is excreted in urine or faeces.

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8
Q

What are the normal levels of bilirubin and urobilinogen present in urine

A

Bilirubin is absent, urobilinogen present

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9
Q

In disease what are the levels of bilirubin

A

Prehepatic absent, hepatic present, posthepatic present

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10
Q

In disease what are the levels of urobilinogen

A

Prehepatic increased, hepatic increased, posthepatic decreased or absent

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11
Q

What happens in pre hepatic jaundice

A

Results in unconjugated hyperbilirubinaemia, which is not water soluble so does not enter urine

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12
Q

Causes of post hepatic jaundice

A

PBS, PSC, gall stones, head of pancreas adenocarcinoma, cholangiocarcinoma, biliary atresia, some drugs such as steroids, sulfonylureas, nitrofurantoin, flucloxacillin, co-amoxiclav

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13
Q

Causes of post hepatic jaundice

A

Conjugation disorders - Gilberts, Crigler-Naajjar. Haemolysis - malaria or haemolytic anaemia. Drugs - contrasts or rifampicin

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14
Q

What happens in hepatic jaundice

A

Hepatocellular dysfunction resulting in conjugated hyperbilrubinaemia

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15
Q

Causes of hepatic jaundice

A

Viruses (Hep, CMV), alcohol, cirrhosis, abscess, malignancy, AIAD, Wilson’s, haemochromatosis, Budd-Chiari, Drugs (paracetemol, valproate, statins, halothane, TB antibiotics)

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16
Q

What happens in post-hepatic jaundice

A

Impaired excretion of conjugated bilirubin causes cholestasis.

17
Q

Symptoms of post hepatic jaundice

A

Dark urine (water soluble) and pale stools (less reaches gut). Also pruritis

18
Q

Causes of splenomegaly

A

Infections, cancer, portal hypertension, sickle cell, haemolytic anaemia, chronic inflammatory diseases

19
Q

Symptoms of splenomegaly

A

Abdominal pain, decreased appetite, symptoms of cryptopenias, signs of underlying cause - fever, chills, night sweats

20
Q

Treatment of splenomegaly

A

Treat underlying cause to avoid ruptured spleen - splenectomy

21
Q

GI causes of RIF pain

A

Acute appendicitis, mesenteric addenitis, inflamed Merkles diverticulum, diverticulitis, IBD esp Crohns

22
Q

Gynae causes of RIF pain

A

Ectopic pregnancy, ovarian torsion of cyst, PID

23
Q

Male causes of RIF pain

A

Testicular torsion

24
Q

Urological causes of RIF pain

A

Pyelonephritis, ureteric colic

25
Q

GI causes of RUQ pain

A

Biliary colic, acute cholecystitis, ascending cholangitis, hepatic abscess, epigastric causes can also radiate such as ulcer, oesophagitis, acute pancreatitis

26
Q

Non Gi causes of RUQ pain

A

ACS, right sided pneumonia, MI, diabetic ketoacidosis

27
Q

Differentials for RUQ mass

A

Hepatomegaly, hepatic abscess, hepatic cyst, enlarged gall bladder, pancreatic cancer, right kidney, lipoma, sebaceous cyst

28
Q

GI causes of LIF pain

A

Diverticulitis, IBD, IBS, constipation

29
Q

Non GI causes of LIF pain

A

Pyelonephritis, renal stones

30
Q

Specific male or female causes of LIF pain

A

Ectopic pregnancy, ovarian torsion, cyst, PID, testicular torsion

31
Q

Differentials of mass in LIF

A

Faecal mass, cancer, diverticular abscess, undescended/ectopic testis, ovarian tumour, fibroid, transplanted kidney, ectopic kidney, lymphadenopathy, aneurysm of common/external iliac arteries, lipoma, sebaceous cyst

32
Q

Urological causes of suprapubic pain

A

Cystitis, urinary retention

33
Q

Specific male or female causes of suprapubic pain

A

Tseticular torsion, ectopic pregnancy, PID, ovarian torsion/cyst

34
Q

Gi causes of suprapubic pain

A

Constipation, IBS, IBD, diverticulitis

35
Q

Differentials of mass in suprapubic area

A

Urinary retention, bladder cancer, stone, bladder diverticulum, ovarian mass, fibroids, pregnancy, colorectal cancer, lipoma, sebaceous cyst

36
Q

What is Grey Turner’s sign

A

Bruising along flanks indicating retroperitoneal bleeding, highly associated with acute pancreatitis

37
Q

What is Cullen’s sign

A

Bruising around peri-umbilical area which is associated highly with pancreatitis

38
Q

What is Rosving’s sign

A

Palpation in LIF produces pain on RIF due to appendicitis

39
Q

What is Courvoiser’s sign

A

Painless, palpable gallbladder with jaundice

Gastroenterology (19 decks)

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