Random Flashcards
What is Meckel’s Diverticulum
a true congenital diverticulum
out-touching of the small bowel as an embryological remnant
can have gastric mucosa that produces acid like the stomach
What are some causes of vomiting?
Gastroenteritis (Rotavirus, norovirus, E.coli, campylobacter) Morning sickness Abnormal blood pH- metabolic disturbance Severe pain Small bowel obstruction Opioids
What symptom does salmonella normally cause?
Diarrhoea
What is achalasia?
The failure of the oesophageal peristalsis and relaxation of the lower oesophageal sphincter. This is due to degenerative loss of ganglia from Auerbach’s plexus.
In short the lower oesophageal sphincter is contracted and the oesophageal above is dilated
What is scurvy?
Scurvy is vit C deficiency. (Ascorbic acid)
what is clostridium difficile?
a gram postive spore forming anaerobe
what does C.diff release?
enterotoxins A and B
What are some risk factors for C.diff?
abx e.g clindamycin, Cefs, augmentin, quinolones increasing age increased length of stay in hospital contact with c.diff positive patient PPIs
how does C.diff present?
asymptomatic mild diarrhoea colitis without pseudomembranes pseudomemanous colitis fulminant colitis
NB it can present 2 months after stopping abx.
what is pseudomembranous colitis and how does it present?
swelling or inflammation of the large intestine (colon) due to an overgrowth of Clostridium difficile (C difficile) bacteria.
it presents with defer and dehydration, abdominal pain
diarrhoea (bloody diarrhoea and mucus on PR)
pseudomembranes on flexi sig
what are some complications of pseudomembranous colitis?
paralytic ileus
toxic megacolon–>perforation
multiorgan failure
what is the first line management for c.diff?
Stop offfending abx
give metronidazole 400mg TDS PO for 10-14 days
what is the second line treatment for C.diff or the first abx in severe c.dif?
Vancomycin 125mg QDS PO for 10-14days
you may add metronidazole in severe cases
what is the treatment for toxic megacolon?
urgent colectomy
what is dysentery?
bloody diarrhoea
what is bloody diarrhoea (dysentery) associated with?
shigella and e.coliO157
what is the usual cause of post BBQ diarrhoea?
campylobacter jejuni
outbreaks of vomiting and diarrhoea in institutions usually due to what organisms?
small structured round virus e.g. norovirus
what is a hiatus hernia?
when the upper part of the stomach moves through the diaphragm into the thorax
what are the 2 main types of hiatus hernia?
sliding (80%)
paraoesophagheal or rolling (15%)
which of the 2 types of hiatus hernia is associated with GORD?
sliding as the lower oesophageal sphincter moves up through the diaphragm.
what investigations would reveal a hiatus hernia?
CXR- gas bubble and fluid level in chest
Barium swallow is often diagnostic
what is Barrett’s oesophagus?
metaplastic change of the distal oesophageal mucosa secondary to prolonged acidic irritation
what histological change occurs to the epithelium in Barrett’s oesophagus?
squamous epithelium to columnar epithelium (with goblet cells|)
