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Gastoenterology > Rugby GI Powerpoint > Flashcards

Rugby GI Powerpoint Flashcards

1
Q

How does oral thrush present?

A

White plaques on the oral mucosa that can be wiped off to leave red, painless base

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2
Q

How is oral thrush treated?

A

Anti-fungals (miconazole)

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3
Q

What is the main type of malignant tumour in the mouth?

A

Squamous cell carcinoma

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4
Q

How do salivary gland stones present and what is the first line investigation?

A

Colicky post-prandial pain and swelling

Refer for ultrasound

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5
Q

What is achalasia?

A

Poor relaxation of the low oesophageal sphincter - causes birds beak appearance on barium swallow

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6
Q

How is achalasia treated?

A

Myotomy (Hellers cardiomyotomy)

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7
Q

How is Baretts oesophagus managed?

A

PPIs

Lifestyle advice

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8
Q

What is the first line investigation of dysphagia?

A

OGD +/- biopsy

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9
Q

How is oesophageal cancer treated?

A

Surgery

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10
Q

What causes oesophageal varices and how are they treated?

A

Portal hypertension

Band ligation + TIPS

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11
Q

What is TIPS?

A

Addition of an artificial vein that bypasses the liver (if cirrhosed)

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12
Q

How does hiatus hernia present?

A

Reflux

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13
Q

How is dyspepsia managed?

A

Lifestyle advice,
Antacids,
PPIs

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14
Q

What are the most common causes of dyspepsia?

A

GORD,

Peptic ulcer

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15
Q

How do peptic ulcers present?

A

Bleeding,
Postprandial epigastric pain (if duodenum is relieved by food, if gastric worsened by food),
Nausea,
Bloating

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16
Q

What test is done to check for H pylori?

A

Carbon 13 urea test

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17
Q

How are peptic ulcers treated?

A

Lifestyle advice,
H pylori eradication therapy,
PPIs

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18
Q

What causes lymphomas in the stomach and how are they treated?

A

H pylori

PPI + antibiotics to eradicate H pylori

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19
Q

What pathological process occurs in coeliac disease?

A

Abnormal response to wheat leads to atrophy of small intestinal villi

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20
Q

How is coeliac screened for and diagnosed?

A

Screening: TTG
Diagnosis: duodenal biopsy

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21
Q

What type of disease increases risk of small bowel ischaemia?

A

Cardiac diseases (AF, AAA, previous MI - increase risk of emboli)

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22
Q

How does mesenteric ischaemia present?

A

Pain out of context to clinical findings + acidosis

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23
Q

How is mesenteric ischaemia treated?

A

Warfarin/heparin

Surgery if gangrenous/necrotic

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24
Q

Why is the blood supply to the large bowel more effective than the small bowel if there is a blockage?

A

Due to the marginal artery (of Dummond)

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25
Q

What causes chronic mesenteric ischaemia and what are the symptoms? (what is the treatment)

A

Caused by atheroma of the vessels supplying the large bowel
Symptoms: weight loss, fear of eating, postprandial pain
(treatment = surgery - usually bypass)

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26
Q

What causes ischaemic colitis?

A

Compromise of the blood supply to the colon (affects middle and left colic arteries)

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27
Q

What occurs in a hernia?

A

A section of bowel protruding through a weakness in the body wall

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28
Q

What is the risk associated with an irreducible hernia?

A

Strangulation

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29
Q

What is the sign of complete small bowel obstruction?

A

Absolute constipation - no faeces or flatus can pass through

30
Q

How is small bowel obstruction diagnosed and treated?

A

Diagnosis: dilated SI on AXR
Treatment: ‘drip and suck’ + bowel rest

31
Q

What is peritonitis and how does it present?

A

Inflammation of the peritoneum

Presentation: pain, fever, tachycardia

32
Q

What is ileus?

A

Non-mechanical intestinal obstruction (can be paralytic (inactivity of the bowel) often post-op|)

33
Q

What test is used to screen for colorectal cancer and what is used to diagnose it?

A

Screening: FOB test
Diagnosis: colonoscopy +/- biopsy

34
Q

What is the difference between diverticulosis, diverticulitis and diverticular disease?

A

Diverticulosis: asymptomatic diverticula
Diverticular disease: symptomatic diverticula
Diverticulitis: inflammation of diverticula

35
Q

How does diverticulitis present?

A

Abdominal pain (especially in LIF) - exacerbated by eating and relieved by defecation
Fever,
Constipation,
Bloating,

36
Q

What is a volvulus and what are its symptoms?

A

A twisting of the bowel (usually the sigmoid)

Presents with gross abdominal distention, sudden onset colicky pain and absolute constipation

37
Q

How is a volvulus diagnosed?

A

AXR (coffe bean sign)

38
Q

What is proctitis?

A

Inflammation of the lining of the rectum (causes renal pain)

39
Q

What are haemorrhoids?

A

NOT distended veins - are swollen mucosal tissue in the vascular canal

40
Q

What is the grading for haemorrhoids?

A

Grade I: do not prolapse
Grade II: prolapse upon straining, spontaneously reduce
Grade III: prolapse upon straining, can be manually reduced
Grade IV: permanently prolapsed (cannot be reduced)

41
Q

How are haemorrhoids treated?

A

If asymptomatic - nothing

If symptomatic; analgesia, banding, haemorrhoidectomy

42
Q

Which LFTs indicate that the liver is not functioning correctly?

A

Bilirubin, prothrombin and albumin (takes up to 20 days to be affected)

43
Q

Which LFTs indicate liver damage and which indicate bile duct damage?

A

Liver damage: ALT, AST

Bile duct: ALP GGT

44
Q

How does viral hepatitis present?

A

Nausea and vomiting (N&V),
Itch,
Pain (RUQ),
Diarrhoea

45
Q

Which forms of viral hepatitis can become chronic?

A

B and C

46
Q

What pathological process occurs in auto-immune hepatitis and how does it present?

A

Chronic hepatocellular inflammation leading to cirrhosis

Presents with fatigue, upper abdominal discomfort, diarrhoea, anorexia

47
Q

How is autoimmune hepatitis tested for and treated?

A 
Test = AMA (anti smooth muscle antibodies)
Treatment = prednisolone/azathioprine (immunosuppression)
48
Q

How does fatty liver disease present and how is it treated?

A

Fatigue, RUQ pain, hepatomegaly, malaise

Treatment: lifestyle changes (weight loss, good diet, abstinence)

49
Q

What is fatty liver disease associated with?

A

Obesity and alcohol

50
Q

What are the consequences of cirrhosis?

A

Portal hypertension; oesophageal varices, haemorrhoids, caped medusa, ascites, jaundice

51
Q

How is portal hypertension treated?

A

Nitrates + B-blockers

52
Q

What increases risk of hepatocellular carcinoma and how is it treated?

A

Previous liver injury (cirrhosis, chronic liver disease)

Treatment: surgical resection, radiotherapy, liver transplant

53
Q

How does primary biliary cirrhosis present and what is the treatment?

A

Fatigue, RUQ pain, cirrhosis

Treatment: urseodeoxycholic acid

54
Q

What is primary sclerosis cholangitis and who is it most common in?

A

Fibrosis of the bile ducts

More common in males (association with UC)

55
Q

How is primary sclerosis cholangitis diagnosed and treated?

A

Diagnosis: LFTs, MRCP, ERCP (+ biopsy)
Treatment: symptom relief (antihistamines, urseodeoxycholic acid), liver transplant

56
Q

What is cholangiocarcinoma and what increases risk of developing it?

A

Carcinoma in the biliary tree

Risk increased with primary sclerosis cholangitis and hepC

57
Q

How is cholangiocarcinoma treated?

A

Surgery or stents

58
Q

How do gall stones (cholethiasis) typically present and what is their cause and treatment?

A

Usually asymptomatic, so no treatment

Made from cholesterol or bilirubin

59
Q

What is biliary colic and how does it present?

A

When a gallstone travels out of the gallbladder and gets stuck in the biliary tree
Presents with sudden onset RUQ/epigastric pain (can radiate to the back), N&V

60
Q

How is biliary colic investigated and treated?

A

Investigation: CXR, LFTs, abdo ultrasound
Treatment: ERCP

61
Q

What causes cholecystitis and how does it present?

A

Inflammation of the gall bladder after a stone has got stuck in the cystic duct
Presentation: continuous Run/epigastric pain, mass, vomiting, fever

62
Q

How is cholecystitis investigated and treated?

A

Investigation: FBC, LFTs, abdominal ultrasound
Treatment: Cholecystectomy

63
Q

How does acute pancreatitis present?

A

Sudden onset epigastric pain which radiates through to the back, vomiting, nausea, fever

64
Q

How is pancreatitis investigated and treated?

A

Investigation: serum amylase (3x normal limit)
Treatment: Analgesics, fluid, nil by mouth (if infected = antibiotics)

65
Q

How does chronic pancreatitis present?

A

Severe abdominal pain, loss of exocrine and endocrine functions, decreased appetite, nausea and vomiting

66
Q

How is chronic pancreatitis treated?

A

Creon to replace loss of digestive enzymes, diabetes treatment

67
Q

Which type of pancreatic tumour is more common?

A

Exocrine

68
Q

How is pancreatic cancer treated?

A

Usually palliative as presents late, surgery if young and fit enough

69
Q

Where can gastrinoma affect?

A

Pancreas or duodenum - severe peptic ulceration

70
Q

What are the causes of acute and chronic pancreatitis?

A 
Acute: GET SMASHED
G- gall stones
E- ethanol 
T- trauma
S- steroids
M- mumps
A- autoimmune
S- scorpion
H- hyperlipidaemia/thermia
E- ERCP
D- drugs

Chronic:
Alcohol, gallstones, idiopathic

Gastoenterology (15 decks)

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