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phase2a medicine > some random GI stuff > Flashcards

some random GI stuff Flashcards

1
Q

risk factors for Coeliac disease

A

Irish
female
HLA DQ2 gene

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2
Q

pathology of Coeliac disease

A

reaction to gliadin - T cell mediated

villous atrophy and malabsorption of bile acids and crypt hyperplasia

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3
Q

signs of Coeliac disease

A 
diarrhoea that smells offensive
bloating
abdominal pain 
nausea and vomiting
aphthous ulcers
weight loss
angular stomatitis
fatigue
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4
Q

complications of Coeliac disease

A 
osteoporosis
malignancies (if pt does not adhere to diet)
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5
Q

diagnosis of coeliac disease

A

jejunal and duodenal biopsies
serology - tissue transglutaminase and anti-endomysial antibodies
gastroscopy

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6
Q

treatment of coeliac disease

A

gluten free diet

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7
Q

risk factors for oesophageal reflux

A

hiatus hernia
gastric surgery
increased abdominal pressure

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8
Q

symptoms of oesophageal reflux

A

heartburn (acid reflux)

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9
Q

complications of oesophageal reflux

A

Barrett’s oesophagus
carcinomas
hyperplasia
metaplasia

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10
Q

diagnosis of oesophageal reflux

A

endoscopy
GI bleeding
pH monitoring

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11
Q

treatment of oesophageal reflux

A 
antacids (magnesium trisilicate mixture)
PPIs (omeprazole)
H2RA (ranitidine)
weight loss
meal planning
dietary restraint
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12
Q

risk factors for peptic ulcers

A

inappropriate NSAID use

peptic ulcers

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13
Q

pathology of peptic ulcers

A

ulceration in gastric mucosa, usually due to a pH decrease

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14
Q

signs of peptic ulcers

A

haematemesis
melaena (dark, sticky faeces)
weight loss
epigastric pain

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15
Q

complications of peptic ulcers

A

peritonitis if perforation
pancreatitis
haemorrhage

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16
Q

diagnosis of peptic ulcers

A

endoscopy

H.pylori test

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17
Q

treatment for peptic ulcers

A

triple therapy: PPI, clarithromycin, amoxiclav
stop NSAIDs
stop smoking

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18
Q

what normally protects gastric cells from acid?

A

mucin

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19
Q

mesenteric ischaemia risk factors

A 
chronic renal failure
past MI 
AF
heart failure
thrombophilia
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20
Q

pathology of mesenteric ischaemia

A

restriction of blood flow to mesentery (acute or chronic)

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21
Q

what are the phases of mesenteric ischaemia?

A

hyper-active phase
paralytic phase
shock phase

22
Q

what happens in the hyper-active stage of mesenteric ischaemia?

A

severe abdominal pain
bloody stools

many patients get better after this stage

23
Q

what happens in the paralytic phase of mesenteric ischaemia?

A 
abdominal pain more widespread
more tenderness
bowel motility decreases
abdominal bloating
absent bowel sounds
24
Q

what happens in the shock phase of mesenteric ischaemia?

A

fluids start to leak through damaged colon lining –> shock and metabolic acidosis with dehydration
low bp
fast heart rate
confusion

patients are critically ill and require intensive care

25
Q

diagnosis for mesenteric ischaemia

A 
FBC
test for lactic acid in blood
CT 
XR
colonoscopy 
angiography
26
Q

treatment of mesenteric ischaemia

A

resection of bowel if necrotic

medicines for blood pressure

27
Q

risk factors for Mallory Weiss tear

A 
alcohol excess
chronic cough 
hyperemesis gravidarum 
bulimia
gastroenteritis
28
Q

pathology of Mallory Weiss tear

A

haematemesis due to oesophageal tear or prolonged vomiting

29
Q

signs of Mallory Weiss tear

A

melaena
haematemesis
hypovolaemia/shock

30
Q

complications of Mallory Weiss tear

A

shock

31
Q

diagnosis of Mallory Weiss tear

A

endoscopy

32
Q

risk factors for haemorrhoids

A

hard stool
straining
pregnancy

33
Q

pathology of haemorrhoids

A

congested vascular cushions

dilated venous component

34
Q

signs of haemorrhoids

A

painless bleeding
blood coated stool
pain when pooing

35
Q

diagnosis of haemorrhoids

A

proctoscopy
endoscopy
FBC

36
Q

treatment of haemorrhoids

A

sclerotherapy

37
Q

risk factors for fistulae

A

perianal sepsis
rectal carcinoma
TB
Crohn’s

38
Q

pathology of fistulae

A

a track communicates between skin and anal canal

blockage of deep intramuscular gland ducts - formation of abscesses

39
Q

symptoms of fistulae

A

inflammation
pain
pus secretion
pruritus ani - itching

40
Q

complications of fistulae

A

active infection

41
Q

diagnosis of fistulae

A

MRI
endoanal USS
anoscopy

42
Q

treatment of fistulae

A

fistulostomy and excision
low ones are laid open to healing
high ones are sutured tight

43
Q

risk factors for fissure

A

hard faeces
anal cancer
rectal artery spasm causing ischaemia
anal sex

44
Q

pathology of fissure

A

tear in squamous lining (usually on posterior wall of lower anal canal)

45
Q

symptoms of fissure

A

pain after defecation

46
Q

treatment of fissure

A 
5% lidocaine ointment
stool softener
dietary fibre
topical GTN
surgery if needed
47
Q

risk factors for pilonidal sinus/abscess

A

obesity
family history
prolonged sitting
greater amounts of hair

48
Q

risk factors for perianal abscess

A

Crohn’s
malignancy
fistulae

49
Q

pathology of perianal abscess

A

abscess usually caused by gut organisms, usually E.coli

50
Q

symptoms of perianal abscess

A

palpable mass near the anus
pain
constipation
fever

51
Q

treatment of perianal abscess

A

incise and drain under GA

52
Q

pathology of pilonoidal sinus/abscess

A

ingrown hair in central superior portion of bum crack, sweat can fill space –> anaerobic bacteria grow

phase2a medicine (53 decks)

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