Week 10 - Gastrointestinal Flashcards
- What are the solid and hollow organs of the abdo?
- Solid = liver, spleen, pancreas
- Hollow = stomach, gallbladder, duodenum, small intestines, cecum, colon
- What are the key s/s of GORD/Oesophagitis/Hiatus hernia?
- Burning sensation in chest
- Sour taste
- Difficulty in swallowing
- Dry cough
- Sore throat
- Regurgitation of food/liquid
- Lump in throat
- What are some causes of oesophageal bleeding? Different coloured blood?
- Mallory-weiss tear - caused by excessive vomiting
- Oesophageal varices - hypertension of venous portal system
Blood: frank - bright red blood (non-digested); coffee grounds - digested blood
- What are the key features of Hiatus Hernia?
- Protrusion of part of the stomach through diaphragmatic hiatus into thoracic cavity
- Caused by higher pressure in abdominal cavity compared to thoracic cavity - obesity, age, heredity
- Presents with epigastric burning, nausea, regurgitation, difficulty swallowing
- What is peptic ulcer disease?
Chronic illness manifested by recurrent ulcerations in the stomach and proximal duodenum. Caused by bacteria and excessive acid secretion. Most commonly presents as GIT bleeding.
- What is Diverticulitis?
Acute inflammation of the wall of diverticulum and surrounding tissue.
- Caused by micro/macro perforation
- Common disorder of industrialised nations
- 2/3 population acquired by 85yrs
- Only 10-25% with divericulosis
- What is liver cirrhosis?
The liver does not function properly due to long-term damage. This damage is characterised by the replacement of normal liver tissue by scar tissue.
Increase in portal hypertension.
- What is pancreatitis and the main causes? Clinical signs?
Inflammation in the pancreas
Causes: 80% of acute pancreatitis caused by alcohol or gall stones; also drugs, infection, inflammation, trauma, metabolic disturbances
Clinical signs: mid-epigastric/LUQ pain, N/V, bloating, Cullen’s sign, Turner’s sign
- What is biliary tract disease? Main features?
Diseases affecting the bile ducts, gallbladder and other structures involved in the production and transportation of bile. Bile is a fluid produced by the liver that aids digestion.
- Most common diagnosis in ED pt>50yrs - classic pt obese females 20-40yrs
- Cholelithiasis = gall stones, move from gall bladder into biliary tract and obstruct, pain + N/V
- What is Cholecystitis? Risks, presentation?
Inflammation of gall bladder
- risks: pregnancy, elderly, family hx, chronic liver disease
- presentation: RUQ or epigastric pain with back/shoulder radiation, n/v, 10-30% jaundiced, pain usually persistent not colicky
- What is Appendicitis? Presentation?
Acute inflammation of vermiform appendix
- occurs when obstruction (food matter, adhesions, lymphoid hyperplasis) occurs leading to infection - perforation and spillage of infected appendiceal contents into peritoneum.
- presentation: initial umbilicus pain, moves to McBurneys point, n/v, constipation, fever late sign
- What is the definition of diarrhoea and what are the 4 basic mechanisms?
Passage of 3 or more loose or liquid stools per day, or more frequently than is normal for the individual.
4 mechanisms: increased intestinal secretion, decreased intestinal absorption, increased osmotic load, abnormal intestinal motility
- What are the 4 ways the vomiting centre in medulla is excited?
- Vagal and sympathetic nerves from peritoneum, GI, biliary and genitourinary tracts, pelvic organs, heart, pharynx, head, vestibular apparatus
- Impulses converging at nucleus tractus solitarius in medulla
- Chemoreceptor trigger zone - 4th ventricle
- Vestibular or vestibulocerebellar system
- What is Crohn’s disease and Ulcerative colitis?
- Crohn’s = chronic inflammatory disease involving part of GI tract from mouth to anus - chronic abdo pain, anorexia, weight loss, persistent diarrhoea/constipation, painful defecation
- UC = inflammatory bowel disease, ulcerated intestinal mucosa, often between 15-30yrs - similar s/s to crohn’s
- What is the difference between Visceral and Somatic pain?
- Visceral = deep-seated, dull pain from hollow viscera or capsule of solid organs; poorly localised, falls along midline
- Somatic (Parietal) = pain localised over time (over organ involved), pain sharper intensity, guarding, rigidity, legs raised, decreased movement
