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Main diseases for each system > GIT > Flashcards

GIT Flashcards

1
Q

symptoms of appendicitis

A 
shifting central to R sided pain
nausea
vomiting
appetite loss
fever
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2
Q

Investigations of appendicitis

A

FBC
abdo/pelvic CT
urinary pregnancy test
Abdominal ultrasound

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3
Q

treatment of appendicitis

A

appendectomy + supportive care + IV Ab

If abscess; antibiotic IV + supportive care + appendectomy + drainage

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4
Q

Symptoms of acute pancreatitis

A 
abdo pain
nausea and vomiting 
anorexia
Grey Turner's Sign
Cullen sign
Fox's sign
Chvostek's sign
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5
Q

risk factors for acute pancreatitis

A

middle age woman
young-middle aged man
gallstones
alcohol

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6
Q

Diagnosis of acute pancreatitis

A 
serum lipase/amylase
AST/ALT
FBC
CRP
abdo CT
MRCP
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7
Q

Treatment of acute pancreatitis

A

initial resus + analgesia + nutritional support

may give O2, antiemetic, calcium replacement, magnesium replacement, insulin

w/gallstones = cholecystectomy

w/gallstones and cholangitis = ERCP

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8
Q

Symptoms of chronic pancreatitis

A 
abdo pain
steatorrhoea
jaundice
weight loss
malnutrition
nausea/vomiting
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9
Q

Diagnosis of chronic pancreatitis

A

FIRST LINE

  • blood glucose
  • CT, abdo US, abdo x-ray

SECOND LINE

  • EUS, ERCP, MRCP
  • faecal-elastase-1
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10
Q

treatment of chronic pancreatitis

A

Acute pain; analgesics

Alcohol and smoking cessation
analgesia and pancreatic enzymes

If limited to tail ca do distal pancreatectomy

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11
Q

symptoms of peptic ulcers

A 
abdo pain
nausea
vomiting
"pointing sign"
epigastric tenderness
early satiety
weight loss
anorexia
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12
Q

Investigations for peptic ulcers

A

Urea breath test
stool antigen test
upper GI endoscopy
FBC

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13
Q

Treatment for peptic ulcers

A

Active bleeding

  • endoscopy ± blood transfusion
  • PPI

Non-active bleeding, H Pylori positive
- clarithromycin + amoxicillin/metronidazole + PPI

Non-active bleeding, H Pylori negative

  • treat cause + PPI
  • second line H2 antagonist
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14
Q

symptoms of IBS

A

15% of adult population

abdo pain/discomfort
pain often relieved on defecation
altered bowel habits
abdo distension
mucus w/stool
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15
Q

Diagnosis of IBS

A 
FBC
stool studies
anti-endomysial antibodies
anti-tTG antibodies
hydrogen breath test
faecal calprotectin
CRP
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16
Q

Treatment of IBS

A

Constipation; life and diet mod
- laxatives
± antispasmodics
- second line SRRIs

Diarrhoeal; life and diet mod
- anti-diarrhoeals
± antispasmodic
- second line tricyclic antidepressants

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17
Q

symptoms of ulcerative colitis

A 
rectal bleeding
diarrhoea
blood in stool
abdo pain
arthritis
malnutrition
abdo tenderness
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18
Q

Diagnosis of Ulcerative colitis

A 
stool studies
FBC
metabolic panel
ESR, CRP
colonoscopy
LFTs
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19
Q

treatment of ulcerative colitis

A

Acute

  • fulminant; admission + IV corticosteroids + IV fluids + infliximab, second line colectomy
  • severe non-fulminant; topical and oral mesalazine (aminosalicylate) + oral corticosteroids

Ongoing

  • remission; mesalazine (aminosalicylate), beclometasone
  • refractory; immunosuppressants
20
Q

symptoms of crohn’s disease

A 
abdo pain
prolonged diarrhoea
perianal lesions
bowel obstruction
blood in stools
fever
fatigue
21
Q

Diagnosis of crohn’s

A 
FBC
iron studies
serum B12
serum folate
abdo pelvic ultrasound
tissue biopsy; non-caseating granulomas
colonoscopy; cobblestoning and skip lesions
22
Q

treatment of crohn’s

A

steroids i.e. prednisolone
liquid diet may help
immunosuppressants; azathioprine, methatrexate
biological medicines; adalimubab, infliximab (“umab”)

23
Q

symptoms of coeliac disease

A 
IgA deficiency
diarrhoea
bloating
abdo pain/discomfort
osteoporosis
fatigue
weight loss

dermatitis herpetiforms

24
Q

Risk factors for coeliac disease

A

1 % of population

FHx
IgA deficiency
type 1 diabetes
autoimmune thyroid disease

25
Q

diagnosis of coeliac disease

A 
FB and blood smear
IgA-tTG
endomyseal Ab
skin biopsy
histology; villous atrophy, crypt hypertrophy and raised lymphocytes
26
Q

Treatment of coeliac disease

A

Gluten free diet
Calcium + Vit D supplementation ± iron

CRISIS; rehydration and correction of electrolyte abnormality, corticosteroid

27
Q

describe coeliac crisis presentation

A

watery diarrhoea, hypovolaemia, acidosis, hypocalcaemia, hypoalbuminaeamia

28
Q

symptoms of cholelithiasis

A

Postprandial pain
RUQ/epigastric pain
nausea
jaundice

29
Q

Investigations for cholelithiasis

A

FIRST LINE

  • FBC
  • LFT
  • serum lipase and amylase
  • abdominal US

SECOND LINE

  • MRCP
  • EUS
  • ERCP
30
Q

Treatment for cholelithiasis

A

symptomatic cholelithiasis = cholecystectomy

Choledocholithiasis

  • ERCP
  • ballon dilatation, stenting
31
Q

Symptoms of acute cholangitis

A

CHARCOT’s triad

fever
jaundice
abdo pain

32
Q

Investigations of acute cholangitis

A

FBC
Urea
Creatinine
ABG analysis

LFTs
CRP
ERCP

33
Q

treatment of ascending cholangitis

A

Acutely ill

  • IV ABs broad spectrum
  • biliary drainage i.e. ERCP
34
Q

symptoms of primary sclerosing cholangitis

A 
many asymptomatic 
pruritus
fatigue
weight loss
fever jaundice
35
Q

Diagnosis of primary sclerosing cholangitis

A 
ALP
GGT
AST, ALT
bilirubin
albumin
FBC
abdo US
MRCP
ERCP
36
Q

Treatment of primary sclerosing cholangitis

A

pruritus relief

calcium and vitamin D supplementation

37
Q

Symptoms of cholecystitis

A 
abdo pain --> right shoulder
tender abdomen
deep breathing worsens pain
jaundice
nausea
vomiting
sweating
appetite loss

Murphy’s sign

38
Q

Investigations for cholecystitis

A

FBC
CRP
LFTs
RUQ US

39
Q

Treatment of cholecystitis

A

Supportive care
antibiotics
NSAIDs
Cholecystectomy

40
Q

Symptoms of inguinal hernias

A 
groin discomfort/pain
groin mass
abdo discomfort/pain
nausea and vomiting
constipation
41
Q

Diagnosis of inguinal hernia

A

usually clinical

may do US of groin if unsure, CT scan

42
Q

Treatment of inguinal hernia

A

small asymptomatic
- watchful waiting

large symptomatic
- open mesh/laparoscopic repair

43
Q

symptoms of liver cirrhosis

A 
tired/weak
nauseous
appetite loss
sex drive loss
jaundice
haemoptosis (coffee ground)
pruritus
melaena
oedema
44
Q

Signs of liver cirrhosis

A 
clubbing
palmar erythema
spider naevi
jaundiced sclera
telangiectasia
clubbing
45
Q

Diagnosis of liver cirrhosis

A 
LFTs
GGT
albumin reduced
sodium reduced
prothrombin time (long)
platelet count (low)

Liver US, CT
Liver biopsy

46
Q

treatment of liver cirrhosis

A

Treat causative condition
monitor for complications
may need Na restriction, diuretic therapy
eventual liver transplant

Main diseases for each system (12 decks)

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