Abdomen 1

Question 1

Sensitive to wheat fat and coffeine

Answer 1

Irritable bowel syndrome

Question 2

Gastrointestinal and hepatic consequences of alcohol

Answer 2

Alcoholic liver disease 
Gastritis 
Pancreatitis 
esophageal cancer 
Diarrhoea

Question 3

Smoking

Answer 3

increased risk of oesophageal cancer, colorectal

cancer and peptic ulcer.

Question 4

Aspirin and non-steroidal anti-inflammatory

drugs can cause

Answer 4

Dyspepsia
Gastric erosion
Peptic ulcer

Question 5

opioid analgesia causes

Answer 5

Nausea
Vomiting
Constipation

Question 6

Antibiotics can cause

Answer 6

Diarrhea

Question 7

In patients with liver diseases- risk factors

for viral hepatitis:

Answer 7

• foreign travel
• tattoos
• multiple sexual partners
• Iv drugs
• blood transfusion

Question 8

UGI

Dry mouth

Answer 8

Xerostomia atropine, Sjogren sdr.

Question 9

UGI

Altered taste sensation

Answer 9

Dysgeusia

Question 10

UGI

Difficulty in swallowing

Answer 10

Dysphasia

Question 11

UGI

Sensation of a lump in the mouth

Answer 11

Globus

Question 12

UGI

Pain swallowing

Answer 12

Odynophagia

Question 13

Burning retrosternal discomfort

Answer 13

Heartburn

Question 14

UGI

malodorous breath

Answer 14

Halitosis

Question 15

Anorexia

Answer 15

– common in many gastrointestinal and liver
diseases (cancer, hepatitis)
– does not specifically indicate a
gastrointestinal disease

Question 16

Weight loss with normal, or even increased,

calorie intake is rare, but may occur in

Answer 16

• type 1 diabetis mellitus
• hyperthyroidism
• malabsorption
• fever

Question 17

Very rapid weight loss (> 0.5 kg/day)

indicates

Answer 17

Fluid loss

Question 18

Causes of weight loss?

Answer 18

– malignancies of the upper gastrointestinal tract, liver
and pancreas, but is a late feature of colon cancer.
hen severe it is called cancer cachexia.
– Inflammatory gastrointestinal disorders (pancreatitis,
inflammatory bowel disease).
– chronic liver disease: weight loss - multifactorial; a
reduced calorie intake because of anorexia, ascites
and imposed dietary restrictions on salt,
malabsorption of food due to reduced bile production,
and the diseased liver cannot process the absorbed
nutrients.

Question 19

Other causes of weight loss : non-gastrointestinal diseases:
other malignancies, chronic infections or
inflammatory conditions.

Answer 19

Mental illness such as depression is easy to
overlook, especially in the elderly, and anorexia
nervosa or bulimia is a common cause in
adolescents.

Amenorrhoea is not specific to anorexia nervosa,
and menstrual irregularity is common in women
who lose weight from any cause.

Question 20

Pale smooth tongue

Answer 20

Atrophic glossitis
Beefy raw appearance in folate and Vitamin B12 deficiency
–> malabsorption

Question 21

Painful hacks at the corner of the mouth

Answer 21

Angular chelates

Question 22

Telangiectasis

Answer 22

Osler-weber re du syndrom

Question 23

Oral ulceration

Answer 23

Crohn

Behcet

Question 24

Clubbing

Answer 24

Inflammatory bowel syndrome
Amyloidosis
Cirrhosis

Question 25

Leukonychia

Answer 25

Hypoalbuminemia due to liver disease Nephrotic syndrome Malabsorption Protein malnutrischen

Question 26

Dupuytren's contracture

Answer 26

Shortening and thickening of the skin Alcoholic liver disease Congenital and occupational factors More often in smokers

Question 27

Bilateral parotid swelling

Answer 27

Malnourished alcohol dependent patients

Question 28

palpable metastatic scalene lymph node in the supraclavicular fossa, most commonly on the left side

Answer 28

Trosier s sign | May be caused by gastric or pancreatic cancer

Question 29

widespread lymphadenopathy with | hepatosplenomegaly may suggest

Answer 29

Lymphoma

Question 30

Unpleasant taste: parodontopathies, gum | infections;

Answer 30

– Sour taste: acid regurgitations, gastritis, – bitter taste: gallblender diseases; – metallic taste: intoxication (Pb,Cr), – radish taste – hepatic failure

Question 31

small red spots surrounded by white areas over the buccal mucosa

Answer 31

(Koplik sign) measles in prod royal stage

Question 32

blue line along the gum, with bluish black edging to the teeth

Answer 32

Saturnism (chronic lead poisoning )

Question 33

Hypersalivation (sialorrhea, ptyalism):

Answer 33

– Teething – Infections of the upper resp.tract – Allergies

Question 34

Color aspect tongue

Answer 34

``` – Dry tongue (“fried” tongue) –severe dehydration – Saburral– white-yellow layer: fever, dehydration – issured (cracked) tongue – scrotal tongue – congenital anomalies – Geographic tongue – allergies – Strawberry tongue – inflamed red papillae: scarlet fever, Kawasaki sdr. – Ulcerations – injuries, trauma (the abuse of cigarettes and excessive consumption of alcoholic beverages) ``` Pain= glossodinia – local causes: inflammation, ulcerations, tumors, candidosis – general causes: anemia, uremia, diabetes

Question 35

Diet lacking fruits, vegetables and fibres

Answer 35

Increased risk of developing colonic cancer and diverticular disease

Question 36

Esophageal syndrome

Answer 36

``` – Dysphagia – Chest pain – heartburn – regurgitation s (pitting up of food from the esophagus or stomach without nausea or forceful contractions of abdominal muscles) ``` in any oesophageal disease- due to motility disorders or organic causes

Question 37

Dysphagia

Answer 37

Risk of aspiration pneumonia, malnutrition, weight loss, dehydration Causes- according to the affected phase of swallowing: – oral: impaired control of the tongue – Pharyngeal: lack of coordination of the pharyngeal muscles, a poor opening of the upper esophageal sphincter – Esophageal: a mechanical obstruction, a motility disorder, an impairment of the opening of the lower esophageal sphincter Aspiration= the passage of food or liquid through the vocal folds.

Question 38

Achalasia

Answer 38

megaoesophagus, cardiospasm – Motility disorder- lower esoph.sphincter cannot relax completely - incrs.tone – Dysphagia for both solids and liquids – chest pain; – regurgitation of the bland, nonacidic contents of the enlarged esophagus; -cough at neight

Question 39

GERD=

Answer 39

``` gastroesophageal reflux disease an excess volume of gastric juice that refluxes into the esophagus and cause symptoms with/without associated esophageal mucosal injury ```

Question 40

Typical symptoms GERD

Answer 40

Dysphagia Heartburn Regurgitation

Question 41

GERD atypical symptoms:

Answer 41

coughing, wheezing, damage to the lungs (pneumonia, asthma, idiopathic pulmonary fibrosis), vocal cords (laryngitis, cancer), teeth (enamel decay).

Question 42

Esophagitis is classified into the following 4 grades based on its severity:

Answer 42

– Grade I – Erythema – Grade II – inear nonconfluent erosions – Grade III – Circular confluent erosions – Grade IV – Stricture or Barrett esophagus (the squamous epithelium of is replaced by the intestinal columnar epithelium)

Question 43

Esophageal motility disorders

Answer 43

Achalasia Spastic esophageal motility disorders: diffuse esophageal spasm, nutcracker esophagus Nonspecific esophageal motility disorder (inefficient esophageal motility disorder) Secondary esophageal motility disorders: scleroderma, diabetes mellitus, alcohol consumption, psychiatric disorders, presbyesophagus