Gastro Flashcards
(35 cards)
Presentation of acute pancreatitis
LUQ pain, radiating to back
Jaundice N+V
Weight loss due to lack of pancreatic enzymes
Causes of pancreatitis
Idiopathic Gallstones Ethanol Trauma Steroids Mumps Autoimmune Scorpion sting High triglycerides/calcium ERCP Drugs
Presentation of ascending cholangitis
Charcots triad: Fever
Jaundice
RUQ pain
What is ascending cholangitis?
Inflammation of bile duct from bacteria ascending from duodenum.
Tends to occur if the bile duct is already partially obstructed by gallstones
Treatment of chronic pancreatitis?
Analgesia, pancreatic enzymes (creon)
Features chronic pancreatitis
Pain worse 30m after meal
Steatorrhoea
DM develops in most pt
Management ascending cholangitis?
IV ABx
IV fluids
Biliary decompression + drainage with ERCP
What effect does obstructive jaundice have on clotting?
Can lead to decreased absorption of vit K so check PT
Symptoms of oesophageal ca?
Progressive dysphagia, weight loss, hoarse voice (invades recurrent laryngeal)
Duodenal v gastric ulcers
- duodenal 4x more common
- D: relieved by eating, G: pain on eating
- gastric relieved by antacids
2WW for dyspepsia?
>55 GI bleed Weight loss Dysphagia IDA Persistent vomiting Epigastric mass
Managment for dyspepsia with no alarm symptoms?
- stop drugs causing dyspepsia eg NSAIDs
- antacids
- lifestyle changes
- r/v 4 w
Symptoms of simple GORD:
- less painful than ulcers
- precipitated by specific things eg spicy foods
- radiates up to chest/neck
2ww pancreatic cancer
- > 40y with jaundice
2ww oesophageal cancer
- dysphagia or
- aged >55 with weight loss AND
1. dyspepsia OR
2. upper abdo pain OR
3. reflux
Three inheritance of colon cancer?
- sporadic
- HNPCC (at risk of other cancers)
- FAP (removal of large bowel to form ileo-anal pouch in 20s)
Symptoms of IBD?
- diarrhoea with blood and mucus
- frequent toileting
- urgency
- abdo pain
- may experience fatigue, weight loss, decreased appetite.
How does UC occur?
It is an autoimmune condition. The body sees the gut as foreign and attacks it, therefore causing inflammation
Cardinal symptom of UC?
bloody diarrhoea
Extra-abdominal manifestations of IBD
Ank spond PSC+ cholangiocarcinoma (esp UC) Gallstones (esp crohns) iritis/episcleritis/conjunctivitis arthritis Clubbing erythema nodosum
Investigations for IBD?
B: FBC, U+E, LFT, CRP, ESR, O: faecal calprotectin X: AXR E: NA S: Flexi-sig/colonoscopy
Presentation of Gallstone?
May be asymptomatic
May be colicky RUQ pain
May present as acute cholecystitis
presentation of acute cholecystitis
RUQ pain fever vomiting local peritonism GB mass murphys sign +
Treatment of cholecystitis
Pain relief
IV ABx
Laparascopic cholecystectomy
