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Gastroenteritis Flashcards

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1
Q

what can cause Angular Cheilitis?

treatment?

A

fungal infection, iron deficiency

it is self limiting and lip balm can work

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2
Q

what is another word for an ulcer?

A

apthous stomatitis

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3
Q

what do you look for when looking for an ulcer?

A

yellow surface (can scrape off)
red halo around ulcer
lasts a week

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4
Q

what can cause Oral Thrush?

A

inhaled steroids- beclomethasone as this has immunosuppresive effects leading to fungal infection

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5
Q

how do you treat oral thrush?

A

anti fungals

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6
Q

what does Lichen planus look like?

A

white lacy patches on areas of mucous membrane eg mouth

purple patches on skin

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7
Q

what are the ALARMS?

A

Anaemia, Loss of weight, Anorexia, Recent onset of PROGRESSIVE symptoms, masses or melena/ haematemesis, swallowing difficulty

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8
Q

what are the main things to look for when thinking of oral cancer?

A

smoker and or alchol drinker, IRREGULAR SHAPE, increasing in size
soft sites as high risk sites

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9
Q

what are the main types of HPV that can cause oral cancer?

A

HPV 16 and 18 (girls are often vaccinated against these)

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10
Q

where are the high risk sites for oral cancer?

A

soft sites eg ventral tongue, floor of mouth, lateral tongue, non keratinising sites

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11
Q

what are the main causes of chronic oesophagitis?

A

GORD and Crohn’s disease

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12
Q

what are the causes of acute oesophagitis?

A

chemicals and infection

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13
Q

what is allergic oesophagitis also called?

A

eosinophilic oesophagitis

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14
Q

how does allergic oesophagitis present?

A

similar to chronic oesophagitis

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15
Q

how do you differentiate between chronic and allergic oesophagitis?

A

do a pH probe test and if acidity is normal then its likely to be allergic oesophagitis
do bloods- if more eosinophils- allergic

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16
Q

what are the main causes of GORD?

A

pregnancy/ obesity (as abdominal pressure is increased)

Stress

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17
Q

what are the main symptoms of GORD?

A

heartburn, worse lying down, dysphagia (due to stricture formation)

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18
Q

what investigations would be done for GORD?

A 
PPI trial
Endoscopy to see if ulcer causing GORD
pH probe (if normal possibly allergic oesophagitis)
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19
Q

treatment of GORD?

A

smoking cessation, limit acidic foods, sit up in beds, weight loss
PPIs- omeprazole, lansoprazole

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20
Q

what do you use if PPIs are not too effective against stomach acid pH?

A

H2 antagonist such as Ranatidine

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21
Q

what is Barrett’s Oesophagus?

A

chronic reflux damaging the stratified squamous epithelium and thus they become simple columnar epithelium

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22
Q

is barrett’s oesophagus premalignant?

A

yes as the metaplasia means there is an increase chance of dysplasia

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23
Q

what type of cancer is barretts oesophagus premalignant to?

A

adenocarcinoma as it is the simple columnar epithelium (glandular epithelium)

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24
Q

how do you treat low grade dysplasia due to Barrett’s Oesophagus?

A

endoscopic radiofrequency ablation

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25
how do you treat high grade dysplasia due to Barrett's Oesophagus?
oesophagectomy
26
what can cause squamous cell carcinoma of the oesophagus?
HPV 16 or 18 Smoking and alcohol Oesophagitis (due to chronic inflammation)
27
how do you confirm the presence of adenocarcinoma or squamous cell carcinoma?
endoscopic biopsy
28
what is a major symptom of oesophageal cancer?
PROGRESSIVE difficulty swallowing hoarse voice (invasion of recurrent laryngeal nerve) anaemia (due to small chronic bleed)
29
how is Oesophageal cancer staged?
TNM staging
30
what is TNM staging?
T- how far tumour has grown N- how many lymph nodes affected M- if there is metastasis or not
31
what are the main causes of Acute Gastritis?
chemicals and alcohol
32
what are the main causes of chronic Gastritis?
NSAIDs and H.pylori | aswell as alcohol and pernicious anaemia
33
what type of bacteria is H.pylori?
gram negative bacillus with flagella
34
what relevant enzyme does H.pylori produce?
Urease (involved in pathway which causes ammonium production)
35
how is H. Pylori transmitted?
faecal- oral | spread generally in infancy
36
where in the stomach does H.Pylori live?
between the mucous and the epithelium | uses the mucous for protection
37
what investigations can be used to determine presence of H.pylori?
Carbon 13 Urea breath test | FAT (faecal antigen test)
38
what do Peptic Ulcers look like on Endoscopy?
ulcer with Clear Cut edges, punched out (not the same as cancer)
39
how do NSAIDs cause peptic ulcer disease?
NSAIDs inhibit COX, thus inhibiting PGE1 and so there is an increase in Acid in Gastric Lumen so mucous membrane can break
40
what are the main complications of Peptic Ulcer Disease?
Pain predominant Dyspepsia Haemorrhage Perforation (can cause peritonitis)
41
what should be done prior to testing for H.pylori?
stop use of antibiotics and PPIs 2 weeks prior
42
what is the triple therapy treatment for H.Pylori?
PPIs Amoxicillin Metronidazole/ Clarythromycin
43
what are a few of the main risks of Gastric Cancer?
H.Pylori, Obesity, processed meats with high nitrates
44
what is MALT lymphoma?
Gastric lymphoma, these can be cured by eradicating H.Pylori
45
what particular lymph node can suggest Gastric cancer metaplasia?
Virchows lymph node
46
what is Achalasia?
it is an Oesophageal motility disorder, the LOS does not open so food does not enter the stomach
47
what is the biological cause of Achalasia?
degeneration of Myenteric Plexus (in the muscularis externa)
48
is there peristaltic movement in Achalasia?
there is IMPAIRED peristaltic function
49
what are some main symptoms of Achalasia?
vomiting structures (not churned in stomach) chest pain weight loss- no absorption in the stomach
50
what investigations would you do for suspected Achalasia?
barium swallow- bird peak appearance X-ray- shows dilated oesophagus Endoscopy- to rule out cancer
51
what is the management of Achalasia?
CCB and Nitrates to relax sphincter (not too effective and used when waiting for definitive surgery)
52
what surgeries can young patients get for Achalasia?
Cardiomyotomy (Heller's Myotomy)
53
what treatments can older patients get for Achalasia?
balloon dilation (older patients may not be able to undergo surgery)
54
what is Gastroparesis?
delayed gastric emptying
55
what can cause Gastroparesis?
diabetes and chemotherapy | also smoking weed
56
what are the general symptoms of Gastroparesis?
bloating, feeling of fullness, abdo pain
57
what investigations would be done for Gastroparesis?
Manometry (see peristaltic movement if any) | Gastric emptying studies
58
what is the management of Gastroparesis?
metoclopramide nutritional support implantable gastric stimulation
59
what symptoms are evidence of an upper GI bleed?
``` haematemesis= blood in vomit melena= black, very foul smelling stool ```
60
what are 4 things that can cause an upper GI bleed?
ruptured varices ruptured ulcers neoplasms Mallory-Weiss Tear
61
what is the treatment of Peptic Ulcer rupture bleeding?
Haemospray-1st line Omeprazole- to stop acid from dissolving the formed clot Eliminate H.pylori if caused by peptic ulcer treat underlying cause- eg portal hypertension
62
what are the 2 assessments to determine GI bleed severity?
Rockall Scoring System (RSS) | Glasgow Blatchford Bleeding Score (GBBS)
63
Why is Terlipressin used n Acute Variceal Bleed?
it decreases blood flow in the Splanchic arteries by vasoconstriction
64
what is the chronic long term treatment of high portal pressure?
transjugular intrahepatic portosystemic shunt
65
what bacteria can you get from rice?
bacillus cereus
66
what bacteria can you get from cream cake left on counter at room temp?
Staph Aureus
67
what type of bacteria can you get from raw poultry that causes bloody D and V?
Camplyobacter
68
what type of bacteria can be given from raw poultry, eggs and pet reptiles?
Salmonella
69
what types of bacteria have a long incubation period?
shigella and E.coli 0157
70
what bacteria comes from beef and can cause HUS?
E.coli 0157
71
what bacteria comes from unhygienic food prep?
shigella
72
what types of bacteria have a short incubation period?
bacillus cereus and staph aureus
73
what types of bacteria have a medium incubation period?
camplyobacter and salmonella
74
what is the shiga like toxin that comes from E.coli 0157?
Verotoxin (VTEC)
75
what do shiga toxins do?
inhibit protein synthesis in certain cells eg renal cells
76
what type of shiga toxin is more dangerous?
type 2 shiga toxin
77
what bacteria is especially dangerous for Pregnant women?
Listeria
78
how can you get Listeria?
soft cheeses, unpasturised milk, deli meats (FRIDGE FOOD)
79
what is the incubation period for Listeria?
several months
80
what virus is common in nurseries that causes non bloody diarrhoea?
Rotavirus
81
what virus is common on cruise ships, nursing homes and wards and causes EXPLOSIVE Diarrhoea?
Notavirus
82
what is the most common bacterial cause of Acute Travellers Diarrhoea?
Enterotoxigenic E.coli

GI (11 decks)

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