Gastroenterology Flashcards
(64 cards)
How would you characterise the causes of dysphagia
Extrinsic
Intrinsic
Oesophageal wall
Neurological
Extrinsic causes of dysphagia
Mediastinal mass
Cervical spondylosis
Intrinsic causes of dysphagia
Tumours
Strictures
Oesophageal wall causes of dysphagia
Achalasia
Hypertensive LOS
Neurological causes of dysphagia
Stroke
Parkinsons
Myasthenia gravis
CVA
Achalasia - characteristics
Difficulty swallowing both solids and liquids
Pathgnomenomic sign of achalasia
Barium study - Bird beak appearance of the oesophagus - Dilated proximally and tapers distablly
How to differentiate achalasia and pseudoachalasia (Oesophageal cancr)
red flag symptoms of cancer - specifically rapid weight loss, Anorexia, Vomitting
What is the mechanism of action of achalasia
Impaired relaxation of the lower oesophageal sphincter
What scoring system is used to triage the severity of Acute pancreatitis
Modified Glasgow score
What is the threshold of the Modified Glasgow score to assess the severity of developing a complication in a patient diagnosed with acute pancreatitis
MGS >3 - At risk of a severe complication
What are the components of the Modified glasgow score to deleniate risk of developing severe pancreatitis
Age > 55 - 1
wcc >15
Glucose >10
LDH >600
AST >200
Serum calcium <2
Albumin <32
(Score of >3 - High risk of developing a severe complication)
How would you characterise the complications of Acute pancreatitis
Local vs systemic
Local complications of acute pancreatitis
1) fluid collection arouns the pancreas
2) Pseudocyst - Conservative management
3) Abscess (Infected pseudocyst)
4) Pancreatic necrosis:
- Sterile necrosis - conservative management
- Infected necrosis - Necrosectomy (hight mortality)
5) Haemorrhage - Sign - Grey turner sign due to retroperitoneal haemorrhage
Systemic complications of Acute pancreatitis
ARDS
- Sudden onset central cyanosis, tachypnoea and SOB
How to Diagnose C.DIFF
Stool sample - +ve for C.Diff Toxin (A/B)
NB - C.Diff antigen +ve means previous exposure (Important in Abx mgt)
What is the classification of Mild C.diff
Normal WCC
What is the classification of Moderate C.DIFF
WC >15X10^9
What is the classification of severe C.Diff
WCC >15 + Fever >38.5
What is the classification of Life trheatening C.DIFF
1) Haemodynamic compromise
2) CT Findings of Severe C.DIFF
3) Toxic Megacolon
4) Complete Ileus
What is the most common cause of C.diff
2nd/3rd gen cephalosporins
What are the causes of C.diff
1) 2nd/3rd gen cephalosporins
2) Clindamycin
3) PPI’s
1st line management of C.diff (Mild - Severe)
Oral Vancomycin
Management of C.diff
1st line - Oral Vancomycin
2nd line - Oral fidoxamicin
3rd line Oral van +/- IV Metronidazole