Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Finals!!! > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

(99 cards)

Start Studying
1
Q

Features of coeliac

A
  • Wheat intolerance –> villous atrophy and malabsorption
  • Sx: Weight loss, offensive stools, diarrhoea, fatigue
  • Ix: Anti-transglutaminase, biopsy
  • Tx: gluten free diet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Causes of pancreatitis

A
  • Gallstones
  • Ethanol
  • Trauma
  • Steroids
  • Mumps/ Malignancy
  • Autoimmune
  • Scorpion/ spider bite
  • Hypercalcaemia/thyroid/lipidaemia
  • ERCP
  • Drugs- azathioprine, oestrogens, thiazides, isoniazid, steroids, NSAIDs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Functional causes of bowel obstruction

A
  • Paralytic ileus- post abdo surgery, pancreatits, spinal injury. NO BOWEL SOUNDS.
  • Pseudo-obstruction- Ogilvies syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Presentation of colorectal cancer

A
  • Left sided- PR bleed, diarrhoea/constipation, mass on PR, tenesmus, ++ obstruction
  • Right sided- Iron deficient anaemia, weight loss, abdo pain, fatigue
  • Rectal- PR bleed, tenesmus
  • General- Weight loss, loss of appetite, obstruction, perforation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Budd-Chiari syndrome?

A

Occlusion of hepatic vein Triad:

  1. Abdo pain
  2. Ascites
  3. Hepatomegaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Jaundice- Post-hepatic causes

A

Conjugated

  • Gallstone/ cholangitis
  • External compression- PSC, pancreatic cancer, Mirrizi syndrome
  • Drugs- flucloxacillin, fusidic acid, nitrofurantoin, sulfonylureas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Features of large bowel obstruction

A
  • More gradual onset.
  • Continual pain.
  • Normal bowel sounds
  • Metabolic acidosis
  • AXR- Peripheral. Haustra partial width of bowel.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Psoas sign

A

Pain on extension of hip. (Appendicitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pancreatic cancer 2 week wait criteria

A
  • >40y with jaundice
  • >60 years + weight loss and 1 of: diarrhoea, back pain, abdo pain, nausea, vomiting, constipation, new onset DM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Signs of chronic liver disease

A
  • Hepatosplenomegaly
  • Encephalopathy
  • Constructional apraxia
  • Jaundice
  • Ascited
  • Spider naevi (>5)
  • Caput medusae
  • Oesophageal
  • Varices
  • Palmar erythema/ Dupuytren’s
  • Bruising
  • Testicular atrophy
  • Gynaecomastia
  • Peripheral oedema
  • Asterixis
  • Clubbing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Definition of SBP

A

Neutrophils >250/mm3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Features and management of Wilson’s

A
  • Copper in liver and CNS
  • Sx: Liver failure, tremor, dysarthria, dyskinesias, parkinsonism, kayser-fleischer rings
  • Ix: Urine 24h copper excretion, serum caeruloplasmin
  • Tx: Penacillamine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Alcoholic liver disease bloods

A
  • AST:ALT 2:1
  • Normal Alk phos
  • Raised GGT
  • Macrocytic anaemia
  • Raised IgA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Bacterial infections that cause gastroenteritis

A
  • Campylobacter- milk, poultry, water
  • Salmonella- meat, eggs, poultry
  • E. Coli
  • Shigella- ++ blood
  • C. Diff- ABx, PPIs. Green watery stool. Risks: Perforation, toxic megacolon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Causes of small and large bowel obstruction

A
  • Small- adhesions, hernias
  • Large- Colon Ca, constipation, diverticular stricture, volvulus, caecal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Features of delirium tremens

A
  • 2-3d later
  • Hallucinations
  • Seizures
  • Confusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Dyspepsia management

A
  1. lifestyle and stop high risk drugs
  2. PPI eg lansoprazole (risk C. Diff)
  3. H2 receptor antagonist eg ranitidine (X with CYP450)
  4. Antacids eg aluminium hydroxide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Appendicitis ABx

A

Metronidazole + cefuroxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Conditions associated with IBD

A

APICES

  • Apthos ulcers
  • Pyoderma gangrenosum
  • Iritis
  • Clubbing
  • Erythema nodosum
  • Sclerosing cholangitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Causes of acute liver failure

A
  • Infection
  • Metabolic eg Wilson’s, haemachromatosis
  • Alcohol
  • AI
  • Fatty liver
  • Pre-eclampsia/ HELLP
  • Drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Features of duodenal ulcer

A
  • 4x more common
  • 50% ASx
  • Sx- Epigastric pain RELIEVED by eating
  • Ix- upper GI endoscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Features of Korsikoff’s

A
  • Often after Wernicke’s
  • Confabulation
  • Amnesia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Features of chronic colonic ischaemia

A
  • ‘Ischaemic colitis’
  • Left lower abdominal pain +/- bloody diarrhoea
  • Ix= Lower GI endoscopy
  • Tx: IVT, ABx, surgical resection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Indications for stool sample in gastroenteritis

A
  • Travel
  • Institutional care
  • ??Outbreak
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Genetic RF for colorectal cancer
* Lynch syndrome (HNPCC)- small no. adenomas with rapid malignancy. Aspirin prophylaxis * FAP- 1000s adenomas
26
Gastritis RF
* H. Pylori * Alcohol * NSAIDs * Hiatus hernia * CMV * Crohn's * Sarcoidosis
27
Indication for upper GI endoscopy
* Dysphagia or \>55y with persistent alarms symptoms
28
H. Pylori triple therapy
* PPI + 2x ABx * Lansoprazole * Amoxicillin (metronidazole if pen allergic) * Clarithromicin
29
Treatment of ascities
* Bed rest * Fluid and salt restriction * Spironolactone * Daily weights and U+Es
30
Presentation of pancreatic cancer
* Painless jaundice * Weight loss + anorexia * Steatorrhoea * Epigastric pain --\> back. Relieved by sitting forward * ?Acute pancreatitis * Epigastric mass * Hepatosplenomegaly * Lymphadenopathy * Portal hypertension * Hypercalcaemia * Coirvoisier's law- jaundice, palpable GB * Thrombophlebitis migrans
31
What is GORD? Symptoms and RF.
* Gatroesophageal Ruflux Disease Reflux of stomach contents --\> 2 or more heart burn episodes/ week. * Sx- heartburn, belching, water brash, chronic cough * RF- Hiatus hernia, pregnancy, obesity, alcohol, smoking, overeating, H. Pylori
32
Murphy's sign
Hand on RUQ --\> breath in --\> sharp pain Only +ve if -ve on left
33
Key features of UC
* Colon and rectum * Diffuse. * Mucous * RF: non-smokers, 15-30y or \>50y * Sx- diarrhoea \*\*BLOOD\*\*, weight loss, tenesmus * Complications- ++ Colorectal cancer, toxic megacolon, VTE, hypokalaemia
34
Features of inguinal and femoral hernias
* Indirect- through deep and superficial ring. Doesn't come out if deep ring occluded. More common. Commonly into scrotum * Direct- though superficial ring. Comes out when deep ring occluded. Rarely into scrotum. * Femoral hernias- more in women. Most likely to strangulate.
35
Signs of peritonitis
* Fever +/- rigors * Severe generalised abdo pain --\> back/ shoulders. * Worse with movement/ coughing * Guarding and rigidity * Septic
36
Jaundice- Pre-hepatic causes
* Unconjucated hyperbilirubinaemia * Haemolysis- haemolytic anaemia, DIC, antimalarials * Impaired hepatic uptake- contrast, RHF Impaired conjugation- Gilbert's Physiological neonatal jaundice (combo of above)
37
Colorectal cancer 2 week wait referral
* \>40y with unexplained weight loss and abdo pain * \>50y with unexplained rectal bleeding * \>60 with one of: Fe deficient anaemia, change in bowel habit, tenesmus, FOB * ?Rectal/abdominal mass * ?\<50y with rectal bleeding and 1 of: abdo pain, change in bowel habit, weight loss, iron deficient anaemia
38
Features of gastric ulcer
* RF- H.Pylori, smoking, NSAIDs * Sx- Epigastric pain made WORSE by meals and relieved by antacids * Ix- upper GI endoscopy + biopsies. Repeat 6-8w to rule out malignancy
39
What is Barrett's oesophagus?
Distal oesophagus epithelium from squamous --\> collumnar. Metaplasia --\> dysplasia --\> neoplasia
40
Key features of Crohn's
* Mouth to anus. Esp terminal ileum * Patchy. Transmural. * RF: smoking, esp 20-40y * Sx: diarrhoea, abdo pain, weight loss, fever, lethargy, anorexia, mouth ulcer, perianal skin tags, arthritis * Complications- SBO, fistulae
41
Pancreatic cancer Ix and Tx
* Ix: Bm, Ca19-9, USS, CT, ERCP * Tx: Palliative, Whipples, CBD stent
42
2 week wait criteria for upper GI endoscopy
* Dysphagia * \>55y with weight loss and 1 of: upper abdo pain, reflux, dyspepsia
43
Antibiotics in gastroenteritis + their indication
Ciprofloxacin Indications- unwell ++, elderly, immunosuppressed
44
Rovsing's Sign
Pain in RIF when LIF pressed. Seen in appendicitis.
45
Features of IBS
* Recurrent abdo pain associated with at least 2 of: * Relief by defecation * Altered stool form * Altered bowel frequency * FLUCTUATING * Doesn't wake from sleep
46
Charcot's triangle
= Cholangitis RUQ, fever, obstructive jaundice
47
Features of norovirus
* Fever * Abdominal pain * Diarrhoea * Projectile vomiting- "winter vomiting illness"
48
Dyspepsia ALARMS symptoms
* Anaemia (iron deficient) * Loss of weight * Anorexia * Recent/ progressive change * Melaena/ haematemesis * Swallowing difficulty
49
Presentation of acute liver failure
* Jaundice * Hepatic encephalopathy- confusion, flap * Fetor hepaticus * Constructional apraxia
50
Liver cancer presentation
* Jaundice (late) * Weight loss * Anorexia * Malaise * Fever * RUQ liver capsule pain * Abdo mass Bruit
51
Grading and management of hepatic encephalopathy
1. altered mood, sleep disturbance, dyspraxia 2. drowsiness, confusion, inappropriate behaviour +/- flap 3. Incoherent, stupor, liver flap 4. coma. GCS\<8 * Ix= ammonia * Tx= lactulose +/- rifaxamin
52
Types of obstruction
* Simple * Closed loops (2 points of obstruction) --\> grossly distended with risk of perforation. * Strangulated- blood supply compromised. ++pain, localised peritonism, Fever, high WCC.
53
Causes of acute lower GI bleed
* Anal fissure * Haemorrhoids * Polyps * Diverticular disease * IBD * Colon cancer * Ischaemic colitis * Radiation proctitis * Upper GI bleed * Angiodysplasia
54
IBD investigations
* Bedside- NEWS, stool culture and faecal calprotectin * Bloods- FBC, U+Es, LFTs, ESR, CRP, culture, coags, B12, folate * Imaging- AXR, colonoscopy, MRI, USS
55
Features of Auto-immune hepatitis
* Markers: ANA/ASMA, IgG, raised ALT * Any age any sex * Ix: Biopsy * Tx: immunosuppression- azathioprine, prednisolone
56
RF for acute mesenteric ischaemia
* !!! AF !!! * Hypercoaguable state * Poor cardiac output * Renal failure * Trauma * Vasculitis * Radiation
57
What is dysentry?
Diarrhoea with blood
58
Treatment of oesophageal varices
* ABCDE +/- IVT/ transfusion * Tx based on Child-Pugh score- risk of variceal bleeding in cirrhossis * Blachford score- guides acute management * Rockall score= post-endoscopy prognosis * Terlipressin + ABx Endoscopic banding
59
Causes of acute upper GI bleed
* Peptic ulcer * Oesophageal varices * Mallory-Weiss tear * Oesophagitis * Swallowed blood- epistaxis * Upper GI cancer * AVM * Underlying coagulopathy * High risk meds- NSAIDs, blood thinners, aspirin, steroids
60
Features and treatment of hepatorenal syndrome
* Cirrhosis + ascites + renal failure * Tx: type 1= terlipressin, haemodialysis type 2= transjugular intrahepatic portosystemic shunt
61
Features of haemachromatosis
* Iron deposition in joints, liver, heart, pancreas, pituitary, adrenals, skin * Sx: Tired, arthralgia, slate-grey pigmentation, cirrhosis, cardiomyopathy * Tx: venesection
62
Features of Wernicke's encephalopathy
Low thiamine Triad: 1. Ophthalmoplegia 2. Altered GCS 3. Ataxia
63
Phlegmon
RUQ mass of inflamed omentum/ bowel
64
UC management
* ABCDE * Mild- mesalazine, topical steroids * Mod- PO prednisolone * Severe- IVT, IV hydrocortisone, VTE prophylaxis * Day 3-5 decline --\> rescue therapy: ciclosporin, infliximab * Immunomodulation- azathioprine if \>2 steroids/ year. CHECK TPMT LEVELS * All fail --\> colectomy
65
Antibiotic treatment for peritonitis
Metronidazole + Cefuroxime
66
Features of primary sclerosis cholangitis
* Markers: ANCA, raised ALP * Men\>women. Esp IBD (UC)!! * Sx: ASx, jaundice, RUQ pain, cholangitis? * Ix: MRCP- beeding in large duct, Biopsy- onion skin in small duct * Tx: Sx control, ERCP
67
Presentation of bowel obstruction
* Vomiting * Nausea * Anorexia * Abdominal distention * Constipation * No flatus
68
Jaundice- Hepatic causes
* Mixed conjugated and unconjugated * Infection- Hep A/B/C, CMV, EBV * Drugs- paracetamol OD, isoniazid, rifampicin, MAOi, statins, sodium valproate * Alcohol * Cirrhosis * Genetic- haemachromatosis, Wilson's, alpha1 antitryptase AI hepatitis Budd-Chiari
69
Crohn's management
* ABCDE * Mild- Prednisolone PO * Severe- IV hydrocortisone Immune modulation- azathioprine/ methotrexate
70
Causes of liver decompensation
* Sepsis * Bleed * Medication - new/ OD, paracetamol * Constipation * AKI
71
Presentation of gastric cancer
* Non-specific * Early satiety * Dyspepsia * Weight loss * Vomiting * Dysphagia * Anaemia
72
Liver screen bloods
* LFTs * Coags/ PT * Hep A/B/C serology * EBV * CMV * AMA, ASMA, Anti-LKM, ANA, pANCA * Immunoglobulins- IgM, IgG * Alpha-1 antitrypsin * Serum copper * Ceruloplasmin * Ferratin * Paracetamol level
73
Management of acute upper GI bleed
* Ix: UO, ABG, bloods including X-match, OGD * Tx: ABCDE + fluid/ transfusion. ??SHOCK * NBM * analgesia * X anti-coags/ NSAIDs * Endoscopy * PPI post endoscopy
74
Symptoms and complications of diverticular disease
* Altered bowel habit * L abdo pain relieved by defecation * Nausea * Flatulance * PR bleed * Complications- haemorrhage, perforation, fistulae, abscess
75
Colorectal cancer Ix
* FOB * CEA * Colonoscopy * CT
76
Different presentations of gallstones
* Biliary cholic * Cholecystitis * Obstructive jaundice * Cholangitis * Pancreatitis * Mucocoele/empyema * Coirvoisier's law- GB small, shrunken, not palpable * Gallstone Ileus
77
Features of alpha1-antitrypsin
* Affects lungs and liver * Sx: SOB, cirrhosis, cholestatis jaundice * Ix: liver biopsy * Tx: transplant?
78
Acute liver failure diagnostic criteria
* Raised PT by 4-6s * Encephalopathy In a patient with no pre-existing disease
79
Features of Primary biliary cholangitis
* Markers: AMA, raised ALP, raised IGM * Middle aged women * Sx: liver disease, jaundice, cholestatis LFTs * Tx: Ursodeoxycholic acid, fibrates, obeticholic acid, transplant?
80
Features of chronic mesenteric ischaemia
* 'Abdominal angina' * Sx: weight loss, abdo pain (esp post-prandial), upper abdominal bruit * Ix: CT, MR angiography * Tx: revascularisation and stent
81
Presentation of oesophageal cancer
* Dysphagia * Weight loss * Anaemia * Chest pain * Mass * Horse voice/ mass * Vomiting
82
Management of obesity
1. lifestyle 2. Orlistat + lifestyle. BMI\>28 + complications or BMI\>30 3. Bariatric surgery- banding/ bypass. BMI35-40 + complications or BMI \>40
83
Indications that gastroenteritis is bacterial
* More unwell * Higher fever * Blood/ mucus in stool * Abdominal pain
84
Assessing UC severity
Truelove and Witts Severe: * \>6 motions/ day * Large rectal bleeding * Temp \>37.8 * \>90bpm * Hb \<105g/L * ESR \>30
85
Signs of liver decompensation
* Jaundice * Ascites * Encephalopathy * Renal impairment * Sepsis
86
Presentation of pancreatitis
* Epigastric pain --\> back * Fever * Guarding/ rigidity * Vomiting ++ * Dehydration * Ecchymosis: Cullen's (umbilical), Grey Turner's
87
Symptoms of Cholecystitis
* Epigastric/RUQ pain --\> R shoulder * Phlegmon * Murphy's * Anorexia, vomiting * Local peritonism * Fever
88
Features of small bowel obstruction
* Presents quicker * Pain higher in abdomen * Tingling bowel sounds * Metabolic alkalosis * AXR- central. valvulae coniventes across whole width.
89
HCC screening
6 monthly USS and AFP in those at risk: Cirrhosis (esp HBV), FHx, African, Asian
90
Types of laxatives and examples
* Bulk forming- ispaghula husk * Osmotic- Macrogol, lactulose * Stimulant- senna, bisacodyl * Stool softeners- docusate, liquid paraffin
91
Investigations and management of diverticular disease
* Ix: Obs, bloods, CT * Tx: High fibre diet, IVT, NBM, analgesia, ?ABx, antispasmodics- mebevarine
92
Causes of constipation
* General- diet, elderly, IBS, environmental * Anorectal disease eg fissures * Bowel obstruction * \*\*colorectal cancer\*\* * Metabolic- hypercalcaemia, hypothyroidism, hypokalaemia * Drugs- Iron, opiates, diuretics, CCB, TCAs Neuromuscular eg spinal injury
93
Acute mesenteric ischaemia Ix and Tx
* Bedside- NEWS * Bloods- FBC, amylase, ABG/lactate * Imaging- AXR, CT, MR angiography * Tx: Piptaz, LMWH, surgical resection
94
Presentation of acute mesenteric ischaemia
Triad: 1. No/minimal abdo signs 2. Acute, severe abdominal pain 3. Rapid hypovolaemia/ shock
95
What is achalasia and its symptoms, Ix and Tx?
* Lower oesophageal sphincter fails to relax due to degeneration of myenteric plexus * Sx: Dysphagia or solids and fluids, regurgitation, weight loss, heart burn * Ix- CXR fluid level, barium swallow * Tx- Balloon dilatation
96
Markers of synthetic liver function
* Albumin * Bilirubin * PTT * Glucose
97
Obturator/ Cope's sign
* Pain on flexion and internal rotation of hip. (Appendicitis)
98
What is Mirizzi's Syndrome?
Obstructive Jaundice from CBD compression by gallstone impacted on cystic duct. Associated with cholangitis.
99
Presentation, Ix and Tx of testicular torsion
* = Spermatic cord twists --\> ischaemia. RF= undescended testes. * Presentation- * Sudden onset, severe, **unilateral** abdominal/groin/**testicular** pain --\> always examine testes! * N+V * Fever * Swollen testicle - rapid * No **cremasteric reflex** * **Preh's -ve** (lifting testis doesn't relieve pain) * Ix- Doppler USS, urgent senior r/v * Tx- Emergency surgical exploration with bilateral fixation within 6h

Finals!!! (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions