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Differential Diagnosis 1 > GI > Flashcards

GI Flashcards

(42 cards)

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1
Q

What could a high pitched tinkling on bowel auscultation indicate?

A

Intestinal obstruction

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2
Q

Name 3 things that may cause visceral pain

A
  1. Distension
  2. Ischaemia
  3. Inflammation of an organ
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3
Q

How would you manage a patient with suspected appendicitis?

A

Urgent hospital admission

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4
Q

List 4 reasons why you may prefer an ultrasound over a CT scan?

A
  1. Less invasive
  2. No contrast
  3. Quicker
  4. Useful for solid organs/fluid filled structures
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5
Q

Where is the ascending colon located?

A

Midgut

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6
Q

What are the 5 Fs of abdominal distension?

A

Fat
Faeces
Flatus
Fetus
Fluid

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7
Q

What are 6 causes of an enlarged liver?

A
  1. Alcoholic liver disease
  2. Hepatitis/cirrhosis
  3. Primary Liver cancer
  4. Metastatic cancer
  5. Lymphoma
  6. Leukaemia
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8
Q

List 3 presenting features of colorectal cancer

A
  1. Weight loss
  2. Diffuse and intermittent pain
  3. Change in bowel habit
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9
Q

True or False - biliary colic normally lasts for 5-7 days

A

False

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10
Q

What are 3 risk factors for gastritis/oesophagitis?

A

Spicy Foods
NSAIDs
Alcohol

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11
Q

How might a patient with an anal fissure present?

A

Bright red blood after bowel movements
and
Severe pain on defection - like passing glass

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12
Q

Name the 9 regions of the abdomen

A

Right Hypochondriac
Epigastric
Left Hypochondriac
Right Lumbar
Umbilical
Left Lumbar
Right Iliac Fossa
Hypogastric
Left Iliac Fossa

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13
Q

What is the significance of the hind-gut, fore-gut, mid-gut breakdown?

A

If you know which part of the gut the pain FIRST started, this gives you an idea of which organs may be affected

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14
Q

What organs are in the fore-gut?

A

Oesophagus
Stomach
Liver
Gallbladder
Pancreas
D1 and D2

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15
Q

What organs are in the mid-gut?

A

D3 and D4
Jejenum
Ilium
Caecum
Appendix
Ascending colon
Half transverse colon

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16
Q

What organs are in the hind-gut?

A

Half transverse colon
Descending colon
sigmoid colon
rectum
upper anal canal

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17
Q

What are the 2 causes of abdominal pain which are medical emergencies and need to be ruled out quickly?

Study These Flashcards
A

Ectopic Pregnancy
Ruptured AAA

18
Q

How does diverticular disease typically present?

Study These Flashcards
A

Left iliac fossa pain (sigmoid colon)
Pain is colicky - intermittent and resolves in waves
CBH - pellet like stools, but variable and intermittent
Occasional PR bleed
Occasional mucus
Diverticulitis… Sepsis

19
Q

How does gastritis typically present? Include pain, associations, relieving factors and risk factors

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A

Pain in the upper abdomen
Gradual onset of pain, intermittent
Can be gnawing or burning
Can radiate backwards
Mild to moderate Pain
Associated with belching and nausea
Eating can relieve pain
Risk factors: NSAIDs, spicy food, stress, alcohol

20
Q

What is the difference between biliary colic and cholecystitis?

Study These Flashcards
A

Both cause pain because of gall stones (small mass formed from bile).

Biliary colic - pain from the gall stones: temporary obstruction

Cholecystitis - inflammation and infection: the patient is unwell

21
Q

When might pneumonia end up presenting with GI symptoms?

Study These Flashcards
A

Lower lobe pneumonia can cause upper abdominal pain

22
Q

How can you determine the difference between haemorrhoids or anal fissure?

Study These Flashcards
A

Anal fissure pain is sharp and severe - like passing glass
Haemorrhoids are a more dull pain

23
Q

Describe the symptoms of IBD

Study These Flashcards
A

Often loose liquid stools
Increase frequency
Blood and mucus mixed in the stool
Abdominal Pain
Weight loss
Nausea

24
Q

Why is smoking history important when assessing a person with GI symptoms?

Study These Flashcards
A

It can be a protective factor in ulcerative colitis

25
List 7 clinical signs in the hands that may indicate a GI condition
Temperature: cold and sweaty = anxiety, cold and dry = poor circulation, hot and sweaty = hyperthyroidism, dry and coarse = hypothyroidism Clubbing: chronic disease/IBD/liver disease Leukonychia: chronic liver disease Koilonychia: anaemia Flaps: Liver disease Palmar Erythema: liver disease
26
What is Virchow's node - why is it significant in GI?
Palpable left supraclavicular lymph node... Sign of upper GI malignancy
27
What are the 6 causes of abdominal distension?
Fat Fluid Fetus Faeces Flatus Tumour
28
What should you do if someone has voluntary guarding on abdominal palpation?
Distract them and assess for involuntary guarding
29
What is Rovsing's Sign?
Sign of appendicitis Palpate the left side and pain is felt on the right: positive rosving's
30
What is Murphy's Sign?
Sign of acute cholecystitis Palpate the right hypochondriac region during inspiration - if causes more pain: positive murphy's
31
What are the benefits of a CT colon over a colonoscopy? 4 benefits 1 major drawback
Less severe bowel prep (as virtual colon) Tolerated better by elderly and frail Very low complication risk Can be used where colonoscopy has failed to reach the caecum If abnormal pathology is found - a colonoscopy may be need for biopsy/polyp removal
32
List 5 benefits/negatives of a flexible sigmoidoscopy vs colonoscopy
Bowel prep - just an enema for flexi, full bowel prep for colon Perforation Risk - lower for flexi, higher for colon View - limited for flexi to left side of bowel, stops at distal descending colon, vision until caecum for colon Range of Symptoms - flexi good for just rectal bleeding symptoms, colon good for PR bleed, CBH, unexplained iron deficient anaemia Polyps/lesions - if found by flexi, a colon will be needed anyway
33
What are the important planes to be aware of when examining the abdomen?
Mid-clavicular lines Transpyloric plane (Bottom of ribs above epigastric region) Subcostal plane (between epigastric and umbilical) Transtubercular line (between umbilical and hypogastric)
34
What is the difference between biliary colic and bowel colic?
Biliary colic resolves between waves Bowel colic does not
35
What is the key difference between areas affected by Chron's and ulcerative colitis?
Chron's : mouth to anus Ulcerative Colitis: bowel and rectum only
36
What are some signs of oesophageal cancer?
Dysphagia Weight Loss Chest Pain (referred) Decreased appetite Vomiting
37
What lymph node is relevant for GI conditions?
Subclavicular
38
What would involuntary abdominal guarding be a sign of?
Peritonitis
39
When assessing a patient - what should you ask first and where should you start?
Ask about pain Start away from pain
40
Where should you listen when auscultating for bowel sounds?
Right umbilicus
41
How often should you hear bowel sounds and how long should you listen for?
5-10 seconds Up to 2 minutes
42
What is a positive Murphy's sign for?
Cholecystitis : inflammation of gall bladder

Differential Diagnosis 1 (5 decks)

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