GI 2 - Basics + Common diseases Flashcards Preview

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Flashcards in GI 2 - Basics + Common diseases Deck (27):

Where does peptic ulceration commonly occur?

- Lesser curve @ angulus
- Proximal 1/4 of duodenum


Why is the proximal 1/4 of the duodenum more likely to ulcerate than the rest of the duodenum?

It is before the major duodenal papilla where the alkaline pancreatic juice and bile neutralise the acidic gastric contents.
- Therefore the proximal 1/4 of the duodenum is constantly exposed to gastric acid which can erode the mucosal lining of the duodenum


What are the common symptoms of peptic ulceration?

- Burning/gnawing epigastric pain between meals or at night, relieved by eating
- Heartburn
- Bloating
- Nausea/vomiting


What are the complications of a perforated duodenal ulcer?

* Think anterior vs posterior perforation *

Anterior perforation = Peritonitis

Posterior perforation = Erode in gastroduodenal artery = haemorrhage: haematemesis, malaena, hypovolaemic shock


What are the complications of a gastric ulcer perforating posteriorly?

If erodes into the Splenic artery = haemorrhage: haematemesis, malaena, hypovolaemic shock


What are the common causes of an obstructed bile duct?

- Gallstones
- Pancreatitis
- Malignancy (of liver/pancreas/bile duct/duodenum)


What are the symptoms of an obstructed bile duct?

- Jaundice
- Dark urine
- Steatorrhoea
- Pruritus
- Abdo pain in RUQ


What is Coeliac disease?

- Autoimmune response to Gliadin (in gluten)
- Resulting in mucosal lesions in upper small intestine


What microscopic changes to the intestinal mucosa are caused by Coeliac disease?

In upper part of small intestine:
- Villous atrophy
- Crypt hyperplasia


What are the symptoms of coeliac disease?

- Diarrhoea
- Fatigue
- Weight loss
- Abdominal pain
- Bloating
- Iron-deficiency anaemia
- Osteoporosis
- Dermatitis herpetiformis
- Mouth ulcers
- Hyposplenism
- Acid reflux


What is Zollinger-Ellison syndrome?

Diarrhoea and peptc ulcers, caused by a gastrin-secreting tumour of the pancreas (stimulating over-production of gastric acid from parietal cells)


What are the symptoms of appendicitis?

- Dull umbilical pain which sharpens and locates to RIF
- Nausea
- Vomiting
- Loss of appetite
- Bloating


What is a pseudo diverticulum?

A protrusion of a wall which doesn't contain all layers of the wall. ie may only contain mucosa


Are colonic diverticula 'true' or 'pseudo' diverticula?

Pseudo, as only herniation of mucosa and submucosa, not all layers of the gut wall


What are the risk factors for colonic diverticula?

- Increasing age
- Low fibre diet
- Obesity
- Little physical activity
- Alcohol
- Smoking


What are the risk factors for colorectal cancer?

- Age
- Familial adenomatous polyposis
- Crohn's
- Ulcerative colitis
- Diabetes type II
- Obesity
- Heavy drinking


What is the most common type of colorectal cancer?



What tumour marker is sometimes released by colorectal carcinomas?

CEA - Carcinoembryonic antigen


Where does colorectal cancer often metastasise to?

- Liver
- Lung
- Peritoneum


What type of colorectal cancers affect above and below the dentate line?

Above dentate line = adenocarcinoma
Below dentate line = squamous cell carcinoma


What are haemorrhoids?

Dilations of superior rectal veins


What can cause haemorrhoids?

- Straining
- Constipation
- Obesity
- Pregnancy
- Anal sex
- Low fibre diet


At which point do haemorrhoids become extremely painful?

Begin above dentate line. If they extend below the dentate line, somatic innervation = pain


What is a Meckel's diverticulum?

Vestigial remnant of vitelline duct


What is the rule of 2's associated with Meckel's diverticula?

- Detected in under 2's
- 2:1 M:F ratio
- ~2% population
- 2ft from ileocaecal valve
- 2" long


What are the symptoms of a Meckel's diverticulum?

- Loss of appetite
- Nausea
- Vomiting
- Malaena


What is a sigmoid volvulus?

Large sigmoid loop full of faeces and distended with gas, twisted on its mesenteric pedicle to create a closed-loop obstruction

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