Complications of ulcerative colitis?
severe bleeding, toxic megacolon, rupture of bowel, colon cancer, osteoporosis, haemorrhage, primary sclerosing cholangitis
What is peritonitis?
Inflammation of the peritoneum and endothelial lining of the abdominal cavity and can be localised or generalised.
How does a rolling hiatus hernia occur?
Part of the fundus prolapses through the hiatus, alongside the oesophagus so the sphincter remains competent and below the diaphragm
What does Achalasia cause dysphagia for from onset and what other symptoms occur?
Solids and liquids. and regurgitation of food from dilated oesophagus, mainly at night, with spontaneous chest pains due to oesophageal spasm.
What does TNF-a do in cirrhosis?
Attract more neutrophils and T cells for inflammation causing necrosis and fibrosis.
What are factors influencing IBD?
antimicrobial peptide problems, autophagy, handling of bacteria, cytokines, diet, infection, stress, NSAIDs, smoking, antibiotics
What is a toxin mediated cause of infective diarrhoea?
Shiga toxin (bloody), B cereus and S aureus
What do clonochis sinensis and opisthorchis spp. cause?
relapsing cholangitis and cholangiocarcinoma
What happens in hepatic carcinoma and the symptoms?
Causes pain, sweating, hepatomegaly and weight loss. Cell apoptosis and uncontrolled multiplication of liver cells.
What are probiotics?
Live or attenuated bacteria or bacterial products for a significant health benefit in the host e.g. bifidobacterium infancts 35624
What is the difference between a micro and macro nodular in the liver and in what diseases would you see them?
What is an appendicitis and what does if present with?
Inflammation of the appendix, causing umbilical pain, migrating to the right iliac fossa and tenderness with guarding, nausea, vomiting, anorexia and diarrhoea
What are the symptoms of peritonitis?
Generalised acute abdominal pain that can become localised, abdominal tenderness and muscle guarding, fever, decreased peristalsis, abdominal distension, pyrexia, chills, dizziness, inability to pass stool, nausea, anorexia, vomiting, sinus tachycardia, lie still with shallow breaths
Describe stage 1-4 of ascites
1 - detectable after careful examination/US 2 - easily detectable but of relatively small volume 3 - obvious but not tense 4 - tense and large
What is toxic megacolon?
dilated thin walled colon with >6cm diameter, gas filled and contains mucosal islands, risk or perforation and mortality
Complications of cirrhosis?
Increase in pressure from portal hypertension causes ascites, hepatic encelopathy, variceal haemorrhage, bacterial peritonitis, hepatic renal syndrome, portal hypertension gastropathy, hepatic hydrothorax, hepatopulmonary syndrome, portopulmonary hypertension, cirrhotic cardiomyopathy.
What is the treatment of an appendicitis?
laparoscopic surgery, IV fluids, antibiotics if mass, interval appendictectomy prevents further acute episodes
What causes intra hepatic portal hypertension and what investigation is needed?
Can be mild fibrosis if non cirrhotic portal hypertension or schistomsomiasis with extensive fibrosis or congenital hepatic fibrosis or nodular regenerative hyperplasia. Need a wedge liver biopsy.
What is a complication of biliary colic if it is not treated?
Complication of TIPS and variceal banding?
Complications of primary biliary cirrhosis?
cirrhosis, osteoporosis, osteomalacia, polyneuropathy
What is the difference in histology between acute and chronic gastritis?
Acute has neutrophil infiltration and chronic has mononuclear cells, chiefly lymphocytes, plasma cells and macrophages.
Complications of gastritis?
Gastric outlet obstruction, pernicious anaemia, peptic ulcers, stricture formation, mucosa associated lymphoid tissue (MALT) lyphoma
What is Achalasia and how is it caused?
degeneration of the lower oesophageal sphincter and the nerves controlling the muscles causing impaired relaxation of the LOS, difficulty swallowing, chest pain and regurgitation of food. Thought to be caused by inflammation of myentreric plexus of the oesophagus with reduced ganglion cell number, reduced NO containing neurons and loss of inhibitory nitregic neurones.
What is biliary pain and what causes it?
Pain associated with temporary obstruction of the cystic duct and common bile duct, caused by a stone. Pain is in the RUQ and spreads to the right shoulder and scapula area.
What investigations would you conduct for liver cirrhosis?
Liver biopsy, liver function test, ultrasound, metabolic breath test (assesses functional reserve of the liver), hepatic venous pressure gradient, transient elastography (measure liver stiffness of fibrosis and oedema), CT shows hapatosplenomegaly and dilated collaterals, endoscopy detects varicies and portal hypertensive gasrtopathy
What is chronic cholecystitis, the signs and symptoms?
Chronic inflammation of the gall bladder wall associated with gallstones and IBD, causing flatulence, nausea, discomfort in right hypercondrium, fatty food intolerance and US shows small sunken gall bladder, Treat with cholecystectomy.
What is a common micro organism in peritonitis?
s.pneumoniae and other streptococci, staph aureus, E.coli, P.aeruginosa
What is portal hypertension?
Blockage of blood flow through the liver, causing a portal vein bypass, increasing portal vein pressure, resulting in backflow towards the gastro oesophageal vein and cause oesophageal-gastric varicies causing bleeding.
What is a pilonidal sinus?
An abscess near the anus caused by an obstructed hair follicle which has excited a foreign body reaction causing secondary tracks to open laterally forming foul smelling discharge.