Flashcards in GI Deck (78):
Summary of GI pathology?
Upper GI: Oesophageal/Stomach/SI pathology
Lower GI: Diverticular/IBD, Polyps, Adenoma, CRC,
Nutritional support in trauma
What is the most common cause of oesophagitis?
(infection if immunocomp/ corrosives)
State 5 risk factors for reflex oesophagitis.
Increased intra-abdo pressure
Ulceration/Haemorrhage/Perforation/Strictures are possible complications of long-standing reflux oesophagitis.
What is another one which is a pre-malignant condition?
What are the risk factors for Barrett's oesophagus?
Same as reflex oesophagitis
State the histiological changes in Barrett's oesophagus.
(sq --> columnar)
Those wth Barrett's oesophagus require regular endoscopic surviellance. For what?
What are the 2 types of Oesophageal cancer?
Adenocarcinoma - from Barrett's
Squamous Carcinoma - from native cells (middle/lower 1/3)
Which Oesophageal cancer has the same risk factors as Barrett's/reflex oesophagitis?
Risk factors for Squamous carcinoma?
The 2 oesophageal cancers have the same macroscopic appearence. Describe these.
Causes of Chronic gastritis?
ABC: Autoimmune, Bacterial (H.pylori), Chemical injury
H.pylori is associated with which 2 cancers?
What effects does H.pylori have on the stomach?
Chronic inflammation (mucosa)
Glandular atrophy (fibrosis, intestinal metaplasia)
What is defined as a localised defect extending to the submucosa +
Name 5 causes of peptic ulcers
Is duodenal or gastric ulcer more common?
What is it always almost caused by?
Complications of peptic ulcers?
Penetrate adjacent organs
Stricturing (hour-glass deforming --> reflux)
The most common type of gastric cancer is MALT lymphoma. T/F?
Adenocarcinoma of the GOJ has the same risk factors as Reflux oesophagitis.
What are the risk factors for Adenocarcinoma of body/antrum?
Gastric cancer in
Other uncommon forms of gastric cancer?
Coeliac D is autoimmune and gliadin induces IL-15 expression --> CD8 IEL activation --> villi atrophy.
Give 4 symptoms of Coeliac D.
Chronic fatigue (malabsorption)
How would you investigate for Coeliac D?
If got symptoms despite gluten-free diet, what would this suggest?
Are diverticula are inward or outward protrusion of mucosa and submucosa?
Diverticula are associated with...?
Most diverticula present as...?
Diverticulosis, Perforation, Haemorrhage are examples of what?
Acute complications of diverticula
Intestinal obstruction, Fistula, Colitis, Polypoid prolapsing mucosa folds are examples of what?
Chronic complications of diverticulosis
IBD is a form of chronic colitis. T/F?
3 Risk factors for IBD?
The longer you have UC, the more likely you are to develop CRC. What is neccessary after 10yrs of UC?
The following features are indicative of which IBD?
-affects colon- starts in rectum
Clinical presentation of UC? (4)
Diarrhoea -- urgency
Anorexia --> weight loss
The complications of UC include...? CRC was already mentioned
The complication of Crohns are the same as UC. What other ones are there that are not seen in UC?
Small bowel syndrome --> malabsorption
Crohns is transmural/affects any part of GI/ pathcy/ cobblestone appearence. T/F?
State 5 ways Crohns way present.
Colicky abdo pain
Palpable abdo mass
Name systems in the body which may show extra IBD-mainfestations.
Colorectal polyps are an outward mucosal protrusion. T/F?
What is the term for the common non-neoplastic polyps that are benign unless LARGE & RIGHT-SIDED?
Name the 2 non-neoplastic polyps that present in youth and ass with cancers
Juvenille polyps (malignanrt potential)
Peutz-Jeghers syndrome (predisposes to many cancers)
The neoplastic benign polyp is called adenoma. Is it a precursor of CRC?
What type of cancer is CRC generally?
Risk factors for CRC?
Are most CRC related to FH or sporadic?
Sporadic ~ 75%
Which inhertied conditions increase your risk of CRC?
Which one also increases risk for other cancers?
Where does CRC tend to spread to?
State the staging system for CRC.
A: confined to wall
B: invading wall
C: regional LN
D: distant mets
What mode of infection is common in Infectious Gastroenteritis (GE)
Common viral causes of GE include Rotavirus/Norovirus. What about bacteria?
Presenting complaint of GE are SUDDEN non-specific GI symptoms. Complications?
What SHOULDN'T you give to treat GE?
(except in young/old/immunocomp)
bacteria dying will release toxins --> worse
The Winter-vomiting disease = Norovirus. What is the classic presentation?
Which strain of E.Coli releases shinga toxin causing diarrhoea + dehydration?
Complication of E.Col 0157 GE?
Shinga toxin acts on RBC
Antibiotic-associated diarrhoea can occur up to how long after treatment?
C.dif is common in >60s / taken borad spectrum antibiotics.
Whats the treatment?
State 2 sources of intra-abdominal infections.
What are the 3 mechanisms of how an intra-abdo infection can occur?
1. Translocation across wall
2. Translocation across lumen
3. Translocation from extra-intestinal source
Cholecystitis = ?
= inflammation of GB wall
Obstruction of cystic duct (GALL STONES, malignancy, worms, ERCP)
How does cholecystitis present?
Complication and treatment of cholecystitis?
Empyema of GB
Cholangitis = ?
= Inflammation of biliary tree
Same as cholecystitis
Intraperitoneal abscesses can be caused by...?
Is the presentation oof intra-peritoneal abscesses specific or non-specific?
State the locations where intra-peritoneal abscesses occur.
How would you investigate intra-abdominal infections?
Bloods: FBC, CRP, LFTs
Imaging: CXR, USS, Abdo CT
Microbiological: microscopy, culture, sensitivity testing
Intra-abdominal infections are treated diff for > 65s and
Cefuroxime + Metronidazole 65s
What are the 3 phases post-trauma?
Phase 1: Clinical shock
Phase 2: Catabolic state
Phase 3: Anabolic state
What is the amrker for tissue hypoxia?
When is a patient most vulnerable of refeeding syndrome?
What is it?
IN ANABOLIC PHASE
If feed too quickly from malnourishment --> increased uptake into cells --> ions decrease in blood (when already low) --> CARDIAC ARREST
Manifestation of refeeding syndrome after tests?
Decreased K/Mg/Pi, Thiame
Salt/H20 retetion --> oedema
The term for inflammation of the large intestine due to C.dif overgrowth?
Complication of antibitoic therapy.
What is the term for inflammation of the ascites fluid?
Spontaneous Bacterial Peritonitis