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GI Flashcards

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1
Q

What is a cause of epigastric pain?

A

Peptic ulcer, pancreatitis, gastritis, gallbladder disease, AAA

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2
Q

What are possible causes for left upper quadrant pain?

A

Renal problems, peptic ulcer, gastric or colonic cancer, splenic rupture, subphrenic and polyphrenic abscesses

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3
Q

What can cause right upper quadrant pain?

A

Peptic ulcer, colonic or gastric cancer, hepatitis, cholecystis, renal problems, subphrenic and perinephric abscess

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4
Q

What can cause loin pain?

A

Polynephritis, perinephritic abscess, renal tumour, a in from vertebral column

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5
Q

What can cause left iliac fossa pain?

A

IBS, diverticulitis, volvulus, colon cancer, cancer of un descended testes, zoster, pelvic abscess, hip pathology

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6
Q

What can cause right iliac fossa pain?

A

IBS, chron’s ileities , volvulus, colon cancer, cancer of un descended testes, zoster, pelvic abscess, hip pathology

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7
Q

What can cause generalised abdominal pain?

A

IBS, gastroenteritis, peritonitis, constipation

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8
Q

What can cause central abdominal pain?

A

Mesenteric ischaemia, IBS, AAA, pancreatitis

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9
Q

What can cause pelvic pain?

A

UTI, stones, retention

Ovarian torsion, salpingitis, pregnancy, menstruation, endometriosis, endometritis

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10
Q

What can cause abdominal distension?

A 
Fetus,
Fat
Flatus,
Faeces
Fluid
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11
Q

What can cause faecal incontinence?

A

Idiopathic
Sphincter problems- surgery or tearing
Loss of sensation- ms, dementia, diabetes, spinal cord lesion
Copious diarrhoea,

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12
Q

What is tenesmus and what can cause it?

A

A feeling of incomplete bowl emptying, can be caused by IBS or tumours

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13
Q

What is regurgitation?

A

Effortless entry of gastric or oesophageal contents into mouth without contraction of muscles

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14
Q

What is steatorrhea and what can cause it?

A

Fatty stools, caused by malabsorption of fats and high fat content in stools. Caused by iliac problems, such as Crohn’s and iliel resection, obstructive jaundice and pancreatic disease

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15
Q

What signs of chronic liver disease CN be observed on inspection?

A

Asterix, halitosis, gynaecomastia, purpura, muscle wasting, scratch marks, spider naevi

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16
Q

What is leuconychia and what is it caused by?

A

Whitening of nails caused by hypoalbunism

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17
Q

What is koilonychia and what is it caused by?

A

Spooning of nails due to b12 or iron deficiency

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18
Q

What are Muehrcke’s lines and what causes them?

A

Transverse white lines on nails caused by hupoabuminaemia

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19
Q

What are palmar erythema’s and what are they caused by?

A

Chronic liver disease and pregnancy

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20
Q

What are blue lanulae and what are they caused by?

A

Bluish discolouration of nails caused by Wilson’s disease

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21
Q

What are dupuytren’s contracture and what are they caused by?

A

Thickening and contraction of palmar fascia, caused by alcoholic liver disease

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22
Q

What can hepatic flap be caused by?

A

Hepatic encephalopathy, uremia

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23
Q

What can cause angular stomatitis?

A

Thiamine, iron or b12 deficiencies

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24
Q

What can cause glossitis?

A

Folate, b12 or iron deficiencies

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25
What are keiser-Fleischer rings and what can cause them?
Greenish yellow corneal ring, caused by Wilson's disease
26
What are causes of Hepatomegaly?
RHF, hepatitis, malaria, sickle celled anaemia, leukemia, lymphoma, myeloproliferative diseases, malignancy
27
What can cause splenomegaly?
Malaria, chronic myeloid leukemia, myelofibrosis
28
What can cause dysphagia and chest pain?
Oesophageal spasm
29
What is dyspepsia?
Indigestion
30
What are the symptoms of gastric pain?
Change in weight, asymptomatic, epigastric pain
31
What are the causes of gastro oesophageal reflux disease?
Obesity, over eating, smoking, alcohol, drugs, pregnancy, oesophageal sphincter dysfunction, hiatus hernia
32
What is GORD?
When reflux of stomach into the oesophagus causes problems
33
What are the complications of GORD?
Barret's oesophagus, Oesophagitis, Stricture, Iron deficiency
34
What is a sliding hiatus hernia?
Gastro-oesophageal junction moves up into chest. LOS becomes less competent, can lead to acid reflux
35
What is a rolling hiatus hernia?
A part of the stomach bulges out, but rarely causes gross acid reflux
36
What can cause bloody diarrhoea?
Campylobacter, shigella, salmonella, ecoli, UC, Crohn's, ischaemic colitis, pseudo membranous colitis, ameobiasis, colorectal cancer, polyps
37
What can cause mucousy diarrhoea?
IBS, colorectal cancer, polyps
38
What can cause frank pus diarrhoea?
Fistula, abscess, IBD | Absence of white blood cells:ncholera, ecoli, ameobiasis, viruses
39
What can cause explosive diarrhoea?
Cholera, yersenia, giardia, rotavirus
40
What are symptoms of large bowel diarrhoea?
Pain relieved by defaecation Watery stools, sometimes blood Tenesmus Urgency
41
What are the symptoms of small bowle diarrhoea?
Pain not relieved by defecation
42
What can be used to treat diarrhoea?
Oral rehydration therapy Codeine phosphate or loperamide to treat urgency Antibiotics if needed
43
What can be used to treat constipation?
Bulking agents to increase faecal matter Osmotic laxatives to retain water Faecal softeners to do that Stimulant laxatives to increase motility
44
What can cause constipation?
Neuromuscular disorders - spinal cord lesion, diabetes, systemic sclerosis Drugs - morphine Anorectal disease - prolapse Obstruction - strictures, crohn's, UC, diverticulitis
45
What is unconjugated hyperbilirubinaemia and what are possible causes?
Bilirubin doesn't enter blood, Over production: malaria, hemolysis, ineffective erythropoeisis Impaired hepatic function: drugs Neonatal
46
What are the causes of Conjugated hyperbilirubinaemia?
Hepatocellular dysfunction: hepatitis, EBV, CMV, leptospirosis, cirrhosis, alcohol, Wilson's disease, liver metastasis and abscesses, autoimmune hepatitis Impaired hepatic excretion: biliary cirrhosis, gallstones, pancreatic cancer, cholangitis
47
Fulminant hepatic failure
Liver failure due to massive necrosis of the liver
48
What are the causes of liver failure?
Viruses: CMV ebv, hepatitis (b and c) Drugs: paracetamol overdose, alcohol Vascular: increased portal hypertension, veno occlusive disease Others: autoimmune hepatitis, primary biliary cirrhosis, Wilson's disease, cirrhosis, fatty liver
49
What are the clinical presentations of liver failure?
Hepatic flap, jaundice, encephalopathy
50
What is liver cirrhosis?
Irreparable damage to liver
51
What are the causes of liver cirrhosis?
``` Alcohol abuse Fatty lover disease Chronic HBV and HCV Primary biliary cirrhosis Autoimmune hepatitis ```
52
What is the clinical presentation of liver cirrhosis?
Dupytren's contracture, palmar erythema, spider naevi, spooning of nails, xanthelsma, gynaecomastia, clubbing and Ascites
53
What is hereditary hemochromatosis?
A genetic disease that increases iron absorption in the body and causes deposits in the joints and stuff. Need regular venesection Reverse vampires
54
What are the indications for liver transplant?
Hepatitis b and c Alcoholic liver disease Primary biliary Fatty liver disease
55
What is alpha1 antitrypsin deficiency?
It's a genetic disorder that causes inadequate mucus clearing in the lungs and liver
56
What is the clinical presentation of alpha1 antitrypsin deficiency?
Dyspnoea due to bronchiectasis, cholecystic jaundice, cirrhosis. Presentation usually starts at adolescence
57
What is primary biliary cirrhosis?
Damage to bike ducts due to chronic granulomatous inflammation leading to cholecystis which can cause cirrhosis, fibrosis and portal hypertension
58
What is the clinical presentation of primary biliary cirrhosis?
Lethargy can precede jaundice | Jaundice, xanthomata, xanthelsma, skin pigmentation, hepatosplenomegaly
59
What are the complications of primary biliary cirrhosis?
Coagulapathy, osteoporosis, osteomalacia, poor absorption of fat soluble vitamins
60
What is primary sclerosing cholangitis?
Progressive cholestasis with strictures and bile duct inflammation
61
What are the signs and symptoms of primary sclerosing cholangitis?
End stage liver failure, cirrhosis, lethargy, pruritis
62
What is Wilson's disease?
Genetic disease of biliary secretion, causing increased copper (and copper deposition) in liver and basal ganglia
63
What are the clinical presentations of Wilson's disease?
Keiser Fleischer rings, blue lines on hand, reduced libido, depression, dysarthria, dysphasia, tremor, arthritis, fulminant liver failure, cirrhosis,
64
What are the signs and symptoms of liver cancer?
Fever,malaise, anorexia, weight loss,pain, | Hepatomegaly, other cancers, clubbing,
65
What is ulcerative colitis?
It is caused by inflammation of colonic mucosa and it rarely spreads above the ileocaecal valve
66
What are the symptoms and signs of ulcerative colitis?
Bloody diarrhoea with mucus, increased bowel frequency Fever, tachycardia, malaise, weight loss Clubbing, mouth ulcers, ankylosing spondylitis, conjunctivitis, iritis, uveitis, arthritis
67
What is the surgery used to treat ulcerative colitis?
Proctocolectomy with terminal iliectomy. Will require pouch later
68
What is Crohn's disease?
It is a GI disease characterised by granulomatous inflammation anywhere from mouth to anus. Unlike UC, there can be areas without inflammation in between
69
What are the symptoms and signs of Crohn's disease?
Diarrhoea, urgency, fever, anorexia, failure to thrive, weight loss, very smelly stool, malaise Clubbing, eye problems, skin tags, ulcers, strictures, abdominal distension/tenderness
70
What signs and symptoms can a cancer of the pancreas have?
Painless,obstructive jaundice (cholecystic picture in LFTs)
71
What is scurvy and what are the signs?
Vit C deficiency | Bleeding gums, nose or hair follicles, caxhexia, listlessness, muscle weakness, oedema, loose teeth and foul breath
72
What is beriberi and it's usual presentations?
HF caused by vit b1 deficiency Dry beriberi shows neuropathy Wet beriberi has centralised oedema
73
What is pellagra and it's clinical presentation?
Nicotinic acid deficiency, | Depression, ataxia, fits, dementia, dermatitis, diarrhoea, neuropathy
74
What is xerophthalmia and what does it cause?
Vit A deficiency. | Blindness, corneal softening and triangular/oval spots on the eye
75
What are the signs and symptoms of gastrointestinal malabsorption?
Diarrhoea, steatorrhea, bloating, lethargy, anaemia, bleeding disorders, metabolic bone disorder
76
What are there presenting symptoms for GI histories?
Abdominal pain, distension, dysphasia, haematomesis, dyspepsia, jaundice, weight loss, diarrhoea, constipation, rectal bleeding,
77
What is coeliac disease and what causes it?
T cell mediated attack of small bowel that causes glutin intolerance, which in turn, causes villi atrophy and malabsorption
78
What are the symptoms of coeliac disease?
Steatorrhea, diarrhoea, abdominal pain, failure to thrive, bloating, osteomalacia, angular stomatitis, ulcers, weight loss
79
What are the causes of chronic pancreatitis?
Mostly alcohol | Familial, CF, pancreatic duct obstruction, raised PTH, congenital defects
80
What is the clinical presentation of chronic pancreatitis?
Epigastric pain that bores to the back, relieved by sitting forward or hot water bottles, steatorrhea, weight loss, fatigue, bloating, brittle diabetes
81
What are the complications of chronic pancreatitis?
Pseudo cyst, pancreatic obstruction, diabetes, local arterial aneurysm, splenic vein thrombosis, pancreatic carcinoma, gastric varices
82
What is Achalasia?
Loss of oesophageal myenteric plexus | No peristalsis and LOS does not relax?
83
What is oesophageal spasm?qq
Uncoordinated oesophageal spasms
84
What is nut cracker oesophagus?
Type of oesophageal spasm | Distal contractions are of excessive amplitude and cause retro sternal chest pain and intermittent dysphagia
85
What would be seen in a patient with a pharyngeal pouch?
Cough and a prominent neck lump
86
What are the ALARM symptoms and what should be done with a patient who presents with them?
Anorexia, loss of weight, Anaemia, recent onset and Melaena/haematomesis for anyone over 55 Requires urgent referral for endoscopy
87
What is squamous cell and adenocarcinoma of the pancreas associated with?
Hoarse voice
88
What is coughing mid swallow associated with?
Bulbar palsy
89
What does regurgitation if oral intake suggest
Motility disorder like Achalasia
90
What does hypoalbuminaemia cause?
Ascites and peripheral oedema
91
What is biliary cirrhosis associated with?
Anti-mitochondrial antibodies
92
What is long term steroid use associated with?
Ulcers
93
What medications must be avoided before an endoscopy?qq
PPIs and H2 antagonists, for at least 2 weeks before

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