GI

Question 1

Jaundice

Answer 1

1. Haemolytic anaemia
2. Hepatocellular disease (hepatitis, cirrhosis, drugs, venous obstruction)
3. Obstruction/cholestasis (intrahepatic cirrhosis e.g. drugs) (extrahepatic .eg. gallstones, pancreatic ca/cholangiocarcinoma, biliary stricture)

Question 2

Upper GI bleed

Answer 2

1. Oesophagus (varices, Mallory-Weiss tear, erosive oesophagitis)
2. Gastric (ulcer - H. pylori/ASA/NSAIDs, erosive gastritis)
3. Less common: [tumour, AV malf]

Question 3

Lower GI bleed

Answer 3

• Diverticulosis, Ischaemia, Angiodysplasia (elderly), Infectious
• Anorectal (haemorrhoids, fissure, ulcer)
• Uncommon: [upper GI, post-polypectomy, radiation, IBD]

Question 4

Acute diarrhoea

Answer 4

• Inflam (bacteria, protozoa, NSAIDs, IBD, ischaemia)

- Non-inflam

Question 5

Chronic diarrhoea

Answer 5

• Organic (Inflam/Secretory/Steatorrhea/Osmotic)

- Functional (IBS, anal sphincter dysfx)

Question 6

Weight loss

Answer 6

1. Incr appetite (incr exercise, Malabsorption, Endocrine hyperT/DM uncontrolled)
2. Decr appetite
   - Chronic systemic inf TB/HIV/endocarditis
   - Ca
   - Chronic cardiopulm disease
   - Endocrine (Addison)
   - Psych (dep/anorexia)
   - Drugs (etoh, opiate)

Question 7

N&V + abdo pain, relieved by vomiting

Answer 7

• Obstruction (gastric outlet, small bowel)

- GORD

Question 8

N&V + abdo pain, NOT relieved by vomiting

Answer 8

• Inflam in other organs (cholecystitis, pancreatitis, hepatitis)
• MI
• Infectious gastroenteritis

Question 9

N&V (no assoc sx)

Answer 9

• Drugs
• Pregnancy
• Uraemia, metabolic, ketoacidosis
• Gastroparesis

Question 10

N&V (+headache/dizziness)

Answer 10

• Migraine
• Meningitis
• Raised ICP (SOL)
• Vestibular

Question 11

Abdo distension

Answer 11

• Fluid (portal HTN e.g.cirrhosis,CCF,hepatic vein thrombosis. no HTN e.g. cancer, pancreatitis, TB)
• Flatulence
• Faeces (constip, obstr, dysmot)
• Fetus, Fat, Fatal growth (tumour)

Question 12

Constipation (usually idiopathic if no assoc PR bleed/weight loss)

Answer 12

• Functional (diet, IBS, sedentary), Structural (stricture from diverticulosis/ischaemia/radiation, compression, rectocoele, CRC obstruction)
• Drugs (narcotic/antidep/CaBlocker)
• Metabolic (DM, thyroid, hyperCa)
• Neurogenic (Parkn, MS, stroke)

Question 13

Acute abdo pain (upper-mid abdo)

Answer 13

• CV/Resp (MI, AAA, pneumonia)

- GI (gastro, cholec, ulcer, pancreatitis, small bowel ob, mesenteric ischaemia)

Question 14

Acute abdo pain (lower abdo)

Answer 14

• GI (gastro, appendicitis, diverticulitis, Crohn)

- Gynae (PID, ectopic)

Question 15

Chronic/recurrent abdo pain

Answer 15

• Inflam (ulcer, biliary colic, IBD, chronic pancreatitis)
• Neoplastic/Vasc (recurrent bowel ob, ischaemic, sickle cell anaemia)
• Toxin (lead), Endometriosis, IBS, Radiculopathy