GI and Hepatic Lecture Flashcards
What is dysphagia and what happens when it gets worse?
Difficulty Swallowing
If dysphagia gets worse and theres weight loss it could possibly mean oesophageal cancer
What is the difference between dysphagia and neurmouscular dysfunction?
Dysphagia = Liquids are easier to swallow NMD = Solids are easier to swallow, cough with swallowing
What does Sharp, burning pain on swallowing suggest?
mucosal inflammation
What causes a globus sensation?
Pharyngeal dysfunction
GERD
Emotion
What are some red flags for globus sensation?
Neck or throat pain Weight loss Abrupt onset after age 50 Pain, choking, or difficulty with swallowing Regurgitation of food Muscle weakness Palpable or visible mass Progressive worsening of symptoms
What is Dyspepsia and what is it commonly associated with?
A gnawing, burning, ‘indigestion’ type pain in the upper abdomen
What causes Dyspepsia?
Achalasia Cancer (Oesophageal, Gastric) Coronary Ischemia Oesophageal Spasm GERD Peptic Ulcer Disease
What are some red flags of Dyspepsia?
Acute episode with dyspnoea, diaphoresis*, or tachycardia Anorexia Nausea or vomiting Weight loss Blood in the stool Dysphagia Medication doesnt work
Describe Heartburn
Burning pain behind the sternum
Worsens when lying down, straining, or after eating
Suggests the presence of GERD and acid reflux
What could cause acute Acute Nausea and Vomiting?
GI infection Food poisoning Drugs Head trauma/migrane Abdominal visceral pain Pregnancy
What could cause Chronic Acute Nausea and Vomiting?
Motility disturbance
Endocrine/metabolic disorder
Intracranial pathology
Partial obstruction of GI tract
Nausea/Vomiting Red Flags
Signs of hypovolemia HA Stiff neck Change in mental status Rebound tenderness Abdominal guarding Distended, tympanic abdomen
What Types of Abdominal Pain are there?
Referred
Somato-parietal
Visceral
Describe visceral pain
Dull, poorly localised pain
Often associated with autonomic features
Describe Somato-parietal pain
Originates from parietal peritoneum
More localised than visceral pain
What is Peritonitis ?
Inflammation of the peritoneal cavity
What would be some signs and symptoms of peritonitis?
Guarding, rigidity, rebound tenderness on examination
What is Irritable Bowel Syndrome ?
Abdominal discomfort accompanied by at least two of: Relief by defecation Change in frequency of stool Change in consistency of stool Unknown cause
Acute Abdominal Pain Red Flags
Severe pain
Signs of shock (eg, tachycardia, hypotension, diaphoresis, confusion)
Signs of peritonitis
Abdominal distention
Chronic Abdominal Pain Red Flags
Fever Anorexia, weight loss Pain that awakens patient Blood in stool or urine Jaundice Oedema Abdominal mass or organomegaly
What is Haematemesis ?
Vomiting of blood from the upper part of the GI Tract
What is Melaena ?
Blood in the stool from anywhere in the GI Tract
Why does diarrhoea occur?
Osmotic load – un-absorbable, water-soluble solutes retain water in the bowel
Increased secretions – infections, unabsorbed fats and certain drugs lead to increased water/electrolyte secretion
Reduced contact time/surface area – rapid intestinal transit and less surface area for absorbing fluid such as in celiac disease
What Causes Diarrhoea ?
Travel Bad food Disease exposure Usually associated with acute watery diarrhoea Diverticular bleeding and ischemic colitis Inflammatory bowel disease Associated with, acute bloody diarrhoea
