GI and Surgery Flashcards by Catreena Ferguson

What causes renal colic?

Kidney stones

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What is a peptic ulcer?

Erosion of the lining of the stomach or duodenum

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What factors can lead to a peptic ulcer?

Helicobacter pylori
NSAID usage
Alcohol
Smoking

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Who usually gets appendicitis?

Younger people

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What are the causes of pancreatitis?

GET SMASHED

Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune Disorders
Scorpion Bites
Hypercalcaemia
post ERCP
Drugs

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What is biliary colic?

Pain caused by gallstones impacting on the bile duct or small intestine

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What can cause the formation of gallstones?

Increased cholesterol
Haemolytic
Medications

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What are the risk factors for gallstones?

Fat
Forty
Female
Fertile
Contraceptive pill
HRT 
Diabetes

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Who typically gets diverticular disease?

Middle aged and elderly

65% of 85 year olds

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What are diverticula?

Small out-pouching of large bowel

When these are inflamed=diverticulitis

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What antibiotic is commonly used for skin infections?

Flucloxacillin

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How is hepatitis E spread?

Fecally contaminated water

Uncooked/undercooked meat

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In what situations is hepatitis E associated with chronic hepatitis?

Solid organ transplant recipients
Patients with HIV
Patients on rituximab treatment for non-Hodgkin lymphoma

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What are the phases of infection of hepatitis E?

prodromal phase

- icteric phase

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Which patients are at greater risk of mortality from hepatitis E

Pregnant

Liver transplant recipients

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What is the incubation period of hepatitis E?

15-60 days

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Which phase of hepatitis E infection is usually of short duration?

Prodromal

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What are the symptoms of the prodromal phase of hepatitis E infection?

Myalgia
Athralgia 
Fever
Anorexia
Nausea/vomiting 
Weight loss
Dehydration 
Right upper quadrant pain that increases with activity

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How long can symptoms of icteric phase of hepatitis E infection last?

Days to several weeks

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What are the symptoms of the icteric phase of hepatitis E infection?

Jaundice
Dark urine
Light colour stools
Prutitus 
Malaise
Arthritis
Pancreatitis 
Aplastic anaemia
Thrombocytopenia 
Neurological symptoms

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What is a prehepatic cause of jaundice?

Haemolysis

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What are the hepatic causes of jaundice?

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Viral hepatitis
Drugs 
Alcoholic hepatitis
Cirrhosis
Pregnancy 
Recurrent idiopathic cholestasis 
Congenital disorders

What are the post hepatic causes of jaundice?

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Common duct stones
Carcinoma (bile duct, head of pancreas, ampulla)
Biliary stricture
Sclerosis cholangitis 
Pancreatitis 
Pseudocyst

Name some common types of hernia?

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Inguinal
Femoral 
Umbilical
Incisional 
Epigastric 
Hiatal

What is an inguinal hernia?

Protrusion of abdominal or pelvic contents, through a dilated internal ring or attenuated inguinal floor in inguinal canal

What is a hiatus hernia?

Protrusions of intra-abdominal contents through an enlarged oesophageal hiatus of the diaphragm Commonly-contains variable portion of stomach. Herniated contents usually within a sac of peritoneum

What is an umbilical hernia?

Defect of the anterior abdominal wall fascia that occurs when the umbilical ring fails to close.

What are the complications of Crohn’s disease?

``` Extra-intestinal involvement Intestinal obstruction Abscess formation Sinuses Fistulae ```

1. What is Crohn’s disease? 2. Parts of tract involved 3. how is it different from UC 4. what it can lead to?

1. Characterised by transmural inflammation of GI tract. Unknown aetiology 2. Can involve any or all parts of GI tact but usually in terminal ileum and perianal locations 3. In Crohn’s there are skip lesions not in UC 4. Transmural inflammation—> fibrosis—>intestinal obstruction. It can also result in sinus tracts, penetrating serosa

What are the risk factors of Crohn’s disease?

White ancestry Age 15-40 or 60-80 Family history Weak: smoking, diet high in sugar, oral contraceptive, not breastfed, NSAIDs

What investigations would you order with suspected Crohn’s disease?

``` FBC Iron studies Serum vitamin B12 Serum folate CMP CRP ESR Stool testing Yersinia enterocolitica serology Plain abdominal films CT abdomen MRI abdomen ```

What other differentials could there be for Crohn’s disease?

Ulcerative Colitis Infective Colitis Pseudomembranous Colitis

What is some of the first line treatment used in Crohn’s disease?

Budesonide 5-ASA therapy Oral corticosteroids

What is irritable bowel syndrome?

Chronic condition characterised by abdominal pain and bowel dysfunction Pain often relieved by defecation and accompanied by abdominal bloating. No structural abnormalities to explain pain

What are the risk factors for irritable bowel syndrome?

Physical/sexual abuse Age <50 Female Previous enteric infection

What diagnostic tests could be done for suspected irritable bowel syndrome?

``` FBC Stool studies Anti-endomysial antibodies Anti-tTG antibodies Abdominal X-ray Flexible sigmoidoscopy Colonoscopy ```

What are the susceptible loci implicated in Crohn’s disease?

NOD2 Autophagy genes Th17 pathway

What conditions does inflammatory bowel disease involve?

Crohn’s disease | Ulcerative colitis

What is microscopic colitis and the types?

No macroscopic evidence of inflammation | Lymphocytic + collagenous

What is the incidence of Crohn’s disease?

4-10/100 000 annually

What is the prevalence of Crohn’s disease?

25-100/10000

What age range is Crohn’s disease more aggressive in?

Younger patients

What are the differences in faecal and mucosal samples in Crohn’s patients?

More bacteroidies and E.col | Less F. Prausnitzii

What are the macroscopic changes in Crohn’s disease?

Bowel usually thickened and narrowed | Cobblestone appearance due to fissures and ulcers

What are the microscopic changes seen in Crohn’s disease?

Transmural inflammation (all layers affected) Increase in chronic inflammatory cells and lymphoid hyperplasia Sometimes granulomas

What percentage of Crohn’s patients require resection within 5 years of diagnosis?

50%

On colonoscopy what does blue indicate?

Liver and spleen at the hepatic and splenic flexure

What drugs are used as sedatives for colonoscopy?

Midazolam | Phenytoin

What is the route through the bowel during colonoscopy?

Anus —> rectum —> descending colon —> splenic flexure —> transverse colon —> hepatic colon —> ascending colon —> cecum (appendix)

What can be seen on colonoscopy at the appendix?

Mercedes sign

Where in the GI tract is Colitis usually worse?

Rectum

What part of the bowel does Ulcerative Colitis not affect?

Small bowel

In colonoscopy is vasculature normally seen?

Yes

What part of the GI tract does Crohn’s usually affect?

More proximally

GI and Surgery Flashcards

(54 cards)