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Flashcards in GI and Surgery Deck (54)
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1

What causes renal colic?

Kidney stones

2

What is a peptic ulcer?

Erosion of the lining of the stomach or duodenum

3

What factors can lead to a peptic ulcer?

Helicobacter pylori
NSAID usage
Alcohol
Smoking

4

Who usually gets appendicitis?

Younger people

5

What are the causes of pancreatitis?

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

6

What is biliary colic?

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

7

What can cause the formation of gallstones?

Increased cholesterol
Haemolytic
Medications

8

What are the risk factors for gallstones?

Fat
Forty
Female
Fertile
Contraceptive pill
HRT
Diabetes

9

Who typically gets diverticular disease?

Middle aged and elderly
(65% of 85 year olds)

10

What are diverticula?

Small out-pouching of large bowel
When these are inflamed=diverticulitis

11

What antibiotic is commonly used for skin infections?

Flucloxacillin

12

How is hepatitis E spread?

Fecally contaminated water
Uncooked/undercooked meat

13

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

14

What are the phases of infection of hepatitis E?

-prodromal phase
-icteric phase

15

Which patients are at greater risk of mortality from hepatitis E

Pregnant
Liver transplant recipients

16

What is the incubation period of hepatitis E?

15-60 days

17

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

Prodromal

18

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

19

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

Days to several weeks

20

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

21

What is a prehepatic cause of jaundice?

Haemolysis

22

What are the hepatic causes of jaundice?

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

23

What are the post hepatic causes of jaundice?

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

24

Name some common types of hernia?

Inguinal
Femoral
Umbilical
Incisional
Epigastric
Hiatal

25

What is an inguinal hernia?

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

26

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

27

What is an umbilical hernia?

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

28

What are the complications of Crohn’s disease?

Extra-intestinal involvement
Intestinal obstruction
Abscess formation
Sinuses
Fistulae

29

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

30

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

31

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

32

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

Ulcerative Colitis
Infective Colitis
Pseudomembranous Colitis

33

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

Budesonide
5-ASA therapy
Oral corticosteroids

34

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

35

What are the risk factors for irritable bowel syndrome?

Physical/sexual abuse
Age <50
Female
Previous enteric infection

36

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

37

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

NOD2
Autophagy genes
Th17 pathway

38

What conditions does inflammatory bowel disease involve?

Crohn’s disease
Ulcerative colitis

39

What is microscopic colitis and the types?

No macroscopic evidence of inflammation
Lymphocytic + collagenous

40

What is the incidence of Crohn’s disease?

4-10/100 000 annually

41

What is the prevalence of Crohn’s disease?

25-100/10000

42

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

Younger patients

43

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

More bacteroidies and E.col
Less F. Prausnitzii

44

What are the macroscopic changes in Crohn’s disease?

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

45

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

46

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

50%

47

On colonoscopy what does blue indicate?

Liver and spleen at the hepatic and splenic flexure

48

What drugs are used as sedatives for colonoscopy?

Midazolam
Phenytoin

49

What is the route through the bowel during colonoscopy?

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

50

What can be seen on colonoscopy at the appendix?

Mercedes sign

51

Where in the GI tract is Colitis usually worse?

Rectum

52

What part of the bowel does Ulcerative Colitis not affect?

Small bowel

53

In colonoscopy is vasculature normally seen?

Yes

54

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

More proximally