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
