GIT Flashcards
(41 cards)
1
Q
Complications of Dysphagia x4
A
- Aspiration
- Pneumonia
- Weight loss
- Malnutrition
2
Q
Causes of Gastritis
A
COMMON
- NSAIDs
- Alcohol
- Stress
LESS COMMON
- Radiation
- Viral infection
- Vascular injury
3
Q
Symptoms and signs of Gastritis x6
A
- Dyspepsia
- Nausea
- Vomiting
- Anorexia
- Hematemesis
- Melena
4
Q
Complications of Gastritis x3
A
- Ulcers or GI bleeding
- Chronic atrophic gastritis
- B12 deficiency
5
Q
Causes of PUD x4
A
- NSAIDs (Aspirin, ibuprofen)
- Zollinger Ellison Syndrome (gastrinoma)
- Helicobacter pylori infection
- Hyperacidity
- Duodenal-gastric reflux
6
Q
Symptoms of PUD (Gastric ulcer) x8
A
- Bloating
- Nausea
- Vomiting
- Abd pain
- Anorexia
- Recent weight loss
- Loss of appetite
- Pain worsens with eating
7
Q
Signs of PUD (Gastric ulcer)
A
- Pallor
- Epigastric tenderness
- Hyperactive bowel sounds
8
Q
Symptoms of PUD (Duodenal ulcer)
A
- Abd pain
- Weight gain
- Pain that is relieved by food or antiacids for 2-3 hours after ingestion
9
Q
Signs of PUD (Duodenal ulcer)
A
- Epigastric pain
- Pallor
- Tenderness on the abdomen
- Hyperactive bowel sounds
10
Q
Risk factors of PUD
A
Increased acid can result from:
a) Stress
b) Alcohol
c) Caffeine
d) Smoking
e) Spicy foods
11
Q
Investigations of PUD
A
- Endoscopy
a) rapid urease test (CLO test) can be performed to check for H. pylori
b) Biopsy to exclude malignancy
12
Q
Complications of PUD
A
- Hemorrhage
- Stomach cancer
- Penetration
- Free perforation
13
Q
DDx of PUD
A
- Gastroenteritis
- Gastritis
- Pancreatitis
14
Q
Causes of Gastroenteritis
A
VIRUS
- Norovirus
- Rotavirus
- Astrovirus
- Adenovirus
BACTERIAL
- Salmonella
- Shigella
- Campylobacter
- E.Coli
15
Q
Symptoms of Gastroenteritis
A
- Nausea
- Vomiting
- Diarrhea
- Anorexia
- Abd cramps
16
Q
Post-Gastroenteritis Complications
A
- Lactose intolerance
- Irritable bowel syndrome
- Reactive arthritis
- Guillain–Barré syndrome
17
Q
Patho steps bacterial gastroenteritis
A
- Mucosal adherence
- Mucosal invasion
- Toxin production
18
Q
Hepatitis types and causes
A
TYPE CAUSE TRANSMISSION
- Hep. A by Viral Fecal oral route
- Hep. B by Infections Sex & infective body fluids
- Hep. C by drugs & alcohol Infective bdy fluids
- Hep. D by auto-immune Hep. B
- Hep. E by seronegative F O route
19
Q
Causes of Hepatitis
A
- Alcoholic hepatitis
- Non-alcoholic fatty liver disease
- Viral hepatitis
- Autoimmune hepatitis
- Drug-induced hepatitis (e.g. paracetamol overdose
20
Q
Presentation of Hepatitis
A
- Abdominal pain
- Fatigue
- Pruritis (itching)
- Muscle and joint aches
- Nausea and vomiting
- Jaundice
- Fever (viral hepatitis)
21
Q
Causes of Chronic Liver Disease
A
- HBV and HCV
- Wilson’s disease
- Alcoholism
- Drug-induced disease
- Auto-immune Hepatitis
22
Q
Risk factors of Chronic Liver Disease
A
- Obesity
- Exessive use of Alcohol
- Unprotected sex
- Sharing of needles
23
Q
Signs and symptoms CLD OR Liver Cirrhosis
A
- Jaundice – caused by raised bilirubin
- Hepatomegaly – however, the liver can shrink as it becomes more cirrhotic
- Splenomegaly – due to portal hypertension
- Spider Naevi – these are telangiectasia with a central arteriole and small vessels radiating away
- Palmar Erythema – caused by hyperdynamic circulation
- Gynecomastia and testicular atrophy in males due to endocrine dysfunction
- Bruising – due to abnormal clotting
- Ascites
- Caput Medusae – distended paraumbilical veins due to portal hypertension
- Asterixis – “flapping tremor” in decompensated liver disease
24
Q
Investigations of Liver Cirrhosis or CLD
A
- Liver biopsy
- Blood- cirrhosis all of the markers (ALT, AST, ALP, and bilirubin) …. Increased LFT
- Nodularity of the surface of the liver
a) A “corkscrew” appearance to the arteries with increased flow as they compensate for reduced portal flow
b) Enlarged portal vein with reduced flow
c) Ascites
d) Splenomegaly
25
Cholecystitis
Inflammation of the gallbladder
26
Causes of Cholecystitis
1. Cholelithiasis (most common)
2. Acute acalculous cholecystitis (without stones)
* Inadequate or absent blood flow to the gallbladder
* Abnormal metabolism of cholesterol and bile salts
* Tumor
* Bile duct blockage (due to shrinking & scarring)
* Infection
27
Symptoms of cholecystitis
1. Nausea
2. Vomiting
3. Fever
4. RUQ pain
28
Signs of cholecystitis
1. + Murphy's sign
2. Right subcostal tenderness (rebound tenderness)
3. involuntary guarding of RUQ
4. Low-grade fever
5. Jaundice
6. Hyperactive bowel sounds
29
Complications of cholecystitis
1. Gangrene
2. Peritonitis
3. Perforation
4. Gallbladder fistula formation
5. Empyema
30
Investigations of Cholecystitis
1. FBC- Increased WCC
- Increased Amylase/ lipase
- ↑CRP, EUC, LFT
- ↑Bilirubin
2. Ultrasound- Detects gallstones and is used to elicit Murphy's sign
31
Causes of pancreatitis
1. Gallstones
2. Alcohol
3. Genetic abnormalities of the pancreas
32
Pancreatitis overview
1. Inflammation of the pancreas
2. Pancreatic enzymes (amylase/lipase) attack the pancreatic tissue
3. Cause epigastric pain radiating to the back
4. Diagnosed clinically / by rise in amylase (>3 x normal) / CT scan
5. Amylase may not rise in an acute exacerbation of chronic pancreatitis because the pancreas has lost it’s ability to produce the enzyme
33
Complications of Pancreatitis
1. Pancreatitis necrosis
2. Infection in necrotic areas
3. Pseudocysts
4. Chronic pancreatitis
34
Causes of Intestinal Obstruction
MECHANICAL
1. Adhesion
2. Tumor
3. Strangulated hernia
4. Intussusception
5. Volvulus
35
8 signs of intestinal obstruction
1. Visible peristalsis
2. Abnormal bowel sounds (High pitched early then later become absent)
3. Abdominal tenderness
4. Abdominal distension
5. Empty rectum on examination
6. Muscle guarding
7. Hernia (Cecal volvulus)
8. Dilated loops of bowel
36
Name and explain 3 Investigations of intestinal obstruction
1. Abdominal xray- This may show dilated loops of bowel proximal to the obstruction and collapsed loops of bowel distal to the obstruction and COFFEE BEAN SIGN
2. Rectal exam- Absent stool or empty rectum
3. Abdominal CT scan- is being used more often in suspected small-bowel obstruction (The small bowel is dilated and filled with air and fluid)
37
Medicine management for cholecystitis
Amoxicillin/calvulanic acid, oral, 875/125mg 12hrly
if unable to tolerate oral
Augmentin, IV, 1.2mg 8 hourly
38
General measures for cholecystitis
1. Admit the patient
2. GI rest- nil by mouth until recovered
3. Low-fat diet
4. Large bore IV for fluids
5. Drain care- Cholecystectomy "C-tube", placed through abdominal wall & into the gallbladder.
6. Cholecystectomy
39
Medicine treatment for PUD
```
H.pylori +ve
Proton pump inhibitor, e.g.:
Adults- Lansoprazole, oral, 30mg 12 hourly
-Duodenal ulcer: for 7 days
-Gastric ulcer: for 28 days
```
AND
H.pylori eradication:
-Amoxicillin, oral, 1g 12 hourly
OR
for severe penicillin allergy
-Azithromycin, oral, 500mg daily for 3 days.
AND
Metronidazole,oral, 400mg 12 hourly for 14 days
IF
H.pylori -ve
-These are usually a consequence of NSAID use.
-Stop NSAID until the ulcer has healed.
-If the patient is unable to stop NSAID, refer to a
specialist.
PPI, e.g.:
Lansoprazole, oral, 60 mg daily
-Duodenal ulcer: for 14 days
- Gastric ulcer: for 28 days
40
General Measures of PUD
- Advise patient to avoid ulcerogenic medications, e.g. NSAIDs.
- Advise patient to stop smoking and drinking alcohol.
- Dietary advice by a dietician
41
Essential history in Gastroenteritis
Essential history must be obtained while simultaneously assessing vital signs and hydration.
* Is the child vomiting; how much?
* When was the last oral intake?
* Stools: blood, mucus, amount, consistency, frequency;
* Diet: malnutrition risk;
* Other systems: especially heart/lung disease
* Use of oral rehydration solution;
* Length of history (if > 10 days of loose stools, manage for ‘persistent’ or ‘chronic’ diarrhea).
