Session 11 - Signs and Symptoms of Abdominal Disorders Flashcards Preview

Semester 3 - Gastrointestinal > Session 11 - Signs and Symptoms of Abdominal Disorders > Flashcards

Flashcards in Session 11 - Signs and Symptoms of Abdominal Disorders Deck (32):
1

Give four common presentations for abdominal disorders

Dyspepsia
Abdominal Pain
Constipation
Dysphagia

2

Define dyspepsia

Upper abdominal pain

3

Give four causes of dyspepsia

o Chronic peptic ulcer disease
o GORD
o Malignancy
o Functional/non ulcer

4

What is functional dyspepsia?

60% of dyspepsia
No functional problem found to account for symptoms - 3 months of dyspepsia with no structural causes found

5

What are the three main actions when someone presents with dyspepsia?

o Empirical acid suppression
o Non invasive H-pylori testing/eradication
o Early endoscopy

6

How common is abdominal pain as a presentation?

2% of all admissions

7

What is the first thing you need to do when thinking about abdominal pain?

Localise it

8

How do you localise abdominal pian?

Is it intra-peritoneal/extra-peritoneal?
What embryological division does it belong to?

9

WHat are the three embryological divisions of the abdomen and where does pain localise?

 Foregut – Up to 2nd part of Duodenum - Epigastric area
 Midgut – Up until the distal third of the transverse colon - Peri-umbilical
 Hindgut – Supra-pubic

10

Give three causes of foregut pain

o Ulcers-epigastric pain
 Commonly in the first part of the duodenum / lesser curve of the stomach
o Pancreatits – Epigastric pain, back pain (retroperitoneal structure)
o Gallstones – Epigastric pain, can also get Right Upper Quadrant (RUQ) pain. Often refered to as colicky pain (slight misnomer as the pain fairly constant).

11

Give two examples of causes of midgut pain

‘Real’ colicky pain
o Small bowel – Every 2-3 minutes
o Large bowel – Every 10-15 mins

12

Give four signs and symptoms of small bowel obstruction

o Vomiting (fairly early feature)
o Abdominal distension
o Xray may show
 central abdominal distended loops
 Circular folds (extending the full width of the bowel lumen)

13

Give one cause of hindgut pain

Sigmoid volvulus

14

What is a sigmoid volvulus?

Causes 8% of all intestinal obstruction
Twists on itself or its mesentery, causing bowel obstruction and an interrupted blood supply

15

What is anorexia?

Loss of appetite

16

Give five causes of anorexia

o Subjectively unpleasant food or surroundings
o Anxiety
o Anger/fear
o Symptom of a physical disorder
o Symptom of a psychological disorder

17

Give five physical causes of anorexia

 Cancer (in particular GI tract)
 Chemotherapy/certain Antibiotics
 Pregnancy
 Depression
 Endocrine disorders

18

What do you need to distinguis between when asking about weight loss?

Intentional or unintentional?
More than a 5% unintentional weight loss should be investigated

19

What is nausea?

Subjective sensation of needing toi vomit

20

Give four causes of nausea

o Food poisoning (Staphlococcal, salmonella, E-coli)
o Gastroenteritis (viral- Norwalk)
o Cholecystitis
o Appendicitis

21

HOw is constipation classified?

Defecate less than 3 times a week - Change in bowel habit more important

22

Give four causes of constipation

Diet
Medication
Dehydration
Immobility

23

Why is a good history necessary for diarrhoea?

Many causes which change depending on the time and place of onset

24

What are five categories of diarrhoea?

o Secretory (Infection)
o Osmotic (Lactose intolerance)
o Abnormal Intestinal Motility (Thyrotoxicosis, IBS)
o Exudative (Colitis, Cancer)
o Malabsorption (Pancreatic enzyme/Bile Salt Deficiency)

25

What is dyspagia?

o Difficulty swallowing (solids and liquids)
o Differentiate from painful swallowing (Odynophagia)

26

What are two broad categories of dysphagia?

Difficulty initating swallow
Food sticking in oesophagus

27

Give five causes of bleeding from oesophagus (haematemesis)

o Acute/chronic peptic ulcer
o Mallory-Weiss tear
 Tear in oesophagus from repetitive retching
o Oesophageal/Gastric Varices
o Erosive Oesophagitis
o Gastric/Oesophageal cancer

28

Give six causes of rectal bleeding

o Angiodysplasia
 Vascular malformation of the gut blood vessels
o Diverticular disease
o Colonic carcinoma
o Haemorrhoids/Anal fissure
o Inflammatory Bowel Disease
o Massive upper GI bleed
 Malaena

29

Give course for hepatic portal vein so superior vena cava

Hepatic portal vein -> Left gastric vein-> Oesophageal veins -> Azygous vein -> Upper extremities vein > SVC

30

Give five causes of abdominal distension

The five F's
o Fat
o Fluid
o Faeces
o Flatus
o Foetus

31

Give three cause sof fluid ascites

Liver fialure
Portal hypertension
Cancer

32

Give two causes of flatulus

Aerophagia (air swallowing)
Gas production in gut