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Medicine Phase 2a GI > Peer Teaching > Flashcards

Peer Teaching Flashcards

1
Q

Risk factors of infective diarrhoea

A

Foreign travel
Poor hygiene
Overcrowding
New or different food

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2
Q

Causes of infective diarrhoea

A

Usually viral: rotavirus (children), norovirus, adenovirus
Sometimes bacterial: Campylobacter jejuni, E.coli, Salmonella, Shigella
Occasionally parasitic: Giardia lamblia, cryptosporidium
Antibiotics Associated (C diff): clindamycin, ciprofloxacin, coamoxiclav, cephalosporins

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3
Q

Presentation of infective diarrhoea

A

Blood suggests hernia

May also experience vomiting, fever, fatigue, headache and muscle pains

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4
Q

Diagnosis of infective diarrhoea

A

Stool culture

If chronic, consider sigmoidoscopy and bloods

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5
Q

Treatment of infective diarrhoea

A

Rehydration
Antibiotics
Antimotility (Loperamide)
Antiemetics (maybe)

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6
Q

What is a hernia

A

A protrusion of organ or tissue out of the body cavity that it normally lies

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7
Q

Causes of hernia

A 
Muscle weakness (age, trauma)
Body strain (constipation, heavy lifting, pregnancy, chronic cough)
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8
Q

What is an inguinal hernia

A

Protrusion of abdominal cavity contents through the inguinal canal

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9
Q

Describe Direct inguinal hernia

A

Bulge through weakened fascia of abdominal wall
Directly behind the superficial inguinal ring
Protrudes directly into the inguinal canal
MEDIAL to inferior epigastric vessels
Rarely enters the scrotum

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10
Q

In what patients is direct inguinal hernia common

A

Elderly men with weak abdominal muscles

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11
Q

Describe indirect inguinal hernia

A

Traverses inguinal canal
Same course as spermatic cord
Enter inguinal canal at deep inguinal ring (indirect)
LATERAL to inferior epigastric vessels
Can pass into the scrotum or labia majora

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12
Q

Where would you more likely see an indirect inguinal hernia

A

Male > female

Congenital, injury

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13
Q

What is a hiatus hernia

A

Part of the stomach herniates through the oesophageal hiatus of the diaphragm

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14
Q

Describe sliding hiatus hernia

A

Oesophageal-gastric junction slides through the hiatus and lies above the diaphragm

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15
Q

Symptom of sliding hiatus hernia

A

No symptoms other than reflux symptoms

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16
Q

Describe para-oesophageal hiatus hernia

A

Uncommon - gastric fundus rolls up through hiatus alongside the oesophagus, therefore the gastro-oesophageal junction remains below the diaphragm.
Treated via surgery.

17
Q

Describe where pain is felt in appendicitis

A

Umbilicus to RIF

18
Q

What is peritonitis

A

Inflammation of the peritoneum due to entry of blood, air, bacteria or GI contents (Faeces or bile)

19
Q

Symptoms of peritonitis

A

Dull pain that becomes sharp
Pain worse on coughing or moving
Systemic symptoms and generally unwell

20
Q

Causes of peritonitis

A

AEIOU P
A - Appendicitis: umbilicus to RIF pain
E - Ectopic Pregnancy: low abdo pain, sudden onset, tachycardia, low bp
I - Infection with TB:
O - Obstruction: colicky pain, history of abdominal surgery
U - Ulcer: epigastric pain radiating to shoulder
Peritoneal Dialysis

21
Q

Investigations of peritonitis

A

Clinical examination: rigid and guarding, laying still
AXR: dilated bowel, flat fluid level, gas under diaphragm
Bloods: FBCs, U&Es, LFTs, clotting
Ascitic Tap: high neutrophil count

22
Q

When would you suspect sepsis in peritonitis

A

If BP is low

23
Q

What is pancreatitis

A

Pancreatic enzymes destroy the pancreas and possibly nearby blood vessels

24
Q

Presentation of pancreatitis

A

Nausea and vomiting, epigastric pain radiating to the back (relieved by sitting forwards)
Cullens/Grey Turner’s
Tachycardia

25
Q

Causes of pancreatitis

A 
I GET SMASHED
Idiopathic
Gall stones
Ethanol (alcohol)
Trauma
Steroids
Mumps/malignancy
Autoimmune
Scorpion stings
Hypercalcaemia/hypertriglyceridemia
ERCP
Drugs
26
Q

Investigations of pancreatitis

A

High amylase, high lipase, AXR shows no psoas shadow (raised retroperitoneal fluid). CT chest/abdo

27
Q

Management of pancreatitis

A

IV fluids and maintain electrolyte balance
Pain relief
May need bowel rest

28
Q

Cause of ischaemic colitis

A

Low flow in inferior Mesenteric Artery

29
Q

Presentation of ischaemic colitis

A

LLQ pain

Bloody diarrhoea

30
Q

Diagnosis of ischaemic colitis

A

Colonoscopy

31
Q

Cause of acute mesenteric ischaemia

A

Low flow in the Superior Mesenteric artery

32
Q

Presentation of acute mesenteric ischaemia

A

Acute severe abdo pain, out of proportion with signs

33
Q

Diagnosis of acute mesenteric ischaemia

A

Metabolic acidosis & high lactate

Often made on laparotomy

34
Q

Management of acute mesenteric ischaemia and ischaemic colitis

A

Ischaemic colitis - conservative
Acute mesenteric ischaemia - Surgery to remove dead bowel
Fluid resus and antibiotics

Medicine Phase 2a GI (35 decks)

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