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)
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1
Q

Give four common presentations for abdominal disorders

A

Dyspepsia
Abdominal Pain
Constipation
Dysphagia

2
Q

Define dyspepsia

A

Upper abdominal pain

3
Q

Give four causes of dyspepsia

A

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

4
Q

What is functional dyspepsia?

A

60% of dyspepsia

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

5
Q

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

A

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

6
Q

How common is abdominal pain as a presentation?

A

2% of all admissions

7
Q

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

A

Localise it

8
Q

How do you localise abdominal pian?

A

Is it intra-peritoneal/extra-peritoneal?

What embryological division does it belong to?

9
Q

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

A

 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
Q

Give three causes of foregut pain

A

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
Q

Give two examples of causes of midgut pain

A

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

12
Q

Give four signs and symptoms of small bowel obstruction

A
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
Q

Give one cause of hindgut pain

A

Sigmoid volvulus

14
Q

What is a sigmoid volvulus?

A

Causes 8% of all intestinal obstruction

Twists on itself or its mesentery, causing bowel obstruction and an interrupted blood supply

15
Q

What is anorexia?

A

Loss of appetite

16
Q

Give five causes of anorexia

A
o	Subjectively unpleasant food or surroundings
o	Anxiety
o	Anger/fear
o	Symptom of a physical disorder
o	Symptom of a psychological disorder
17
Q

Give five physical causes of anorexia

A
	Cancer (in particular GI tract)
	Chemotherapy/certain Antibiotics
	Pregnancy
	Depression
	Endocrine disorders
18
Q

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

A

Intentional or unintentional?

More than a 5% unintentional weight loss should be investigated

19
Q

What is nausea?

A

Subjective sensation of needing toi vomit

20
Q

Give four causes of nausea

A

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

21
Q

HOw is constipation classified?

A

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

22
Q

Give four causes of constipation

A

Diet
Medication
Dehydration
Immobility

23
Q

Why is a good history necessary for diarrhoea?

A

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

24
Q

What are five categories of diarrhoea?

A
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
Q

What is dyspagia?

A

o Difficulty swallowing (solids and liquids)

o Differentiate from painful swallowing (Odynophagia)

26
Q

What are two broad categories of dysphagia?

A

Difficulty initating swallow

Food sticking in oesophagus

27
Q

Give five causes of bleeding from oesophagus (haematemesis)

A
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
Q

Give six causes of rectal bleeding

A
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
Q

Give course for hepatic portal vein so superior vena cava

A

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

30
Q

Give five causes of abdominal distension

A
The five F's
o	Fat
o	Fluid
o	Faeces
o	Flatus
o	Foetus
31
Q

Give three cause sof fluid ascites

A

Liver fialure
Portal hypertension
Cancer

32
Q

Give two causes of flatulus

A

Aerophagia (air swallowing)

Gas production in gut