Signs and Symptoms of Abdominal Disorders Flashcards Preview

ESA 3 - Gastrointestinal System > Signs and Symptoms of Abdominal Disorders > Flashcards

Flashcards in Signs and Symptoms of Abdominal Disorders Deck (81):
1

What are the common presentations of abdominal disorders? 

  • Dyspepsia 
  • Abdominal pain
  • Constipation
  • Diahorrea
  • Dysphagia

 

2

What is meant by dyspepsia? 

  • Upper abdominal pain and bloating
  • Chronic or recurrent pain or discomfort in the upper abdomen 

 

3

What are the causes of dyspepsia? 

  • Chronic peptic ulcer disease 
  • GORD
  • Malignancy 
  • Functional / non-ulcer 

Some debate over this 

 

 

4

What % of dyspepsia is functional / non-ulcer? 

60%

5

What is meant by functional / non-ulcer dyspepsia? 

No functional problem found to account for symptoms 

6

When is dyspepsia classified as functional? 

When there is 3 months of dyspepsia with no structural causes found 

7

What is the course of treatment for dyspepsia? 

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

 

8

How common is abdominal pain? 

Very common, 2% of all hospital admissions 

 

9

What must be taken into consideration when a patient presents with abdominal pain? 

That there are many causes, and it can be misleading, so we must therefore adopt a sensible approach 

10

Is abdominal pain related to the small bowel intra- or extra-peritoneal? 

Intra-peritoneal 

11

Why is it important to question what embryological division abdominal pain related to the small bowel belongs to? 

Because intra-peritoneal structures refer pain to shared areas of the abdominal wall

12

Where does the foregut refer pain to? 

Up to the 2nd part of the duodenum to the epigastric area 

13

Where does the midgut refer pain to? 

 Up to the distal third of the transverse colon to the peri-umbilical area 

14

Where does the hindgut refer pain to? 

Supra-pubic 

15

What may cause foregut pain? 

  • Ulcers 
  • Pancreatitis 
  • Gallstones 

 

16

What kind of foregut pain is produced when caused by ulcers 

Epigastric pain 

 

17

Where does epigastric pain caused by ulcers commonly occur? 

In the first part of the duodenum or lesser curve of the stomach 

18

Where does pancreatitis cause pain? 

  • Epigastric pain 
  • Back pain (retroperitoneal structure) 

 

19

Where do gallstones cause pain? 

  • Epigastric pain 
  • Can also get right upper quadrant (RUQ) pain 

 

20

What is gallstones pain sometimes referred to as? 

Colicky pain 

21

Why is referring to gallstones pain as colicky a slight misnomer? 

Because the pain is fairly constant 

22

What is midgut pain sometimes referred to as? 

'Real' colicky pain 

23

At what frequency is colicky pain in the small bowel? 

Every 2-3 minutes 

24

At what frequency is colicky pain in the large bowel? 

Every 10-15 minutes 

25

What are the symptoms of a small bowel obstruction? 

  • Vomiting
  • Abdominal distention 

 

26

What may be shown on an x-ray of a small bowel obstruction? 

  • Central abdominal distended loops
  • Circular folds extending the full width of the bowel lumen 

 

27

What is the classic midgut pain scenario? 

Appendicitis 

28

What may cause hindgut pain? 

Sigmoid volvulus 

29

What % of intestinal obstructions are due to sigmoid volvuluses? 

8%

30

What happens in a sigmoid volvulus? 

Twists in on itself or its mesentery, causing a bowel obstruction and interruption to blood supply 

31

What is the result of a bowel obstruction in a sigmoid volvulus? 

Absolute constipation 

32

What is the result of the interuption to the blood supply in a sigmoid volvulus? 

Tissue death 

33

What is anorexia? 

Loss of appetite 

34

What may cause anorexia? 

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

 

35

What physical disorders may anorexia be a symptom of? 

  • Cancer (in particular, of the GI tract) 
  • Chemotherapy 
  • Certain antibiotics 
  • Pregnancy 
  • Depression 
  • Endocrine disorders 

 

36

At what point should weight loss be investigated? 

More than 5% intentional weight loss

37

What is nausea? 

The subjective sensation of the need to vomit 

38

Where is the vomiting centre? 

In the medulla 

39

What sources of information feed into the vomiting centre? 

  • Labyrinths (in the inner ear) 
  • Cerebral cortex
  • Peripheral pain receptors 
  • Chemo- and baroreceptors 
  • 5-HT
  • Dopamine
  • Emetic drugs 

 

40

Describe the passage of information from the labyrinths to the vomiting centre? 

  • Labyrinths to vestibular, via acetylcholine 
  • Vestibular to vomiting centre, via acetylcholine 

 

41

What neurotransmitter is responsible for communication between peripheral pain receptors and the vomiting centre? 

Histamine 

42

What may trigger chemo- and baroreceptors to stimulate the vomiting centre? 

Distension or irritation 

43

How do substances such as emetic drugs, dopamine and 5-HT communicate with the vomiting centre? 

Via the chemoreceptor trigger zone (CTZ)

44

Where does the CTZ lie? 

At the base of the 4th ventricle 

45

What are the common causes of vomiting? 

  • Food poisoning 
  • Gastroenteritis 
  • Cholecystitis 
  • Appendictis 
  • Viral hepatitis 
  • Pancreatitis 
  • Intestinal blockage 
  • Pain

 

46

What microorganisms can cause food poisoning? 

  • Staphlococcal 
  • Salmonella 
  • E-coli

 

47

What causes viral gastroenteritis? 

Norwalk 

48

When is someone classified as having constipation? 

When they defecate less than 3 times a week (varies)

49

What is more important to consider than the frequency of defication? 

Changes in bowel habits 

50

What are the potentila causes of constipation? 

  • Diet
  • Medication 
  • Dehydration 
  • Immobility 
  • Disease 
  • Functional 

 

51

What medication can cause constipation? 

  • Opiod analgesics
  • Tricyclics 

 

52

What diseases can cause constipation? 

  • Neurological, e.g. stroke 
  • Diabetes 
  • Colorectal stricture 

 

53

What is functional constipation? 

When there is no reason for constipation 

54

What is a possible cause for functional constipation in paediatrics? 

Pain 

55

What is classified to be diarrhoea? 

  • More stools 
  • Change in consistancy 

Different for individuals 

 

56

What is required to make a diagnosis of diarrhoea? 

A good history 

57

 What are the categories of diarrhoea? 

  • Secretory 
  • Osmotic
  • Abnormal intestinal motility 
  • Exudative 
  • Malabsorption 

 

58

What causes secretory diarrhoea? 

Infection 

59

What causes osmotic diarrhoea? 

Lactose intolerance 

60

What causes abnormal intestinal motility diarrhoea? 

  • Thyrotoxicosis 
  • IBS

 

61

What causes exudative diarrhoea? 

  • Colitis 
  • Cancer 

 

62

What causes malabsorption diarrhoea? 

Pancreatic enzyme/bile salt deficiency 

63

What is dysphagia? 

Difficulty swallowing (both solids and liquids) 

64

What should dysphagia be differentiated from? 

Odynophagia 

65

What is odynophagia? 

Painful swallowing 

66

What are the broad categories of dysphagia? 

  • Difficulty initating swallowing 
  • Food sticking in oesophagus 

 

67

What is the cause of difficulty initating swallowing? 

Neurological 

68

What is the cause of food sticking in the oesphagus? 

Anatomical problems 

69

What are the broad categories of GI bleeding? 

  • From the top 
  • From the bottom 

 

70

What can cause bleeding from the top of the GI tract? 

  • Haematemesis 
  • Acute or chronic peptic ulcer 
  • Mallory-Weiss tear 
  • Oesophagea or gastric varices 
  • Erosive oesophagitis 
  • Gastric or oesophageal cancer 

 

71

What is a Mallory-Weiss tear? 

A tear in the oesophagus from repetitive retching 

72

What can cause bleeding from the bottom of the GI tract? 

  • Angiodysplasia
  • Diverticular disease 
  • Colonic carcinoma 
  • Haemorrhoids or anal fissure 
  • Inflammatory bowel disease 
  • Massive upper GI bleed 

 

73

What is angiodysplasia? 

Vascular malformation of the gut blood vessels 

74

What cau cause a massive upper GI bleed? 

Malaena 

75

Draw a diagram illustrating the portal venous system

76

What can cause abdominal distention? 

  • Fat 
  • Fluid
  • Faeces 
  • Flatus 
  • Foetus 

 

77

What is ascites? 

Abnormal amounts of fluid collecting in the peritoneal cavity

78

What can cause ascites? 

  • Liver failure 
  • Portal hypertension 
  • Cancer 

 

79

What can cause flatus? 

  • Aerophagia 
  • Gas production in gut (especially if digestion has been incomplete) 

 

80

What is aerophagia? 

Air swallowing 

 

81

What should be looked for during a GI practical examination? 

  • Hand signs 
  • Jaundice
  • Spider naevi
  • Organomegaly