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26 Cards in this Set
- Front
- Back
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IBS Mx |
1) Pain - antispasmodic agents 2) Constipation - laxatives but avoid lactulose. Linaclotide if had problem > 12 months 3) Diarrhoea - loperamide. 4) Low dose TCA 5) Dietary advice |
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Oesophageal carcinoma |
Adenocarcinoma - middle third of oesophagus Progressive dysphagia, weight loss, voice hoarseness Risk factors - smoking, Barretts, GORD, alcohol, achalasia, Plummer-Vinson syndrome, coeliac, scleroderma |
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Malnutrition |
BMI < 18.5 OR unintentional weight loss > 10 % in the last 3-6 months OR BMI < 20 and unintentional weight loss > 5 % in the last 3-6 months 10 % of those > 65 years MUST score |
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Dyspepsia ALARM symptoms |
Chronic GI bleeding Progressive unintentional weight loss Progressive swallowing difficulties Persistent vomiting Iron deficient anaemia Epigastric mass Suspicious barium meal If any of above - 2WW regardless of age |
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Crohn's Disease |
Diarrhoea - usually non-bloody, weight loss, upper GI symptoms, right iliac fossa palpable mass. Gallstones and renal stones Obstruction, fistula and colorectal cancer Entire GI tract - skip lesions Inflammation in all layers from mucosa-serosa - deep ulcers and skip lesions - cobblestone |
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Ulcerative Colitis |
Bloody diarrhoea, tenesmus, pain in left lower quadrant
Primary sclerosing cholangitis Colorectal cancer risk > crohn's disease Continuous disease at rectum to ileocaecal valve No inflammation beyond submucosa - widespread ucleration |
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Crohn's Disease Management |
1) Stop smoking 2) Remission - glucocorticoids, enteral feeding, mesalazine, azathiprine, methotrexate, infliximab. 3) Maintenance - azathiprine, mercaptopurine, methotrexate, mesalazine 4) Surgery |
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IBS |
> 6 months - abdominal pain +/- bloating +/- change in bowel habit Abdominal pain relieved by defecation or altered bowel frequency + 2 of: Altered stool passage Abdominal bloating Symptoms worsened by eating Passage of mucous |
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Drug induced liver disease |
Hepatocellular - paracetamol, sodium valporate, phenytoin, MAOIs, anti-TB, statins, alcohol, amiodarone, methlydopa, nitrofurantoin Cholestasis - COCP, flucloxacillin, co-amoxiclav, erythromycin, fibrates, sulphonylureas Cirrhosis - methotrexate, methyldopa, amiodarone |
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C.Diff |
Diarrhoea, abdominal pain, raised WCC, toxic megacolon - cephalosporins + clindamycin Mx - metronidazole PO for 10-14 days, Vancopmycin if severe or not responding, life-threatening - IV metronidazole and vancomycin. |
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Cirrhosis Severity |
Raised bilirubin Low albumin Ascites Prolonged PT Encephalopathy |
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NAFLD |
Risk factors - obesity, hyperlipidaemia, T2DM, jejunoileal bypass, sudden weight loss/starvation Features - asymptomatic, hepatomegaly, ALT > AST, US - increased echogenicity. Mx - weight loss. |
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Ulcerative colitis management |
Remission - rectal mesalazine or steroids. Maintenance - oral mesalazine, azathiprine, mercaptopurine. |
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Coeliac disease complications |
Anaemia Hyposplenism Osteoporosis, osteomalacia Lactose intolerance T-cell Lymphoma Subfertility Oesophageal cancer |
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Primary Biliary Cirrhosis |
IgM, anti-Mitochondrial antibodies, Middle aged females Autoimmune - interlobular bile ducts become damaged - cholestasis - cirrhosis Associations - sjorgrens, RA, systemic sclerosis, thyroid disease Mx - cholestyramine, fat-soluble vitamins, ursodeoxycholic acid, live transplant |
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E. Coli |
Most common cause of travellers diarrhoea Watery stools Abdominal cramps and nausea |
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Giardiasis |
Prolonged, non-bloody diarrhoea |
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Cholera |
Profuse, watery diarrhoea Not common among travellers Severe dehydration resulting in weight loss |
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S. Aureus |
Severe vomiting Short incubation period |
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Campylobacter |
Flu-like prodrome followed by crampy abdominal pain, bloody diarrhoea, fever. Leads to Guillain-Barre syndrome |
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Bacillus Cereus |
Rice Vomiting and diarrhoea |
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Amoebiasis |
Gradual onset bloody diarrnoea, abdominal pain, tenderness - can last for weeks. |
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H. pylori eradication |
1) PPI + amoxicillin + clarithromycin 2) PPI + metronidazole + clarithromycin |
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Urea breath test |
No antibiotics in previous 4 weeks No anti-secretary (PPI) in previous 2 weeks |
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Oesophageal Varices |
Prophylaxis - propanolol, endoscopic variceal band ligation - repeated every 2 weeks, PPI. Acute - Terlipressin, octreotide, prophylactic antibiotics, endoscopic variceal band ligation, TIPSS. |
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Primary sclerosing cholangitis |
Inflammation and fibrosis of intra and extra-hepatic bile ducts ulcerative colitis, crohns, HIV Jaundice, pruritus, RUQ pain, fatigue Ix - ERCP, ANA positive, Cholangiocarcinoma, colorectal ca |
