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CHI444: Differential Diagnosis > Gastrointestinal System > Flashcards

Flashcards in Gastrointestinal System Deck (19)
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1
Q

What investigations would you do for a person presenting with GI like symptoms?

A
  1. Liver function tests (LFT)
    a) Alanine aminotransferase (ALT)
    - ALT is an enzyme found in the liver and kidney
    - it catalyses ammonia groups
    - may be found circulating in patients with acute liver damage from any cause
    - blood from vein is taken
    - elevation can be cause by: hepatitis, cirrhosis, billary obstruction
2
Q

How will you conduct a physical exam for someone you expect to have GI issues.

A
  1. Introduction- wash hands, introduce yourself, explain procedure, gain consent, ask if they have pain anywhere or worries?
  2. Insepction:
    a) entirity- look to see if they loo generally unwell, jaundice, weight, wasting, skin lesions, mental state
    b) hands- nails- white under nails, clubbing, spooned nails (iron def, infection, colour (blue-cyanosis,

Actually just refer to reader. But go through system every time this card appears.

3
Q

What investigations will you do?

1st Liver function tests?

A
  1. Alanine aminotransferase (ALT)
    - ALT is an enzyme found in the liver and kidney
    - ALT catalyses an ammonia group
    - may be found circulating in patients with acute liver damage from any cause.
    - elevation can be caused by hepatitis, cirrhosis, billary obstruction, renal infarct, tumor, infection.
  2. Aspartate Aminitransferase (AST)
    - found mainly in liver, skeletal muscle cardiac muscle and red cells.
    - cataclyses an ammonia group too
    - found circulating in patients with damage, but ALT is more specific
    - elevation can be caused by hepatitis, billary obstruction, myocardial damage, muscle damage, red cell damage, cirrhosis, liver metases and other
  3. AST/ ALT ratio-ratio determines if the liver has been damaged, another organs or alcohol dependancy (due to fat infiltration- steatosis)
  4. Alkaline Phosphatases (ALP)
    Why? found in many tissues and can identify problem areas. In liver its used for cholestatic (billary) enzyme analysis. High levels due to physiological (bone and liver) damage can be due to normal bone growth =.
    Pathology: If its raised could can get increased bone deposition (osteoblasts) this occurs due to puberty, disease and drugs. While low levels occur with decreased bone deposition.
    results- high-anemia, billary obstruction, liver damage, drugs, bone problems and normality, bit F, problems and real damage
    low- malnutrition, protein deficiency.
  5. Gamma-GT
  6. Serum bilirubin
4
Q

What are liver serological tests that should be conducted and why?

A
  1. hepatitis Antigen?

2. Hepititis Antibodies?

5
Q

read and understand summary of liver serology?

pg 180

A

h

6
Q
What is the pathology of Oesophagitis/ GORD?
define?
Aetiology?
Pathophysiology? 
risk factors? 
History/exams?
Investigations?
Prevention?
DDx?
Complications? 
Prognosis?
A

pg 181

7
Q
peptic ulcer 
define
Aetiology
Pathophysiology 
Risk factors 
History/ exams 
Invetigations 
Prevention 
DDx
COmplications 
Prognosis
A

182

8
Q

Hiatal Hernia
Pathology
Clinical presentation

A

183

9
Q
gastroenteritis 
Pathology 
Clinical presnetation 
management 
Clinical considerations- ie diff diagnosis
A

184

10
Q
gastritis 
Pathoogy 
clinical presentation 
clinical considerations 
management
A

184

11
Q
Irritable Bowel Syndrome (IBS)
Pathology 
Clinical presentations 
Clinical considerations
Management
A

185

12
Q
Inflammatory bowel disease- differ between Chrons disease and ulcerative colitis?
Ie define 
aetiology 
pathophysiology 
Key features 
macroscopic region 
microscopic region 
Risk factors 
History factors?
Investigations 
Prevention?
DDx?
Complications?
Prognosis?
A

189

13
Q
Appendicitis
Pathology 
Clinical presentation 
Clinical considerations 
Management
A

s

14
Q
Colorectal cancer 
Define
aetiology 
pathophysiology 
prevention/ screening 
risk factors 
history/ exams 
investigations 
Tx/ Mx
DDx
Complications 
Prognosis 
clinical considerations
A

s

15
Q

Piles and fissures (haemorrhoids)
Pathology
clinical presentation
Management

A

191

16
Q
Liver failure/ cirrhosis
define
aetiology 
pathophysiology 
prevention 
risk factors 
history/ exams 
Investigations
DDx
Complications 
prognosis
A

192

17
Q
Hepatocellular carcinoma (hepatoma)
define 
Aetiology 
Pathophysiology 
Prevention 
Risk factors 
History/ exams
A

193

18
Q
pancreatitis 
pathology 
Aetiology 
clinical presentation 
exam findings 
clinical considerations management
A

195

19
Q

Gall stones/ Cholelithiasis
pathology
clinical presentation

A

195