• Archive for May, 2013

    Acute and Chronic Liver Disease

    by  • 11/05/2013 • Gastroenterology • 0 Comments

    Acute hepatitis:  Non-specific term for acute, self-limiting liver inflammation  p/c: jaundice, nausea, anorexia, RUQ pain, fever, fatigue, orange urine, occasional substantial intrahepatic cholestasis (=white stools)  Causes: o Common = viral hepatitis A/B, EBV, drug reactions (=paracetamol) o Uncommon = autoimmune hepatitis o Rare = Wilson’s disease, toxins  Ix: o LFTs:...

    Read more →


    by  • 11/05/2013 • Respiratory

    Silicosis  P/c: SOB, cough, fever, cyanosis, pulmonary oedema, pneumonia, +TB (=’silicotuberculosis’), RF=CP+RHF. May have CTD (SLE, scleroderma) etc.  Uncommon RLD  May be seen in stonemasons, sand-blasters, pottery and ceramic workers.  Caused by the inhalation of SILICA (occupational hazard of sandblasting)  Dust is highly fibrogenic.  CXR = distinctive thin...

    Read more →


    by  • 10/05/2013 • Gastroenterology • 0 Comments

    Acute pancreatitis:  Acute destructive inflammation of pancreas  Incidence 40-500/mil (varying with rate of alcohol consumption and incidence of GS)  Incidence is increasing and mortality is falling  p/c: jaundice (if deep = GS/cholangitis), cyanosis, ARDS (T1 RF), metabolic problems (hypo-/hyperglycaemia, hypocalcaemia), acute renal failure, Grey-Turner sign (=bruising in flanks), DIC and...

    Read more →

    Biliary Disease

    by  • 09/05/2013 • Gastroenterology • 0 Comments

     Gallstone disease: ‘female, fat, fertile and forty!’  Stones occur in 7% of men and 15% of women aged 18-65yo  Prevalence is underestimated because 90% are asymptomatic  Pathophysiology: gallstones form due to precipitation of cholesterol crystals in supersaturated bile. Increase in size by 2.5mm/y  Clinical features: o Asymptomatic = GS...

    Read more →

    Coeliac Disease- Malabsorption

    by  • 07/05/2013 • Gastroenterology • 0 Comments

     Most common cause of malabs in the west  Common, 1/150 (in Ireland), 1/300 (England), peak incidence 20-40yo  Due to allergic reaction to the gliaden fraction of wheat germ. Initially causes an increase in intraepithelial lymphocytes in the small intestinal epitheliumprogresses to flattening of intestinal villi (villous atrophy), strong HLA (human leukocyte...

    Read more →

    Abnormal Liver Function Tests

    by  • 05/05/2013 • Gastroenterology • 0 Comments

     Often abnormal LFTs accompany specific symptoms  Sometimes abnormal LFTs can be seen in well/asymptomatic patients and warrant further investigation  In these patients, the abnormal test may herald an underlying disease and it is then prudent to make a diagnosis to make prognostic and therapeutic decisions.  Causes of abnormal LFTs: o...

    Read more →

    Iron Deficiency due to GI Pathology

    by  • 03/05/2013 • Gastroenterology • 0 Comments

     2 causes of iron deficiency:   1. Reduced absorption in GI tract: due to mucosal disease (=coeliac disease ), duodenal bypass (=polagastrectomy) or dietary deficiency. 2. Chronic blood loss: due to menstrual bleeding, PU disease, GI neoplasia (colonic adenomatous polyps, caecal/gastric/rectal carcinoma),...

    Read more →

    Diverticular Disease

    by  • 02/05/2013 • Gastroenterology • 0 Comments

     Many elderly people have asymptomatic ‘diverticula change’ or ‘diverticulosis’  Prevalence: 50% >50yo  Pathophysiology: may be genetic predisposition, but best considered an acquired condition. Those with Marfan’s and Ehlers-Danlos syndrome tend to develop diverticula earlier in life.  P/c: – tend to present with ‘complications’ rather than symptoms of diverticular change… o...

    Read more →

    Peptic Ulcer Disease

    by  • 01/05/2013 • Gastroenterology • 0 Comments

    Peptic (=’acid-related’) ulcer = DU or GU or both! Duodenal ulcer: o Incidence: improving in line with improvements in living standards, still affects 10-15% in certain populations. Helicobacter pylori carriage and NSAIDs use are the major RFs.  p/c: o Dyspepsia: abdo pain, worse at night, relived by food o Vomiting: due to oedema...

    Read more →