GI CORRELATION

What is the definition of "Acute Abdomen"?

Acute abdomen refers to any serious acute intra-abdominal condition (e.g., appendicitis) attended by pain, tenderness, and muscular rigidity, where emergency surgery may be necessary.

What is Cachexia?

Cachexia is a profound, marked state of constitutional disorder, characterized by general ill health and malnutrition.

What does "Coffee-ground Emesis" indicate?

Coffee-ground emesis refers to blood that has congealed and separated within gastric contents, taking the form of coffee grounds when it contacts an acidic environment.

What is Colic in the context of gastrointestinal (GI) issues?

Colic refers to acute, paroxysmal abdominal pain.

What is Dyspepsia?

Dyspepsia is postprandial epigastric discomfort, often experienced after eating.

What does Dysphagia mean?

Dysphagia is difficulty in swallowing.

What is Esophagitis?

Esophagitis is inflammation of the esophagus.

What is ERCP?

ERCP stands for Endoscopic Retrograde Cholangiopancreatography, a procedure used to examine the bile and pancreatic ducts.

What is Flatus?

Flatus refers to gas or air in the GI tract that is expelled through the anus.

What is Gastritis?

Gastritis is the inflammation of the stomach, characterized by distinctive histologic and endoscopic features.

What is Guarding?

Guarding is a protective response in muscle resulting from pain or fear of movement, which can be voluntary or involuntary.

What is Rovsing’s Sign?

Rovsing’s Sign is pain in the right lower quadrant (RLQ) when pressure is applied to the left side of the abdomen, commonly seen in appendicitis.

What does UGIB stand for?

UGIB stands for Upper Gastrointestinal Bleeding.

What is an Ulcer?

An ulcer is a local defect or excavation of the surface of an organ or tissue caused by the shedding of inflamed necrotic tissue.

What is Ureterolithiasis?

Ureterolithiasis is the presence of stones that have moved from the kidney through the ureter to the bladder, with urine analysis often showing hematuria.

What is Virchow’s Node?

Virchow’s Node is a palpable lymph node in the left supraclavicular or sternoclavicular fossa, often associated with GI malignancy.

What is the typical GI presentation in the Right Upper Quadrant (RUQ)?

In the RUQ, the differential diagnosis typically includes Gallbladder (GB) issues.

What is the typical GI presentation in the Epigastric region?

The differential diagnosis for epigastric pain includes pancreatitis, Peptic Ulcer Disease (PUD), and Gastroesophageal Reflux Disease (GERD).

What is the typical GI presentation in the Left Upper Quadrant (LUQ)?

The differential diagnosis for LUQ pain includes Gastritis and PUD.

What is the typical GI presentation in the Right Lower Quadrant (RLQ)?

In the RLQ, the differential diagnosis includes appendicitis.

What is the typical GI presentation in the Left Lower Quadrant (LLQ)?

In the LLQ, the differential diagnosis includes diverticulitis.

What are Red Flag symptoms in abdominal pain?

Red flag symptoms include dysphagia (difficulty swallowing, especially progressive), odynophagia (painful swallowing), hematemesis (vomiting blood), melena (black tarry stools), unintentional weight loss, persistent vomiting, constant/severe pain, unexplained iron deficiency anemia, palpable mass, lymphadenopathy, and a family history of upper GI cancer.

What is Visceral Pain and where is it typically felt?

Visceral pain is caused by the stimulation of visceral pain fibers, typically due to distension, stretching, or organ ischemia. It is usually felt in the midline and is not localized (e.g., periumbilical pain in early appendicitis).

What is Parietal (Somatic) Pain and how does it differ from visceral pain?

Parietal pain is caused by the stimulation of somatic pain fibers and is usually more constant and severe than visceral pain. It is localized and aggravated by movement or coughing, alleviated by staying still (e.g., RLQ pain in appendicitis).

What are the causes of nausea and vomiting?

Causes include visceral afferent stimulation, vestibular disorders, CNS disorders, and irritation of the chemoreceptor trigger zone. Questions to ask include the appearance of the vomit (blood, coffee grounds), frequency, and if it’s projectile.

What are the two types of Dysphagia?

Oropharyngeal dysphagia involves trouble initiating swallowing, often caused by neurologic, muscular, metabolic, infectious, or structural disorders. Esophageal dysphagia involves difficulty swallowing solids, liquids, or both, often due to mechanical obstructions or motility disorders.

How does Helicobacter pylori contribute to peptic ulcer disease?

H. pylori causes peptic ulcer disease by increasing gastric acid secretion, inducing gastric metaplasia, triggering an immune response, and impairing mucosal defense mechanisms.

What are some diagnostic tests for Helicobacter pylori infection?

Tests include the urea breath test, fecal antigen test, detection of antibodies in serum, upper endoscopy with gastric biopsy, and rapid urease testing.

What are common causes of GERD?

GERD is caused by reflux of gastric contents through the lower esophageal sphincter (LES) into the esophagus, leading to heartburn, regurgitation, and esophageal injury.

What is Peptic Ulcer Disease (PUD), and what are its risk factors?

PUD involves defects in the gastric or duodenal mucosa, often due to H. pylori infection and NSAID use. Other risk factors include smoking, alcohol consumption, and stress.

What are common causes of Upper GI Bleeding (UGIB)?

UGIB can be caused by peptic ulcer disease, erosive gastritis, esophageal varices, vascular anomalies, malignancy, and Mallory-Weiss tears.

What are the primary causes of Lower GI Bleeding (LGIB)?

LGIB is commonly caused by diverticulosis, vascular anomalies, malignancy, inflammatory bowel disease (e.g., Crohn’s disease, ulcerative colitis), and anorectal diseases (e.g., hemorrhoids).

What is Achalasia?

Achalasia is a disorder caused by progressive degeneration of ganglion cells in the myenteric plexus, resulting in failure of the lower esophageal sphincter (LES) to relax, and loss of peristalsis in the distal esophagus.

What is Zollinger-Ellison Syndrome (ZES)?

ZES is caused by gastrin-secreting tumors (gastrinomas) that lead to severe acid-related peptic disease, diarrhea, and weight loss. Diagnosis includes elevated fasting gastrin levels and a positive secretin stimulation test.

What are some common diagnostic tests for assessing gastrointestinal pathology?

Tests include CBC, comprehensive metabolic panel, urinalysis, lipase, amylase, and imaging like CT scans, ultrasounds, and upper endoscopies.

What is the most common cause of acute pancreatitis?

The most common causes of acute pancreatitis are gallstones and heavy alcohol use. Other causes include high triglycerides, trauma, infections, and certain medications.

What is the clinical significance of the Murphy's sign?

Murphy's sign is a test for cholecystitis. It is positive when a patient experiences pain and stops inhaling as the examiner palpates the RUQ while the patient takes a deep breath, indicating inflammation of the gallbladder.

What is the most common cause of a perforated viscus (abdominal organ)?

The most common cause of a perforated viscus is a peptic ulcer, particularly duodenal ulcers. Other causes include diverticulitis, malignancy, and trauma.

What is the diagnostic approach for suspected acute appendicitis?

Diagnosis involves clinical evaluation (including the use of the Alvarado score or appendicitis score), imaging (ultrasound, CT scan), and sometimes diagnostic laparoscopy.

What is the significance of rebound tenderness in the context of abdominal pain?

Rebound tenderness occurs when palpation of the abdomen is quickly released, causing increased pain. It is indicative of peritoneal irritation, commonly associated with conditions like appendicitis, perforated ulcers, or peritonitis.

What is the typical presentation of mesenteric ischemia?

Mesenteric ischemia often presents with sudden, severe abdominal pain out of proportion to physical examination findings. It can be caused by arterial occlusion, venous thrombosis, or non-occlusive causes.

What is the role of imaging in diagnosing diverticulitis?

CT imaging is the gold standard for diagnosing diverticulitis, as it helps confirm the presence of diverticular disease and detect complications like abscesses, perforation, or fistulae.

What are the characteristic findings in Crohn’s disease on colonoscopy?

On colonoscopy, Crohn's disease typically shows skip lesions (patchy inflammation), transmural inflammation, strictures, and cobblestone mucosa.

How is irritable bowel syndrome (IBS) differentiated from inflammatory bowel disease (IBD)?

IBS is a functional gastrointestinal disorder with no structural or inflammatory changes, while IBD (including Crohn’s disease and ulcerative colitis) involves chronic inflammation with mucosal damage. IBS is diagnosed based on symptom criteria (Rome IV), while IBD is diagnosed with endoscopy, biopsy, and imaging.

What is a common complication of untreated celiac disease?

Untreated celiac disease can lead to malabsorption, nutrient deficiencies (e.g., iron, folate, calcium), osteoporosis, infertility, and an increased risk of lymphoma.

What is the typical presentation of a gastric ulcer?

Gastric ulcers typically present with epigastric pain that worsens after eating. Patients may also experience nausea, vomiting, and weight loss.

What is the role of endoscopy in gastrointestinal bleeding?

Endoscopy is essential for diagnosing the source of upper GI bleeding, as it allows visualization of lesions such as ulcers, varices, or tumors, and enables therapeutic interventions such as hemostasis.

How does ischemic colitis typically present?

Ischemic colitis often presents with left lower quadrant abdominal pain, bloody diarrhea, and sometimes fever. It is caused by a reduced blood flow to the colon, typically affecting the watershed areas of the colon.

What is the diagnostic test of choice for gallstones?

The diagnostic test of choice for gallstones is ultrasound, as it is non-invasive, highly sensitive, and specific for detecting gallstones in the gallbladder and bile ducts.

What are the most common causes of non-viral gastroenteritis?

Non-viral causes of gastroenteritis include bacterial pathogens like Salmonella, Shigella, Campylobacter, and E. coli, as well as parasitic infections such as Giardia and Entamoeba histolytica.

What is the difference between acute and chronic mesenteric ischemia?

Acute mesenteric ischemia involves sudden onset of severe abdominal pain due to embolism or thrombosis of mesenteric arteries, whereas chronic mesenteric ischemia (also called "intestinal angina") develops gradually due to atherosclerosis, with symptoms like postprandial pain and weight loss.

What is a common cause of painless rectal bleeding in adults?

Painless rectal bleeding in adults is often caused by hemorrhoids or anal fissures. Less commonly, it can be a sign of malignancy, diverticulosis, or vascular abnormalities.

What is the primary treatment approach for gastroesophageal reflux disease (GERD)?

The primary treatment for GERD includes lifestyle modifications (e.g., weight loss, avoiding triggers) and pharmacologic therapy such as proton pump inhibitors (PPIs) or H2 blockers to reduce acid production.

What is the classic triad of symptoms in acute cholangitis?

The classic triad of symptoms in acute cholangitis is fever, jaundice, and right upper quadrant pain (Charcot's triad). In severe cases, it can progress to septic shock (Reynolds' pentad).

What is the clinical presentation of a perforated appendix?

A perforated appendix typically presents with a sudden worsening of abdominal pain, fever, nausea, vomiting, and signs of peritonitis (e.g., guarding, rigidity, rebound tenderness).

What is the diagnostic approach for suspected bowel obstruction?

Diagnosis of bowel obstruction involves physical examination (e.g., abdominal distention, high-pitched bowel sounds), imaging (X-ray or CT), and sometimes contrast studies to confirm the location and cause of the obstruction.

What is the clinical significance of steatorrhea?

Steatorrhea, the presence of excess fat in the stool, indicates malabsorption, which can be due to conditions like celiac disease, pancreatitis, or bile salt deficiency. It presents as bulky, foul-smelling, and oily stools.

What is the role of stool tests in gastrointestinal disorders?

Stool tests can help diagnose infections (e.g., stool cultures for bacteria, ova, and parasites), malabsorption (e.g., fecal fat), or gastrointestinal bleeding (e.g., fecal occult blood test).

What is the typical presentation of a duodenal ulcer?

Duodenal ulcers typically present with burning epigastric pain that improves after eating (duodenal ulcer pain is relieved by food or antacids). Patients may also experience nausea, bloating, and fullness.

What is a typical sign of a gastric carcinoma?

Gastric carcinoma can present with weight loss, anorexia, early satiety, epigastric pain, and occasionally hematemesis or melena. Palpable masses or lymphadenopathy may also be observed in advanced cases.