GIT MNEMONICS

GIT MNEMONICS

Ulcerative colitis: definition of a severe attack

A STATE: Anemia less than 10g/dl Stool frequency greater than 6 stools/day with blood Temperature greater than 37.5 Albumin less than 30g/L Tachycardia greater than 90bpm ESR greater than 30mm/hr

Vomiting: extra GI differential

VOMITING: Vestibular disturbance/ Vagal (reflex pain) Opiates Migrane/ Metabolic (DKA, gastroparesis, hypercalcemia) Infections Toxicity (cytotoxic, digitalis toxicity) Increased ICP, Ingested alcohol Neurogenic, psychogenic Gestation

Pancreatitis (acute): causes

I GET SMASHED: Idiopathitic Gallstones Ethanol Trauma Steroids Mumps Autoimmune (PAN) Scorpion stings Hyperlipidemia/ Hypercalcemia ERCP Drugs (including azathioprine and diuretics) · Note: 'Get Smashed' is slang in some countries for drinking, and ethanol is an important pancreatitis cause. · Note: Shortest answer is gallstones for women, and ethanol for men. And scorpian stings for people from Trinidad.

Hereditary Nonpolyposis Colorectal Cancer (HNPCC) cause is DNA mismatch repair

DNA mismatch causes a bubble in the strand where the two nucleotides don't match. This looks like the ensuing polyps that arise in the colon. · See diagram. FIG1

IBD: extraintestinal manifestations

A PIE SAC: Aphthous ulcers Pyoderma gangrenosum Iritis Erythema nodosum Sclerosing cholangitis Arthritis Clubbing of fingertips

Digestive disorders: pH level

With vomiting both the pH and food come up. With diarrhea both the pH and food go down.

H. Pylori treatment regimen (rough guidelines)

"Please Make Tummy Better": Proton pump inhibitor Metronidazole Tetracycline Bismuth · Alternatively: TOMB: Tetracycline Omeprazole Metronidazole Bismuth

Bilirubin: common causes for increased levels

"HOT Liver": Hemolysis Obstruction Tumor Liver disease

Ulcerative colitis: complications

"PAST Colitis": Pyoderma gangrenosum Ankylosing spondylitis Sclerosing pericholangitis Toxic megacolon Colon carcinoma

Charcot's triad (gallstones)

"Charcot's Triad is 3 C's": Color change (jaundice) Colic (biliary) pain, aka RUQ pain Chills and fever Cholangitis features CHOLANGITITS: Charcot's triad/ Conjugated bilirubin increase Hepatic abscesses/ Hepatic (intra/extra) bile ducts/ HLA B8, DR3 Obstruction Leukocytosis Alkaline phosphatase increase Neoplasms Gallstones Inflammatory bowel disease (ulcerative colitis) Transaminase increase Infection Sclerosing   Charcot's triad (gallstones) "Charge a FEE": Charcot's triad is: Fever Epigastric & RUQ pain Emesis & nausea   Haemachromatosis complications "HaemoChromatosis Can Cause Deposits Anywhere": Hypogonadism Cancer (hepatocellular) Cirrhosis Cardiomyopathy Diabetes mellitus Arthropathy   Pancreatitis: criteria PANCREAS: PaO2 below 8 Age >55 Neutrophils: WCC >15 Calcium below 2 Renal: Urea >16 Enzymes: LDH >600; AST >200 Albumin below 32 Sugar: Glucose >10 (unless diabetic patient)   Pancreatitis: Ranson criteria for pancreatitis: at admission "GA LAW" (GA is abbreviation for the U.S. state of Georgia): Glucose >200 AST >250 LDH >350 Age >55 y.o. WBC >16000   Pancreatitis: Ranson criteria for pancreatitis: initial 48 hours "C & HOBBS" (Calvin and Hobbes): Calcium < 8 Hct drop > 10% Oxygen < 60 mm BUN > 5 Base deficit > 4 Sequestration of fluid > 6L   Pancreatitis: Ranson criteria for pancreatitis at admission LEGAL: Leukocytes > 16.000 Enzyme AST > 250 Glucose > 200 Age > 55 LDH > 350   GIT symptoms BAD ANAL S#!T: Bleeding Abdominal pain Dysphagia Abdominal bloating Nausea & vomiting Anorexia/ Appetite changes Lethargy S#!ts (diarrhea) Heartburn Increased bilirubin (jaundice) Temperature (fever) Crohn's disease: morphology, symptoms CHRISTMAS: Cobblestones High temperature Reduced lumen Intestinal fistulae Skip lesions Transmural (all layers, may ulcerate) Malabsorption Abdominal pain Submucosal fibrosis   Dysphagia: differential DISPHAGIA: Disease of mouth and tonsils/ Diffuse oesophageal spasm/ Diabetes mellitus Intrinsic lesion Scleroderma Pharyngeal disorders/ Palsy-bulbar-MND Achalasia Heart: eft atrium enlargement Goitre/ myesthenia Gravis/ mediastinal Glands Infections American trypanosomiasis (chagas disease) Dry mouth: differential "DRI": ·2 of each: Drugs/ Dehydration Renal failure/ Radiotherapy Immunological (Sjogren's)/ Intense emotions   Liver failure: decompensating chronic liver failure differential HEPATICUS: Haemorrhage Electrolyte disturbance Protein load/ Paracetamol Alcohol binge Trauma Infection Constipation Uraemia Sedatives/ Shunt/ Surgery   Cirrhosis: causes of hepatic cirrhosis HEPATIC: Hemochromatosis (primary) Enzyme deficiency (alpha-1-anti-trypsin) Post hepatic (infection + drug induced) Alcoholic Tyrosinosis Indian childhood (galactosemia) Cardiac/ Cholestatic (biliary)/ Cancer/ Copper (Wilson's)   Hepatic encephalopathy: precipitating factors HEPATICS: Hemorrhage in GIT/ Hyperkalemia Excess protein in diet Paracentesis Acidosis/ Anemia Trauma Infection Colon surgery Sedatives   Diabetic ketoacidosis: precipitating factors · 5 I's: Infection Ischaemia (cardiac, mesenteric) Infarction Ignorance (poor control) Intoxication (alcohol)   Whipple's disease: clinical manifestations SHELDA: Serositis Hyperpigmentation of skin Eating less (weight loss) Lymphadenopathy Diarrhea Arthritis   Celiac sprue gluten sensitive enteropathy: gluten-containing grains BROW: Barley Rye Oats Wheat · Flattened intestinal villi of celiac sprue are smooth, like an eyebrow.   Liver failure (chronic): signs found on the arms CLAPS: Clubbing Leukonychia Asterixis Palmar erythema Scratch marks   Splenomegaly: causes CHIMP: Cysts Haematological ( eg CML, myelofibrosis) Infective (eg viral (IM), bacterial) Metabolic/ Misc (eg amyloid, Gauchers) Portal hypertension   Constipation: causes DOPED: Drugs (eg opiates) Obstruction (eg IBD, cancer) Pain Endocrine (eg hypothyroid) Depression Splenomegaly: causes CHINA: Congestion/ Cellular infiltration Haematological (eg haemolytic anaemia, Sickle cell) Infection/ Infarction (eg malaria, GF, CMV) Neoplasia (eg CML, lymphoma, other myeloproliferative) Autoimmune Dysphagia: causes MOON: Mouth lesions Obstruction Oesophageal stricture Neurological (eg stroke, Guillain-Barre, achalasia)   Cirrhosis: differential: common and rarer · Common causes are ABC: Alcohol B (Hepatitis) C (Hepatitis) · Rarer are also ABC: Autoimmune Biliary cirrhosis Copper (Wilson's) Hepatic encephalopathy: precipitating factors ABCDEFI: Alcohol withdrawal Bleeding (GI) Constipation Drugs: withdraw any sedatives/narcotics Electrolyte imbalances Fluid depletion: stop diuretics Infections: treat vigorously Celiac disease: gluten-free diet grains BB-WORM: Barley Buckwheat Wheat Oats Rye Malt