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Gastroenterology Mnemonics

Splenomegaly: causes CHINA:


Congestion/ Cellular infiltration
Haematological (eg haemolytic anaemia, Sickle cell)
Infection/ Infarction (eg malaria, GF, CMV)
Neoplasia (eg CML, lymphoma, other myeloproliferatie)
Autoimmune
Dysphagia: causes MOON:
Mouth lesions
O!struction
Oesophageal stricture
Neurological (eg stroke, Guillain"#arre, achalasia)
Cirrhosis: differential: common and rarer $ Common causes
are ABC:
Alcohol
B (%epatitis)
C (%epatitis)
$ &arer are also ABC:
Autoimmune
Biliary cirrhosis
Copper ('ilson(s)
Hepatic encephalopathy: precipitating factors ABCD!I:
Alcohol )ith*ra)al
Blee*ing (G+)
Constipation
Drugs: )ith*ra) any se*aties/narcotics
lectrolyte im!alances
!lui* *epletion: stop *iuretics
Infections: treat igorously
Celiac disease: gluten"free diet grains BB"#O$M:
Barley
Buck)heat
#heat
Oats
$ye
Malt
Dry mouth: differential %D$I%:
$, of each:
Drugs/ Dehy*ration
$enal failure/ $a*iotherapy
Immunological (S-ogren(s)/ Intense emotions
&i'er failure: decompensating chronic li'er failure differential
H(A)IC*S:
Haemorrhage
lectrolyte *istur!ance
(rotein loa*/ (aracetamol
Alcohol !inge
)rauma
Infection
Constipation
*raemia
Se*aties/ Shunt/ Surgery
Cirrhosis: causes of hepatic cirrhosis H(A)IC:
Hemochromatosis (primary)
n.yme *eficiency (alpha"/"anti"trypsin)
(ost hepatic (infection 0 *rug in*uce*)
Alcoholic
)yrosinosis
In*ian chil*hoo* (galactosemia)
Car*iac/ Cholestatic (!iliary)/ Cancer/ Copper
('ilson(s)
Hepatic encephalopathy: precipitating factors H(A)ICS:
Hemorrhage in G+1/ Hyperkalemia
2cess protein in *iet
(aracentesis
Aci*osis/ Anemia
)rauma
Infection
Colon surgery
Se*aties
Dia+etic ,etoacidosis: precipitating factors $ 3 +(s:
Infection
Ischaemia (car*iac, mesenteric)
Infarction
Ignorance (poor control)
Into2ication (alcohol)
#hipple-s disease: clinical manifestations SH&DA:
Serositis
Hyperpigmentation of skin
ating less ()eight loss)
&ympha*enopathy
Diarrhea
Arthritis
Celiac sprue gluten sensiti'e enteropathy: gluten"containing grains
B$O#:
Barley
$ye
Oats
#heat
$ Flattene* intestinal illi of celiac sprue are smooth, like an eye+ro.4
&i'er failure /chronic0: signs found on the arms C&A(S:
Clu!!ing
&eukonychia
Asteri2is
(almar erythema
Scratch marks
Splenomegaly: causes CHIM(:
Cysts
Haematological ( eg CML, myelofi!rosis)
Infectie (eg iral (+M), !acterial)
Meta!olic/ Misc (eg amyloi*, Gauchers)
(ortal hypertension
Constipation: causes DO(D:
Drugs (eg opiates)
O!struction (eg +#5, cancer)
(ain
n*ocrine (eg hypothyroi*)
Depression
Cholangitis features CHO&ANGI)I)S:
Charcot(s tria*/ Con-ugate* !iliru!in increase
Hepatic a!scesses/ Hepatic (intra/e2tra) !ile *ucts/ HL6
#7, 5&8
O!struction
&eukocytosis
Alkaline phosphatase increase
Neoplasms
Gallstones
Inflammatory !o)el *isease (ulceratie colitis)
)ransaminase increase
Infection
Sclerosing
Charcot-s triad /gallstones0 9Charge a !9:
Charcot(s tria* is:
!eer
pigastric : &;< pain
mesis : nausea
Haemachromatosis complications 9HaemoChromatosis
Can Cause Deposits Any)here9:
Hypogona*ism
Cancer (hepatocellular)
Cirrhosis
Car*iomyopathy
Dia!etes mellitus
Arthropathy
(ancreatitis: criteria (ANC$AS:
(a=, !elo) 7
Age >33
Neutrophils: 'CC >/3
Calcium !elo) ,
$enal: ;rea >/?
n.ymes: L5% >?@@A 6S1 >,@@
Al!umin !elo) 8,
Sugar: Glucose >/@ (unless *ia!etic patient)
(ancreatitis: $anson criteria for pancreatitis: at admission
9GA &A#9 (G6 is a!!reiation for the ;4S4 state of Georgia):
Glucose >,@@
AS1 >,3@
&5% >83@
Age >33 y4o4
##C >/?@@@
(ancreatitis: $anson criteria for pancreatitis: initial 12 hours
9C : HOBBS9 (Calin an* Ho++es):
Calcium B 7
Hct *rop > /@C
O2ygen B ?@ mm
B;D > 3
Base *eficit > E
SeFuestration of flui* > ?L
(ancreatitis: $anson criteria for pancreatitis at admission
&GA&:
&eukocytes > /?4@@@
n.yme 6S1 > ,3@
Glucose > ,@@
Age > 33
&5% > 83@
GI) symptoms BAD ANA& S34):
Blee*ing
A!*ominal pain
Dysphagia
A!*ominal !loating
Nausea : omiting
Anore2ia/ Appetite changes
&ethargy
SGHts (*iarrhea)
Heart!urn
Increase* !iliru!in (-aun*ice)
)emperature (feer)
Crohn-s disease: morphology5 symptoms CH$IS)MAS:
Co!!lestones
High temperature
$e*uce* lumen
Intestinal fistulae
Skip lesions
)ransmural (all layers, may ulcerate)
Mala!sorption
A!*ominal pain
Su!mucosal fi!rosis
Dysphagia: differential DIS(HAGIA:
Disease of mouth an* tonsils/ Diffuse oesophageal spasm/ Dia!etes
mellitus
Intrinsic lesion
Sclero*erma
(haryngeal *isor*ers/ (alsy"!ul!ar"MD5
Achalasia
Heart: eft atrium enlargement
Goitre/ myesthenia Grais/ me*iastinal Glan*s
Infections
American trypanosomiasis (chagas *isease)
*lcerati'e colitis: definition of a se'ere attac, A S)A):
Anemia less than /@g/*l
Stool freFuency greater than ? stools/*ay )ith !loo*
)emperature greater than 8I43
Al!umin less than 8@g/L
)achycar*ia greater than J@!pm
S& greater than 8@mm/hr
6omiting: e7tra GI differential 6OMI)ING:
6esti!ular *istur!ance/ 6agal (refle2 pain)
Opiates
Migrane/ Meta!olic (5K6, gastroparesis, hypercalcemia)
Infections
)o2icity (cytoto2ic, *igitalis to2icity)
Increase* +CL, Ingeste* alcohol
Neurogenic, psychogenic
Gestation
(ancreatitis /acute0: causes I G) SMASHD:
I*iopathitic
Gallstones
thanol
)rauma
Steroi*s
Mumps
Autoimmune (L6D)
Scorpion stings
Hyperlipi*emia/ Hypercalcemia
&CL
Drugs (inclu*ing a.athioprine an* *iuretics)
$ Dote: (Get Smashe*( is slang in some countries for *rinking, an* ethanol is an
important pancreatitis cause4
$ Dote: Shortest ans)er is gallstones for )omen, an* ethanol for men4 6n*
scorpian stings for people from 1rini*a*4
Hereditary Nonpolyposis Colorectal Cancer /HN(CC0 cause is DNA
mismatch repair 5D6 mismatch causes a !u!!le in the stran* )here the
t)o nucleoti*es *on(t match4
1his looks like the ensuing polyps that arise in the colon4
IBD: e7traintestinal manifestations A (I SAC:
Aphthous ulcers
(yo*erma gangrenosum
Iritis
rythema no*osum
Sclerosing cholangitis
Arthritis
Clu!!ing of fingertips
Digesti'e disorders: pH le'el 'ith 'omiting !oth the
p% an* foo* come up4
'ith diarrhea !oth the p% an* foo* go do.n4
H8 (ylori treatment regimen /rough guidelines0 9(lease
Make )ummy Better9:
(roton pump inhi!itor
Metroni*a.ole
)etracycline
Bismuth
$ 6lternatiely: )OMB:
)etracycline
Omepra.ole
Metroni*a.ole
Bismuth
Biliru+in: common causes for increased le'els 9HO) &ier9:
Hemolysis
O!struction
)umor
&ier *isease
*lcerati'e colitis: complications 9(AS) Colitis9:
(yo*erma gangrenosum
Ankylosing spon*ylitis
Sclerosing pericholangitis
)o2ic megacolon
Colon carcinoma
Charcot-s triad /gallstones0 9Charcot(s )ria*
is 9 C(s9:
Color change (-aun*ice)
Colic (!iliary) pain, aka &;< pain
Chills an* feer