Bowel Segments "Dow Jones Industrial Averages Closing Stock Report" is a good one, even though it misses the

Cecum... Dow Jones Industrial Averages Closing Stock Report Duodenum Jejunum Ileum Appendix Colon Sigmoid Rectum Liver Lobes The four lobes of the liver: caudate, quadrate, left and right, bring to mind the newspaper headline of the wheelchair bound fellow who left a party right after his ugly girlfriend departed: "QUAD LEFT RIGHT after COW-DATE" Pertoneum Facts The idea is to relate key letters of related parts... stOMach and OMentum (which lays over the stomach) The bacterium e. coLI is found in the Large Intestine The OMentum covers the stOMach The Lesser OMentum holds the Liver and stOMach The Mesentery holds the sMall intestine The mesoCOLON attaches the large intestine (COLON) to the posterior abdominal wall. The periTONEa, which prevents the intestines from kinking, TONES the GI tract. Sphincters of the Ailmentary Canal APE OIL initials the five of them... A P E O I L Anal Pyloric (Lower) Esophageal Oddi Ileocecum iLeocecum Stomach Parts "The CAR is FUN 'til the BODY PILES" relates the four parts of the stomach: Cardiac, Fundus, Body, Pylorus. The pylorus is where the food piles waiting for the sphincter to open. 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 GET SMASHED: 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.

IBD: surgery indications "I CHOP": Infection Carcinoma Haemorrhage Obstruction Perforation "Chop" convenient since surgery chops them open.

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.

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

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