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Jaspie - Surgery > 16 - Small bowel > Flashcards

16 - Small bowel Flashcards

1
Q

currant jelly stools

A

intussusception

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2
Q

cherry red stools

A

intussusception

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3
Q

(+) dance sign

A

intussusception (absence of bowel in the right lower quadrant)

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4
Q

Surgical procedure for treatment of malrotation:

A

Ladd procedure

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5
Q

coiled spring sign

A

intussusception

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6
Q

double bubble sign

A

duodenal obstruction (duodenal atresia)

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7
Q

soap bubble sign

A

meconium ileus

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8
Q

pseudokidney sign

A

intussusception

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9
Q

donut sign

A

intussusception

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10
Q

target sign

A

intussusception

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11
Q

ground-glass appearance in abdominal x-ray

A

meconium ileus

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12
Q

initial treatment for intussusception

A

air then hydrostatic reduction barium enema

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13
Q

microcolon (in contrast enema)

A

meconium ileus

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14
Q

eggshell pattern (in abdominal x-ray)

A

meconium ileus

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15
Q

double track sign

A

pyloric stenosis

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16
Q

Identify: these bands attach the cecum to the retroperitoneum in the right lower quadrant:

A

Ladd’s bands

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17
Q

-Enumerate: steps of the Ladd procedure -This procedure is done for the treatment of _____:

A
  1. untwist the bowels 2. divide the Ladd’s bands 3. indidental appendectomy and rearrange the intestine inside 4. bowel resection if necrosis is present
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18
Q

Where is calcium primarily absorbed

A

duodenum

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19
Q

produced by D cells

A

somatostatin

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20
Q

Produced by G cells

A

Gastrin

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21
Q

Produced by I cells

A

Cholecystokinin

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22
Q

Produced by M cells

A

Motilin

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23
Q

Produced by L cells

A
  1. peptide YY 2. Glucagon like peptide
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24
Q

Produced by S cells

A

Secretin

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25
Inhibits Gi secretion, motility and splanchnic perfusion
somatostatin
26
Stimulates exocrine pancreatic secretion, stimulate intestinal secretion
secretin
27
Stimulate exocrine pancreatic secretion, stimulate gallbladder emptying
cholecystokinin
28
stimulate intestinal motility
motilin
29
stimulate intestinal proliferation
glucagon like peptide 2
30
inhibit intestinal motility and secretion
peptide YY
31
Most common cause of small bowel obstruction
intraabdominal adhesion
32
What portion of the duodenum is compressed in superior mesenteric artery syndrome
3rd portion of duodenum
33
What is the confirmatory test of small bowel obstruction
abdominal series
34
Triad of small bowel obstruction in radiograph
1. dilated small bowel loops \>3 cm 2. air fluid level 3. paucity of air in the colon
35
What is another name for acute colonic pseudo obstruction
ogilvie syndrome
36
treatment of ogilvie syndrome
IV neostigmine Iv atropine to counteract bradycardia
37
What is the normal temporal pattern of GI motility
24 hours - small intestine 48 hours - gastric motility 3 - 5 days - colonic motility
38
Inraoperative measure to reduce ileus
1. minimize handling of bowel 2. laparoscopic approach 3. avoid exxcessive intraoperative fluid administration
39
Post operative measures to reduce ileus
1. early enteral feeding 2. epidural anesthesia, if indicated 3. avoid excessive IV fluid administration 4. correct electrolyte abnormality 5. consider M opioid antagonist
40
Treatment of crohn's disease
Sulfasalazine + steroids
41
Treatment of ulcerative colitis
Sulfasalazine + steroids
42
Earliest leion of crohn's disease
aphthous ulcer
43
This is pathognomonic of crohn's disease: encroachment of mesenteric fat onto the serosal surface of the bowel
fat wrapping
44
Lead pipe colon (lacks hautral markings)
ulcerative colitis
45
Most common area affected by crohn's disease
distal ileum
46
Most common cause of enterocutaneous fistula
iatrogenic
47
What is a low output fistula
less than 200 ml/day
48
What is a high output fistula
more than 500 ml/day
49
90% of fistula are going to close within how many weeks interval
5 weeks
50
Most useful initial test in a fistula
CT scan
51
Fistula usually manifest in how many post operative days
5th to 10th post operative day
52
What are the factors that inhibit closure of fistula?
FRIEND
53
Most common benign neoplasm of small intestine
Adenoma
54
Most common location for primary adenocarcinoma and adenoma in small bowel
duodenum
55
Most common location of GIST
stomach (60 - 70%)
56
Most common mode of presentation of adenocarcinoma in the small bowel
Partial small bowel obstruction
57
What is the most commonly affected area of radiation enteritis
Terminal Ileum
58
Most accurate way to diagnose radiation enteritis
enteroclysis
59
Treatment of radiation enteritis
supportive therapy
60
Most common heterotropic muscosa of meckel's diverticulum
gastric mucosa (60%)
61
Most prevalent congenital anomaly of the GI tract
Meckel's diverticulum
62
Pathology of Meckel's Diverticulum
Failure of ophalomesenteric (vitelline) duct to undergo obliteration during the 8th week of gestation
63
Most common sign of meckel's diverticulum
bleeding in pediatrics intestinal obstruction in adults
64
Treatment of meckel's diverticulum
diverticulectomy
65
It is the most sensitive test to detect jejunoileal diverticula
enteroclysis
66
Most common's of acute mesenteric ischemmia
1. MCC - arterial embolus 2. Most common source - heart 3. most common location - SMA
67
Golder period of mesenteric ischemia
3 hours - intestinal sloughing 6 hours - full thickness intestinal infarction
68
Most common symptom of chronic mesenteric ischemia
postprandial abdominal pain
69
Diagnostic exam of choice for itussuception
CT scan: Target Sign

Jaspie - Surgery (18 decks)

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