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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
Q

Inhibits Gi secretion, motility and splanchnic perfusion

A

somatostatin

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26
Q

Stimulates exocrine pancreatic secretion, stimulate intestinal secretion

A

secretin

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27
Q

Stimulate exocrine pancreatic secretion, stimulate gallbladder emptying

A

cholecystokinin

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28
Q

stimulate intestinal motility

A

motilin

29
Q

stimulate intestinal proliferation

A

glucagon like peptide 2

30
Q

inhibit intestinal motility and secretion

A

peptide YY

31
Q

Most common cause of small bowel obstruction

A

intraabdominal adhesion

32
Q

What portion of the duodenum is compressed in superior mesenteric artery syndrome

A

3rd portion of duodenum

33
Q

What is the confirmatory test of small bowel obstruction

A

abdominal series

34
Q

Triad of small bowel obstruction in radiograph

A
  1. dilated small bowel loops >3 cm 2. air fluid level 3. paucity of air in the colon
35
Q

What is another name for acute colonic pseudo obstruction

A

ogilvie syndrome

36
Q

treatment of ogilvie syndrome

A

IV neostigmine Iv atropine to counteract bradycardia

37
Q

What is the normal temporal pattern of GI motility

A

24 hours - small intestine 48 hours - gastric motility 3 - 5 days - colonic motility

38
Q

Inraoperative measure to reduce ileus

A
  1. minimize handling of bowel 2. laparoscopic approach 3. avoid exxcessive intraoperative fluid administration
39
Q

Post operative measures to reduce ileus

A
  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
Q

Treatment of crohn’s disease

A

Sulfasalazine + steroids

41
Q

Treatment of ulcerative colitis

A

Sulfasalazine + steroids

42
Q

Earliest leion of crohn’s disease

A

aphthous ulcer

43
Q

This is pathognomonic of crohn’s disease: encroachment of mesenteric fat onto the serosal surface of the bowel

A

fat wrapping

44
Q

Lead pipe colon (lacks hautral markings)

A

ulcerative colitis

45
Q

Most common area affected by crohn’s disease

A

distal ileum

46
Q

Most common cause of enterocutaneous fistula

A

iatrogenic

47
Q

What is a low output fistula

A

less than 200 ml/day

48
Q

What is a high output fistula

A

more than 500 ml/day

49
Q

90% of fistula are going to close within how many weeks interval

A

5 weeks

50
Q

Most useful initial test in a fistula

A

CT scan

51
Q

Fistula usually manifest in how many post operative days

A

5th to 10th post operative day

52
Q

What are the factors that inhibit closure of fistula?

A

FRIEND

53
Q

Most common benign neoplasm of small intestine

A

Adenoma

54
Q

Most common location for primary adenocarcinoma and adenoma in small bowel

A

duodenum

55
Q

Most common location of GIST

A

stomach (60 - 70%)

56
Q

Most common mode of presentation of adenocarcinoma in the small bowel

A

Partial small bowel obstruction

57
Q

What is the most commonly affected area of radiation enteritis

A

Terminal Ileum

58
Q

Most accurate way to diagnose radiation enteritis

A

enteroclysis

59
Q

Treatment of radiation enteritis

A

supportive therapy

60
Q

Most common heterotropic muscosa of meckel’s diverticulum

A

gastric mucosa (60%)

61
Q

Most prevalent congenital anomaly of the GI tract

A

Meckel’s diverticulum

62
Q

Pathology of Meckel’s Diverticulum

A

Failure of ophalomesenteric (vitelline) duct to undergo obliteration during the 8th week of gestation

63
Q

Most common sign of meckel’s diverticulum

A

bleeding in pediatrics intestinal obstruction in adults

64
Q

Treatment of meckel’s diverticulum

A

diverticulectomy

65
Q

It is the most sensitive test to detect jejunoileal diverticula

A

enteroclysis

66
Q

Most common’s of acute mesenteric ischemmia

A
  1. MCC - arterial embolus 2. Most common source - heart 3. most common location - SMA
67
Q

Golder period of mesenteric ischemia

A

3 hours - intestinal sloughing 6 hours - full thickness intestinal infarction

68
Q

Most common symptom of chronic mesenteric ischemia

A

postprandial abdominal pain

69
Q

Diagnostic exam of choice for itussuception

A

CT scan: Target Sign

Jaspie - Surgery (18 decks)

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