Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI Extra > 9.1 GI Emergencies > Flashcards

9.1 GI Emergencies Flashcards

1
Q

what is the peritoneal cavity?

A

potential space between visceral and parietal peritoneum contains nothing other than approx 20mLs peritoneal fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

visceral peritoneum

A

serial membrane not lining abdo wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

is a mesentery visceral peritoneum?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

parietal peritoneum

A

serial membrane lining abdo wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what connects the greater and lesser sac?

A

foramen of Winslow, under free edge of lesser omentum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

define primary peritonitis

A

spontaneous bacterial peritonitis is infection of ascitic fluid, cant be attributed to anything else. commonly associated with end stage liver disease (cirrhosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what causes large amounts of ascites fluid in cirrhosis?

A

fibrosis = portal HTN, increases hydrostatic pressure in veins draining gut
also less albumin so lower intravascular oncotic pressure

so fluid moves into peritoneal cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

symptoms of primary peritonitis
and compare to secondary

A

abdo pain (gradual/acute), fever, vomiting. Lie still
milder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

diagnosis of primary peritonitis

A

aspirate ascitic fluid, neutrophil count >250 cells/cm3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

define secondary peritonitis

A

result of inflammatory process secondary to inflammation, perforation, gangrene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

common causes of secondary bacterial peritonitis

A

-perforated peptic ulcer
-perforated appendix
-perforated diverticulum
-post surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

non bacterial causes of secondary peritonitis

A

-tubal pregnancy that bleeds
-ruptured ovarian cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

treatment of peritonitis

A

control infection
surgery if viscera ruptured
maintain organ functions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

common causes of bowel obstruction in children

A

-intususseption
-intestinal atresia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

common causes of bowel obstruction in adults

A

-adhesions
-incarcerated hernias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

intestinal atresia

A

failure of recanalisation (especially duodenum) during development, presents soon after birth (cant have milk, vomit)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

intussusception

A

one part of gut telescopes into adjacent section

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

best explanation for intussusception

A

lead point created by mass, that precipitates telescoping action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

symptoms of intussusception

A

vomiting
abdo pain
haematochezia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

treatment of intussusception

A

air enema- pushes it back
surgery- if air didn’t work, put it back/remove part of bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

symptoms of small bowel obstruction

A

nausea, vomiting
abdo distension
absolute constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

bilious vomiting

A

if small bowel obstruction is distal to where bile enters at 2nd part of duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

causes of small bowel obstruction

A

adhesions
hernias
IBD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are adhesions?

A

abnormal fibrous bands between organs/tissues in abdo cavity that are normally separated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

consequence of adhesions

A

abdo pain due to reduced peristalsis

26
Q

does surgery help adhesions?

A

yes can, but can also cause more

27
Q

diagnosis of small bowel obstruction

A

-Hx of colicky pain 3-5mins for small int, 10-15 mins large int
-abdo distension, increased/absent bowel sounds, hernia
-CT abdo+pelvis

28
Q

finding on CT for small bowel obstruction

A

> 3cm
(central position, place circulares)

29
Q

common causes of large bowel obstruction

A

-colon cancer
-strictures from diverticular disease
-volvulus (sigmoid mainly, can be caecal)

30
Q

symptoms of large bowel obstruction

A

gradual if cancer, acute with volvulus
-change in bowel habit (overflow diarrhoea, cancer)
-abdo distension
-crampy abdo pain
-nausea/vomiting (late)

31
Q

what’s a volvulus?

A

part of colon twists. around its mesentery (cuts off venous drainage, then arterial)

32
Q

how do high fibre diets contribute to volvulus?

A

bulks up stool, sigmoid overloads and twists

33
Q

which bowel does caecal volvulus obstruct?

A

both

34
Q

investigations of volvulus, and typical sign

A

CT abdo and pelvis
coffee bean sign due to distended sigmoid colon

35
Q

relevance of competent oleo-caecal valve

A

colon cant distend proximally, so worsens large bowel obstruction as perforation more likely

36
Q

compare appearance of small and large bowel xray

A

small
-plica circulares (all way round)
-<3cm
-central

large
-<6cm
-haustra incomplete
-peripheral

37
Q

what’s acute mesenteric ischaemia?

A

symptomatic reduction in bood supply to GI tract

38
Q

arterial compromise causes acute mesenteric ischaemia. give some ways

A

-arterial embolism/thrombosis affecting SMA
-vasculitis narrowing artery
-low CO e.g HF

39
Q

where’s the splenic flexure?

A

where transverse colon meets descending

40
Q

venous compromise causes acute mesenteric ischaemia. give some ways

A

-mesenteric venous thrombosis
-systemic coaguloptahy e.g malignancy

41
Q

why could blood supply be limited at splenic flexure?

A

furthest from direct blood supply, anastomoses may not be enough

42
Q

Why can acute mesenteric ischaemia be difficult to diagnose?

A

Symptoms fairly non specific e.g. pain (typocally L sided as splenic flexure fragile), nausea, vomiting

43
Q

Typical presentation leading you to suspect acute mesenteric ischaemia

A

Older patient, agony, no onbvious issue on plapation, worse pain after eating

44
Q

Why is the pain in acute mesenteric ischaemia worst 30mins after eating?

A

Need for Increased blood supply to gut for digestion

45
Q

Investigations for acute mesenteric ischaemia

A

Bloods: metabolic acidosis and high lactate
CT abdo and pelvis, CT angiography
(Erect CXR air under diaphragm suggests perforation)

46
Q

Treatment of acute mesenteric ischaemia

A

Surgery to resect ischaemic bowel
Thrombolysis/angioplasty

47
Q

Mortality in acute mesenteric ischaemia

A

Can be 70%

48
Q

Define ulcer

A

Disruption in the mucosa, through to submucosa (muscularis mucosa)

49
Q

Why can duodenal ulcers be bad?

A

Erode posteriorly in first part of duodenum and interrupt gastroduodenal artery

50
Q

Pre, intra, and post hepatic causes of oesophageal varices

A

Pre: portal vein thrombosis
Intra: cirrhosis, schistomiasis
Post: RHF, hepatic vein thrombosis

51
Q

Normal pressure in portal vein

A

5-10 mmHg

52
Q

Portal and systemic drainage of oesophageal veins

A

Portal: L gastric, then portal
Systemic: azygous, then SVC

53
Q

2 ways to stop oesophageal varices bleeding

A
  1. Banding- around base, necrosis
  2. Transjugular intrahepatic porto systemic shunt- bridges portal to helatic vein by expanding metal
54
Q

Typical presentation leading you to suspect AAA

A

Age over 60, abdo and back pain maybe smoker
Dilated aorta on palpation

55
Q

Define AAA

A

Permanent pathological dilation of aorta diameter >1.5 normal AP, usually 3cm or more

56
Q

Usual cause of AAA

A

Degeneration of tunica media so elastin and collagen degrade and lumen dilates

57
Q

Risk factors for AAA

A

Male
Inherited
Age
Smoking

58
Q

Symptoms of AAA

A

Asymptomatic normally, until rupture
But also
-back pain
-abdo pain
-pulsatile abdo mass
-nausea if compress stomach
-urinary frequency if compress bladder
-back pain if compress vertebra

59
Q

Where are most AAAs?

A

Infrarenal (90%)

60
Q

Diagnosis of AAA

A

Physical exam
-pulsatile abdo mass

US
-can detect free peritoneal blood

CT
-good for planning surgery

61
Q

Non surgical treatment of AAA

A

Smoking cessation
Control HTN
Surveillance if less than 5.5cm

62
Q

Surgical treatment of AAA

A

Endovascular metallic stent
-via femoral artery
If more then 5.5cm

Open
-clamp aorta, synthetic graft sutured in to replace diseased segment

GI Extra (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions