Abdomen

Question 1

Diagnostic criteria for IBS?

Answer 1

ROME III diagnostic criteria which state:

1.Recurrent abdominal pain or discomfort at 3 days per month for the past 3 months associated with two or more of the following:
-Improvement with defecation.
-Onset associated with a change in the frequency of stool.
-Onset associated with a change in the form of the stool.

Question 2

Best test for IBD?

Answer 2

faecal calprotectin

Question 3

Rule of 2s for Meckels?

Answer 3

2% of population
2 inches (5cm) long
2 feet (60 cm) from the ileocaecal valve
2 x’s more common in men
2 tissue types involved

Question 4

What is a meckels diverticulum?

Answer 4

a persistence of the vitello-intestinal duct

Question 5

Causes of mesenteric adenitis?

Answer 5

Adenoviruses, Epstein Barr Virus, beta-haemolytic Streptococcus, Staphylococcus spp., Escherichia coli, Streptococcus viridans and Yersinia spp.

Question 6

Differences between appendicitis and mesenteric adenitis?

Answer 6

Higher temperature in mesenteric
Mesenteric mainly affects children

Question 7

What is abdominal compartment syndrome?

Answer 7

Sustained intra abdominal pressure >20mmHg coupled with new organ dysfunction / failure

Question 8

Risk factors for abdominal compartment syndrome?

Answer 8

obese patients with ileus following major abdominal surgery
prosthetic meshes

Question 9

How is diagnosis of abdominal compartment syndrome made?

Answer 9

transvesical pressure measurements coupled with an index of clinical suspicion.

Question 10

Management of abdominal compartment syndrome?

Answer 10

Gastric decompression
Improve abdominal wall compliance e.g. muscle relaxants/ sedation
Drain abdominal fluid collections.
Consider fluid restriction/ diuretics if clinically indicated.