Abdominal Catastrophes Flashcards

1
Q

What is an abdominal aortic aneurysm?

A

Localised enlargement of the abdominal aorta

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2
Q

What is the pathology of the Abdominal aortic aneurysm?

A

Degeneration in the media of the arterial wall leading to slow continuous dilation of the lumen o the vessels

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3
Q

What is the clinical presentation o abdominal aortic aneurysm?

A

Asymptomatic unless ruptured If ruptured- sudden death or sudden severe abdominal pain, sudden collapse, Shock

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4
Q

What is bowel perforation?

A

Mechanical or functional obstruction of the intestines which prevents normal movement of digestion products

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5
Q

What is the pathology of a bowel perforation?

A

Small bowel- adhesions due to previous surgery, femoral/inguinal hernia, volvulus, carcinoma of the caecum Large bowel- Carcinoma (left side usually) sigmoid volvulus, Diverticular disease

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6
Q

What is the clinical presentation of a bowel perforation?

A

Isotonic hypovolemic, vomiting and then metabolic alkalosis due to loss of HCl, Hypokalemia as compensation for alkalosis, Hypocholermic

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7
Q

What is bowel ischemia?

A

When blood supply through major arteries that supply intestines slows or stops When blood supply through major arteries that supply intestines slows or stops When blood supply through major arteries that supply intestines slows or stops

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8
Q

What can cause bowel ischaemia?

A

Embolism

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9
Q

What is clinical presentation of bowel ischemia?

A

Severe abdominal pain and tenderness, toxic and hypotensive, very high white cell count

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10
Q

What is the treatment of bowel ischemia?

A

Urgent laparotomy and resection of the dead bowel

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11
Q

What is cholangitis?

A

Infection of the bile duct

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12
Q

What is the pathology of cholangitis?

A

Gallstones obstructing the bile duct Ecoli

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13
Q

What is the clinical presentation of cholangitis?

A

Jaundice Biliary stasis Pain in Right upper quadrant Fever Biliary colic- history

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14
Q

What is the treatment of cholangitis?

A

remove gallstones

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15
Q

What is pancreatitis?

A

Disease in which the pancreas becomes inflammed

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16
Q

What is the pathology of pancreatitis?

A

Auto digestion by proteases of retro peritoneum May be due to alcohol or gallstones

17
Q

What is clinical presentation of pancreatitis?

A

Significant dehydration due to vomiting Raised serum amylase Upper abdomen pain that radiates to the back Fever

18
Q

What are the common causes of blood loss into the gut?

A

Bleeding oesphageal varices and bleeding peptic ulcer Bleeding diverticular disease Retroperitoneal bleeding

19
Q

What is the clinical presentation of Bleeding oesphageal varices and bleeding peptic ulcer?

A

Haematemesis Bleeding massively from upper GI tract Melaena Due to alteration of blood by digestive enzymes and intestinal bacteria Occurs with bleeding anywhere from mouth to caecum Patients taking oral iron will have smelly black stool

20
Q

What is the clinical presentation of Bleeding diverticular disease?

A

Bright red bleeding per rectum- Haematochezia Bleeding massively from upper GI tract

21
Q

What causes retroperitoneal bleeding?

A

Due to ruptured AAA or torn retroperitoneal veins if on anticoagulants

22
Q

Where would you feel pain in the small and where in the large bowel?

A
23
Q

When would parietal peritoneum produce pain?

A

Inflammation causes pain

24
Q

What would visceral pain be?

A

Reffered pain

25
Q

What is the nerve supply to the diaphragm?

A

Phrenic nerve

26
Q

Where is gastric and duodenal pain?

A
27
Q

Where is gall bladder pain?

A
28
Q

Where is splenic pain?

A
29
Q

Where is acute appendicitis pain?

A
30
Q

What is pancreatic and abdominal aorta pain?

A
31
Q

Where is small bowel colic?

A
32
Q

Where is large bowel colic?

A
33
Q

Where is renal or uteric colic?

A

Agony- worse than childbirth

34
Q

Where is peritonitis pain?

A