Brainscape's Knowledge GenomeTM

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


See full index

Clin Med II - GI Exam > Appendicitis, Diverticulitis, & Mesenteric Ischemia > Flashcards

Appendicitis, Diverticulitis, & Mesenteric Ischemia Flashcards

1
Q

appendicitis epidemiology

A
  • MC surgical procedure
  • 10% of population
  • teens to 20s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

appendicitis etiology

A
  • appendic fecalith obstruction
  • MC in kids = submucosal hyperplasia of lymphoid follicles
  • MC in adults = fecalith
  • FB
  • strictures of neospams
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

appendicitis pathophysiology

A
  • incr. intraluminal pressure
  • lymphatic/venous obstruction
  • edema
  • ischemia
  • invasive infx
  • perforation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

anatomical variations of the appendix

A
  • MC at McBurney’s Point
  • retrocecal = posterior to cecum or ileum
  • pelvic = inferior, in RLQ
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

appendicitis S+S

A
  • visceral pain, begins at pm, but localizes to RLQ
  • anorexia
  • low grade fever
  • n/v
  • onset less than 24hr
  • leukocytosis
  • “downward urge”
  • TTP + rebound tenderness
  • (+) Rovsing, Psoas, +/or obturator sign
  • indirect rebound tenderness
  • DRE
  • absscess
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

appendicitis unusual presentation

A
  • retrocecal
  • pelvic
  • women of childbearing age
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the presentation of retrocecal appendicitis

A
  • less pain, vomining, muscle rigidity
  • pain starts in RLG
  • (+) diarrhea/urinary frequency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the presenation of pelvic appendicitis

A
  • presents like gastroenteritis
  • diffuse pain, vomiting, diarrhea
  • R tenderness on DRE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the presentation of appendicitis in women of childbearing age

A
  • adnexal tenderness, palpable mass

- MC non-GYN surgical emergency in pregos

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

appendicitis diagnostic studies

A
  • Labs: CBC, electrolytes, UA, HCG
  • US
  • abd CT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

appendicitis tx

A
  • preop IV fluids
  • antipyretic
  • NG suction if pt has peritonitis
  • abx
  • appendectomy
  • drainage of abscess
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

appendicitis complications

A
  • perforation
  • post-op infx
  • abscess
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

define diverticulitis

A
  • inflammation + infection associated w/ diverticula
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

diverticulitis pathophysiology

A
  • not well understood
  • sigmoid colon
  • incr. fiber = decr. risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

diverticulitis types

A
  • uncomplicated
  • complicated
  • hemorrhagic
  • giant colonic
  • R sided
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

diverticulitis S+S

A
  • visceral pain starts in hypogastric region
  • anorexia, n/v
  • pain goes to LLQ (TTP)
  • bowel changes
  • fever
  • palpable mass
  • DRE = L tenderness + (+) occult blood
17
Q

diverticulitis unusual presentation

A
  • R sided = in younger pts, mistaken for appendicitis
  • hemorrhagic = elderly; tx via resucetate, transfuse, localized bleeding site
  • w/ abscess = CT drainage if over 2cm or open laporotomy, IV abx
  • w/ perforation = dx w/ upright abd xr, tx = 2 stage open laparotomy
  • w/ obstruction = conservative tx or surgical resection
  • w/ fistula = ID anatomy
18
Q

diverticulitis diagnostic studies

A
  • labs: leukocytosis
  • plain upright abd XR
  • CT w/ contrast
19
Q

diverticulitis tx

A
  • broad spectrum abx
  • clear liquid diet
  • if unable to po, admit w/ IV fluid + NOP, advance diet prn
20
Q

mesenteric ischemia etiology

A

superior mesenteric a. thrombosis or embolus

21
Q

mesenteric ischemia epidemiology

A

elderly

22
Q

mesenteric ischemia clinical presentation

A
  • severe, constant, abd pain associated w/ vomiting/diarrhea usually epigastric or periumbilical
  • pain out of proportion to amt of tenderness
  • underwhelming PE
  • associated vasc. dx
23
Q

mesenteric ischemia work-up

A
  • CTA or MRA
  • angiography
  • CBC = elevated WBC (L shift)
  • metabolic acidosis
  • hyperkalemia
24
Q

mesenteric ischemia tx

A

embolectomy

25
Q

peritonitis definition

A

sudden or recent onset of unexpected abd pain, usually w/in 24-78hr

26
Q

peritonitis S+S

A
  • based on location of pain
  • worse w/ movement therefore pts lie still
  • n/v
  • fever/chills
  • anorexia
  • high-pitched tinkles of obstruction or absence of sounds
27
Q

peritonitis diagnostic studies

A
  • Labs: CBC, UA, electrolytes, H+H, LFTs, pancreatic studies
  • CT
  • US
28
Q

peritonitis tx

A

refer to general surgery

Clin Med II - GI Exam (14 decks)

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