Appendicitis - lower GI Flashcards

1
Q

What is the name for a very hard piece of faeces?

A

Faecolith

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2
Q

What is the pathophysiology of appendicitis?

A
  • Obstruction of lumen by a faecolith (very hard piece of faeces)
  • –> Appendix constricts to try + drive faecolith out of appendix
  • –> increased pressure in bowel wall
  • –> inference with blood supply (ischaemic changes)
  • –> decreases walls resistance to bacterial infection
  • –> Inflammation of wall (via bacterial invasion)
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3
Q

Which 2 organisms are commonly associated with appendicitis?

A
  1. E. Coli
  2. Streptococci
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4
Q

Describe the processes that occur during appendicitis.

A
  • earliest lesion: ulceration of mucosa surface
  • Interference with circulation
  • –> to areas of necrosis and perforation with spread to the peritoneal cavity
  • walled off infection –> localised abscess (localised area of tissue necrosis) which can eventually
  • –> to generalised peritonitis
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5
Q

Are symptoms associated with obstruction poorly localised or well localised?

A

poorly localised

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6
Q

Is pain associated with peritonitis similar to obstruction?

A

NO - obstruction = poorly localised

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7
Q

Describe the progression of pain in appendicits.

A

abdominal pain

  • initially was generalized,
  • but then localized to the right lower quadrant.
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8
Q

What are some visual signs of appendicitis seen during autopsy?

A
  • yellow/tan exudate
  • hyperaemia

note: hyperaemia = excess of blood in vessels supplying a structure

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9
Q

What are some microscopic signs of acute appendicitis?

A
  • mucosal inflammation
  • mucosal ulceration
  • necrosis
  • neutrophilic exudate.
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10
Q

What can be seen on blood results that indicates appendicitis?

A

raised WBC

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11
Q

What is the clinical presentation of appendicitis?

A
  • Begins with generalised central abdominal pain (referred pain)
  • Pain shifts to right iliac fossa over a few hours to a few days, and is more severe
  • loss of appetite
  • nausea
  • vomiting
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12
Q

What is the clinical presentation of generalised peritonitis?

A
  • generalised abdominal pain
  • nausea and vomiting
  • sweating,
  • rigors
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13
Q
A
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