Appendix Flashcards
in appendicitis, fecoliths are usually located at the ___ of the appendix
exit
when the intralumenal pressure inside the appendix surpasses that of the _____, ischemia occurs
vessels
ischemia of the appendix can cause ___ and ___
edema, necrosis
necrosis can lead directly to ____ or can provide a site for ____
perforation; bacterial invasion
if the appendix perforates, what can happen?
peritonitis and sepsis
the first pain felt with appendicitis is called _____ pain, and is located?
visceral pain; periumbilical region
as the inflammation progresses through the wall of the appendix and reaches the serosa, pain becomes localized to the ____, also known as?
RLQ; McBurney’s point
if perforation occurs, ____ ensues, resulting in?
peritonitis; diffuse abdominal pain
sx of appendicitis
abdominal pain, N/V, mild fever/chills, anorexia
physical findings appendicitis
tachycardia, low grade fever, RLQ pain, Rovsing sign, Psoas sign, Obturator sign
tx of appendicitis
appendectomy + ABX (prophylactic)
majority of diverticula in the West are located in the _____ colon
sigmoid
microperforation of diverticula is due to?
inspissation with fecolith
diverticulitis presentation
LLQ pain, fever, constipation, leukocytosis, bowel obstruction, peritoneal signs if macroperf
do NOT do this on a pt with suspected diverticulitis
colonoscopy, barium enema
complications of macroperforation of diverticula
peritonitis, abscess, fistulas
complications of microperforation of diverticula
local phlegmon, segmental narrowing, stricture, obstruction
tx of diverticulitis
clear liquid diet, ABX against gram-neg, anaerobes; verify etiology after; surgery?
presentation of pseudomembr colitis
diarrhea, crampy abdominal pain, leukocytosis, can develop toxic megacolon
dx of PC
stool for c diff toxin (toxin A only tho); colonoscopy for pseudomembranes
management of PC
stop ABX, AVOID anti-diarrheals, give metronidazole/vancomycin/fidaxomycin; fecal transplant?
prominent lymphoid hyperplasia in the appendix is indicative of?
a normal appendix!
microscopic features of appendicitis
mucosal ulceration and hemorrhage; mural hemorrhage; neutrophilic infiltration of muscularis propria
gross features of appendicitis
erythema, surface exudate, perforation
microscopic features of pseudomembranous colitis
volcano lesions composed of degenerating epithelial cells, PMNs, mucin, and fibrin erupting from distended crypts; varying degrees of necrosis
diverticula occur at sites of colonic wall weakness, including?
portion without taeniae coli, sites where vasa recta penetrate muscularis propria
diverticulitis causes mucosal ____ and ____
necrosis; inflammation
if diverticular inflammation is sufficient, it can produce a ___ and mimic ___
mass; colon cancer
