appendix and peritoneum

Question 1

things that can obstruct the appendix

Answer 1

fecalith, gallstone, tumor, worms

Question 2

process of acute appy

Answer 2

obstruction (possible) –> increased intra-luminal presure and collapse of draining veins –> ischemia, bacterial proliferation, further inflammation

Question 3

key histological criterion of acute appy

Answer 3

neutrophils in the muscular wall

Question 4

late result of untreated appy

Answer 4

rupture and peritonitis

Question 5

sx of appy

Answer 5

n/v (,may come on later). anorexia, RLQ pain and tenderness at mcBurney point

Question 6

complications of appy

Answer 6

perforation, pyleophlebitis and thrombosis of the portal venous drainage, liver abcess and bacteremia

Question 7

ddx of appy

Answer 7

gasteroenteritis
ECTOPIC
meckel diverticulum
meserwnteric lyphadenitis
diverticulitis

Question 8

appy tumor types (4)

Answer 8

carcinoid
mucocele
pseudomyxoma peritonei
adenocarcinoma

Question 9

most common appy tumor

Answer 9

carcinoid

Question 10

“salt and pepper” tumor with nests of tumor cells withut atypia and no mitosis

Answer 10

carcinoid

Question 11

prognisis for carcinoid appy tumor

Answer 11

excellent

Question 12

plump cells containing mucin vaculoes

Answer 12

goblet cell carcinoid

Question 13

dilated appendix filled with mucin

Answer 13

mucocele

Question 14

globular enlargement of the appy by mucus

Answer 14

simple mucocele

Question 15

mucinous mucosa replaces the appendiceal mucosa. No malignant cells

Answer 15

benign mucinous cystadenoma

Question 16

mucin-filled cystic dilation of appendix with pernetration of the appendiceal wall by invasive cells and spread beyond the appendix

Answer 16

malignant mucinous cystadenocarcinoma

Question 17

ruptured mucinous cystadenocarcinoma can lead to

Answer 17

psuedomyxoma peritonei

Question 18

psuedomyxoma peritonei prognosis

Answer 18

aggresive and fatal

Question 19

mucin secretion that fills the peritoneum

Answer 19

psuedomyxoma peritonei

Question 20

def of secondary peritonitis

Answer 20

perforation of hollow viscus with direct dissemination of contamiinated material

Question 21

can cause sterile peritonitis

Answer 21

blood, bile, pancreatic fluid, drugs

Question 22

can cause infective peritonitis

Answer 22

anything that pokes a hole in the GU tract

Question 23

bugs that cause infective peritonitis

Answer 23

e coli, strep, gram neg rods, c perfringes

Question 24

can cause spontaneus bacterial peritonitis

Answer 24

kids with nephrotic syndrome, cirrohis with ascites

Question 25

possible outcomes of peritonitis

Answer 25

self-resolution
walled off abcesses
adhesions

Question 26

tx of peritonitis

Answer 26

surgery, antibiotics, ICU and management of comorbidities

Question 27

dense fibrous overgrowth of peritoneal retroperitoneal tissue

Answer 27

sclerosing retroperitonitis

Question 28

can cause secondary peritoneal tumors

Answer 28

seeding and penetration from other sites (particularly the ovary and pancreas)

Question 29

highly malignant peritoneal tumor in young males

Answer 29

desmoplastic small round cell

Question 30

gene for desmoplastic small round cell tumor

Answer 30

EWS and WT1 gene fusion

Question 31

firm hard neoplastic tissue with myxoid change and necrosis

Answer 31

desmoplastic small round cell tumor

Question 32

aggregates of malignant small cells surrounded by a cellular desmoplastic stroma

Answer 32

desmoplastic small round cell tumor