Bowel Obstruction/Ulcerative Colitis/ Messenteric Infarct/ Appendicitis

Question 1

What is Ulcerative Colitis?

Answer 1

IBD with diffuse mucosal inflammation of the colon, may involve whole colon. Characterized by symptomatic episodes and remissions

Question 2

How is UC and Crohn’s different

Answer 2

Crohn’s does not involve the rectum and no blood diarrhea in Crohn’s

Question 3

Labs and diagnostics for UC

Answer 3

Stool studies are negative

sigmoidoscopy establishes diagnosis

Question 4

Management of UC

Answer 4

Mesalamine suppositories or cortisone suppositories or enemas for 3-12 weeks

Question 5

Causes of Messenteric Infarct

Answer 5

• thromobosis or embolus (arterial or venous)
• atherosclerosis
• smoking
• older adults
• coagulopathy that may follow recent surgery

Question 6

S & S of Messenteric Ischemia

Answer 6

• sudden onset cramping, colicky abd pain
• pain out of proportion to physical exam findings
• N, V
• abd guarding and tenderness
• peritoneal findings increase as state progresses
• shock

Question 7

labs and diagnostics of Messenteric Ischemia

Answer 7

• elevated amylase
• leukocytosis
• abd films
• CT

Question 8

what is a hallmark sign of Appendicitis?

Answer 8

Nausea with 1-2 episodes of emesis. More emesis suggests another diagnosis

High grade fever suggests another diagnosis

pain worsened and localized with coughing

Question 9

physical exam findings in appy

Answer 9

+ Psoas sign (right thigh extension)
+ obturator sign (internal rotation of flexed right thigh)
= Rovsing’s sign: RLQ pain when pressure is applied to the LLQ

Question 10

causes of bowel obstruction

Answer 10

• adhesion** (ask surgical hx)
• hernia
• volvulus
• tumors**
• fecal impaction
• ileus (functional obstruction)

Question 11

what do crohn’s patients usually die from?

Answer 11

Malnutrition. it is a dz thats an absorption problem. the upper part of the small bowel doesn’t really work.

Question 12

most common occurance of appy is in who?

Answer 12

young males