Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Y5 colorectal > bowel pathology > Flashcards

bowel pathology Flashcards

1
Q

what is a closed loop bowel obstruction and give an example of one

A

where there is a second obstructing point proximally eg a LBO with a competent ileocaecal valve

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

3 main causes of SBO in order

A

1) adhesions
2) hernias
3) tumours

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

O/E of a bowel obstruction

A

tympanic to percuss and guarding

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

why would you do a lactate blood for a bowel obstruction

A

to see if it was ischaemic

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

what lines are seen on a SBO xray

A

valvulae conniventes (which are complete lines across the bowel)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Main Mx points for a bowel obstruction

A

NGT for decompression, NBM, fluids, referral to surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

pattern of vomiting in SBO vs LBO

A

SBO has early bilious vomit where as LBO has early constipation and then late faeculant vomit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

LBO causes

A

1) cancer
2) diverticular disease
3) volvulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what can the categories of obstruction be split into

A

intraluminal (foreign body, faecal compaction), mural (cancer) or extramural (hernias or volvulus)

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

how can you spot bowel necrosis on CT

A

pneumatosis intestinalis, oedematous and thickened walls, less contrast infiltration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

complications of bowel obstruction

A

perforation, peritonitis, dehydration, hypovolaemic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

gold standard investigation for a bowel obstruction

A

CT AP with contrast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is angiodysplasia

A

vascular abnormality of GI tract - cause AVMs which can be congenital or acquired. May present with malaena or haematchezia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Mx of angiodysplasia

A

can be conservative but may need interventional radiology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what can cause a pseudo obstruction of the bowel

A

adynamic bowel due to interruption of the ANS which can be caused by recent surgery, electrolyte imbalance, neurological disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how does the anatomy of the intestine change as we move down

A

it becomes smaller in diameter and there are more folds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is a true diverticular

A

an outpouching of the bowel wall which contains all three layers (the mucosa, submucosa and the serosa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

why is the rectum normally spared in diverticulosis

A

the out pouching normally forms where the blood vessels penetrate at the tenaei coli. The rectum does not have these.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

RF for diverticulosis

A

obesity, age and low fibre diet (due to constipation which then increases the luminal pressure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is diverticular disease

A

the presence of diverticular and symptoms (pain, change in bowel habit, PR bleed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the pain usually like in diverticular disease

A

colicky and relieved by defecation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how should diverticular disease by treated

A

increased fibre in diet and can use bulk forming laxatives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is diverticulitis

A

when the diverticular become inflamed, normally due to bacterial growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how does diverticulitis present

A

acute abdo pain, normal LIF and systemic signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
when would you suspect a diverticular abscess
signs of diverticulitis and a mass in LIF
26
Mx of diverticular abscess
<5cm - can use Abx but if bigger need surgical drainage
27
imaging for acute diverticulitis vs non acute diverticular disease
acute - CT AP with contrast non acute - flexible sigmoidoscopy
28
how is acute diverticulitis managed
IV abx and supportive.
29
complications of diverticulitis
recurrence, stricture, fistula (colovesicular and colovaginal) and perforation
30
how may a colovesciular fistula present
pneumaturia / UTI
31
what kind of bowel obstruction does a volvulus cause
closed loop
32
why is volvulus most likely to occur in sigmoid (in older adults)
longest mesenteric attachment
33
RF of volvulus
age, chronic constipation or chronic laxative use, high fibre diet
34
IX for volvulus
bloods (as for any obstruction to rule out a pseudobstruction --> U+E, Ca, TFT -G+S for surgery] -AXR is firstline -CT AP with contrast is goldstandard
35
Mx of volvulus
fluid resus, decompression by sigmoidoscope
36
what is acute mesenteric ischaemia
sudden interruption in blood supply to the mesentery. Normally used by embolus (RF - Afib). Can also be caused by thrombosis. Bowel becomes ischaemic --> necrotic
37
how does acute mesenteric ischameia present
acute onset pain, pain disproportionate to clinical findings, high lactate, GI symptoms, may be in shock
38
IX for mesenteric ischaemia
ABG, bloods, mesenteric angiography or if patient is deteriorating do a laparotomy, CT angiography
39
Mx for mesenteric ischaemia
laparotomy - can do embolectomy or may need to remove necrotic part of the bowel
40
pathway that a bowel cancer develops along
normal epithelium --> abnormal epithelial --> small adenoma --> large adenoma ---> carcinoma
41
screening test fr bowel cancer
FIT test very 2 years from 60 -74
42
HNPCC gene (lynch)
MSH2 (autosomal dom) - associated with 2) endometrial and then ovarian and gastric
43
FAP gene
APC (autosomal dominant)
44
how is Right sided cancer most likely to present
anaemia + mass
45
colonoscopy with biopsy is gold standard for bowel cancer diagnosis, if this cannot be used (patient is too frail), what can be used instead
CT colonography
46
what imaging is done for cancer in rectum and why
MRI to see if it has invaded the mesorectal fascia which is very important for staging
47
what does anyone having a bowel op get
Abx (gentamicin / metronidazole due to gram negative bacteria) and DVT prophylaxis
48
when a defunctioning loop ileostomy is used, when is the distal anastomosis checked
after 6 weeks using a dye
49
when is a high anterior resection appropriate
when the cancer is 5cm clear of the anus, this is a good option because it leaves the anal sphincter in tact
50
what op is done to remove cancer in the transverse colon
extended right hemicolectomy
51
when is a APR done
for low rectal tumours when they are <5cm from anus (removes anal sphincters too so has to have end colostomy)
52
how and when would an anastomotic leak present
5-7 days post surgery and patient present with fever/pain/delirium
53
Mx for anastomotic leak
IVabx and exploratory laparotomy
54
how can be wound infection be treated after bowel surgery
VAC (helps wounds heal faster generally)
55
RF of a post op ileus
opioids, age, pelvic surgery, electrolyte imbalance and intraoperative intestinal handling
56
Presentation of a post op ileus
high NGT output, distension, failure to pass stool or flatulance, vomiting O/E - ABSENT bowel sounds
57
Ix for post op ileus
FBC, U+E, CTAP with contrast
58
MX of post op ileus one a anastomotic leak is ruled out
NBM, daily bloods, encourage mobilisation, reduce opiate analgesia (preventative measures - limited handing of intestine and limit opioid analgesia)
59
when do you not refer someone for a FIT before 2 WW
occult bleeding / rectal mass!
60
what targeted therapy can be used for bowel cancer
anti eGFR
61
when do you do a transverse colectomy vs left/extended right hemi?
can only do a transverse colectomy if the tumour is in the centre of the bowel otherwise have to do a L or a R
62
firstline laxative for anal fissure
bulk forming
63
stepwise Mx of anal fissure
1) conservative - stay hydrated, petroleum jelly, bulk forming laxative, local anaesthetic 2) GTN ointment (be aware of headache and hypotension) 3) topical CCB can be tried 4) botulin injection 5) sphincterotomy NOTE --> becomes chronic after 6 weeks
64
whats the difference between complicated and uncomplicated diverticulitis
uncomplicated --> does not extend beyond peritoneum complicated ---> abscess, stricture, fistula, perforation
65
stepwise Mx of diverticulitis
-if acute need CT AP with contrast -if not acute can do a flexible sigmoidoscopy 1) for divertulosis --> advise lifestyle (important to eat more fibre, lose weight, stay hydrated) 2) diverticular disease --> bulk forming laxative and analgesia 3) diverticulitis --> can offer oral abx if not complicated otherwise need admission to hospital + consideration of surgery
66
Ileus how many days post op should make you suspect of something else
5
67
what is the surgery done to resect a tumour in the hepatic flexure
right hemicolectomy with ileocolic anastomosis
68
what is a extended right hemicolectomy
extends to the splenic flexure
69
what classes as a severe truelove and Witt
>6 too,, systemic signs (Fever/tachy), low Hb and raised ESR
70
Dx of boerhavves
Ct contrast swallow

Y5 colorectal (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions