Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y1 - Gatrointestinal > Colon and Rectum > Flashcards

Colon and Rectum Flashcards

1
Q

What are the parts of the large colon?

A

Ascending, transverse, descending, sigmoid

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

What are the teniae coli?

A

Three bands that complete the longitudinal muscle layer.

They produce the haustral pattern

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

Describe the mucosa of the large intestine

A

Mucosa is lined with epithelial cells and goblet cells.

There are crypts but no villi so the surface is flat

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

Which muscles are contracted and relaxed in defecation?

A

Diaphragm and abdominal muscles are contracted

Pelvic floor and anal sphincter are relaxed

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

Which GI diseases can cause constipation?

A

Intestinal obstruction and pseudo-obstruction
Colonic disease (e.g. carcinoma, diverticula)
Aganglionitis (Hirschsprung’s, Chaga’s)
Painful anal conditions (e.g. fissures)

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

What investigation is indicated when there has been a recent change in bowel habit in association with other significant symptoms?

A

Colonoscopy or CT

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

What are the three categories of constipation, and which is the most common?

A

Normal transit time (most common)
Defecatory disorders
Slow transit

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

What is normal transit constipation?

A

Stool frequency is normal but people believe they have constipation due to passage of hard stools
Patients may have abdominal pain or bleeding

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

What investigation distinguished between normal and slow transit constipation?

A

Marker studies of colonic transit

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

What is defecatory disorder induced constipation?

A

Where contraction rather than relaxation of the puborectalis and external anal sphincter may prevent evacuation

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

What is the most common cause of a defecatory disorder?

A

Dysfunction of the anal sphincter and pelvic floor

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

Who predominantly experiences slow transit constipation?

A

Young women with infrequent bowel movements

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

What are the symptoms of slow transit constipation?

A

Infrequent urge to defecate
Bloating
Abdominal pain and discomfort

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

What treatment measure should be taken in normal and slow transit constipation?

A

Increase in fibre in the diet and increased fluid intake

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

What are examples of bulk-forming laxatives?

A

Dietary fibre
Methylcellulose
Sterculia
Ispaghula husk

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

What are some examples of stimulant laxatives?

A 
Senna
Glycerol suppository
Bisacodyl
Docusate sodium
Sodium picosulphate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are some examples of osmotic laxatives?

A

Lactulose
Macrogols
Phosphate enema
Citrate enema

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

How do stimulant laxatives work?

A

By stimulating motility and intestinal secretion

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

How do osmotic laxatives work?

A

By increasing fluids and electrolytes which stimulates contraction

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

Which type of laxatives are preferred?

A

Osmotic

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

What is megacolon?

A

A term for conditions where the colon is dilated

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

What can megacolon be secondary to?

A

Chronic constipation

Chaga’s disease

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

Which condition should be excluded in megacolon, and what is this condition?

A

Hirschsprung’s disease

An aganglionic section of the rectum causes constipation and subacute obstruction

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

What is minor and major incontinence?

A

Minor: inability to control flatus and liquid stool, causing soiling
Major: frequent and inadvertent evacuation of stool of normal consistency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are some causes of incontinence?

A 
Congenital abnormalities
Anal sphincter dysfunction
Rectal prolapse
Faecal impaction with overflow diarrhoea
Severe diarrhoea
Neurological and psychological disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are causes of anal sphincter dysfunction?

A

Structural damage
Pudendal nerve damage
Perianal descend

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What us the initial medical management for incontinence?

A

Loperamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is ischaemic colitis caused by?

A

Occlusion of branches of the superior or inferior mesenteric artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How does ishaemic colitis present?

A

Sudden onset abdominal pain
Passage of bright red blood per rectum (with or without diarrhoea)
May be signs of shock and CVD

30
Q

Which is the most common part of the colon affected by ischaemic colitis?

A

The splenic flexure

31
Q

Who most commonly experiences ischaemic colitis?

A

Elderly patients
Young women on the pill
Patients on nicorandil
Those with thrombophilia and vasculitis

32
Q

What are the characteristic investigative features of ischaemic colitis, and which investigation is diagnostic?

A

Characteristic:
- Thumb-printing on AXR
- Epithelial cell apoptosis and lamina propria fibrosis on biopsy
Diagnostic: unprepared flexible signoidoscopy

33
Q

Which signs on examination are symptoms of ischaemic colitis?

A

Abdomen may be distended and tender

Patients likely show signs of shock and may have lactic acidosis

34
Q

Which investigations are done for suspected ischaemic colitis, and why?

A

Urgent CT to exclude perforation
Un prepared flexible sigmoidoscopy for diagnosis
Biopsy showing characteristic features
Colonoscopy after recovery to exclude stricture formation

35
Q

What investigation should be done in ishcaemic colitis if the patient has underlying CVD?

A

Screening for thrombophilia and vasculitis

36
Q

What is the management for ischaemic colitis?

A

Symptomatic treatment

If peritonism or imminent perforation - surgery

37
Q

What is diverticulosis?

A

The presence of diverticula

38
Q

What is diverticulitis?

A

Inflamed diverticula

39
Q

What is diverticular colitis?

A

Crescentic inflammation on the folds in areas of diverticulosis

40
Q

How does diverticulitis occur?

A

Faeces obstructs the neck of the diverticulum, causing stagnation and allowing bacteria to multiply and produce inflammation

41
Q

What complications can diverticulitis lead to?

A 
Bowel perforation
Abscess formation
Fistulae
Haemorrhage
Generalised peritonitis
42
Q

Are diverticula most often asymptomatic and discovered incidentally, or symptomatic and discovered due to symptoms?

A

Asymptomatic and discovered incidentally

43
Q

What are the symptoms of diverticular disease?

A

Intermittent LIF pain or discomfort

Erratic bowel habit

44
Q

What is the investigation of choice for diverticular disease?

A

Colonoscopy or virtual colonoscopy

Barium enema combined with flexible sigmoidoscopy can also be used

45
Q

What does the term diverticular disease refer to?

A

The presence of diverticula, with or without inflammation

46
Q

What is the management of diverticular disease?

A

Uncomplicated diverticular disease is managed with a well balanced fibre diet and smooth muscle relaxants if required

47
Q

What are the pathological features of acute diverticulitis?

A

Altered gut motility
Increased luminal pressure
Disordered colonic micro-environment

48
Q

How does acute diverticulitis present?

A

Severe pain in LIF
Fever
Constipation

49
Q

What are signs of acute diverticulitis that can be found on examination?

A

Tenderness, guarding and rigidity on the left side of the abdomen
Sometimes a palpable tender mass in LIF

50
Q

What investigations are done in acute diverticulitis?

A

Blood tests (ESR and CRP raised)
CT colonogrpahy
Ultrasound (less sensitive than CT)

51
Q

What will a CT colonography find in acute diverticulitis?

A

Colonic wall thickening
Diverticula
Often pericolic collections and abscesses

52
Q

What is the management of a mild attack of acute diverticulitis?

A

Oral antibiotics

53
Q

What is the management for acute diverticulitis if there is systemic upset, significant abdominal pain or co-morbidity?

A

Bowel rest

IV fluids and antibiotics

54
Q

When might acute diverticulitis require surgery

A

Repeat attacks

55
Q

What results when a diverticulum forms a fistula into the bladder or vagina?

A

Bladder: dysuria or pneumaturia
Vagina: discharge

56
Q

When might intestinal obstruction occur as a complication of diverticular disease?

A

After repeated attacks of acute diverticulitis

57
Q

What are haemorrhoids?

A

Lumps inside, or around the anus

58
Q

What does it mean when a haemorrhoid is classed as primary, second degree or third degree?

A

1 - internal
2 - prolapsing
3 - prolapsed

59
Q

What can haemorrhoids cause?

A

Rectal bleeding, discomfort and pruritus ani

60
Q

What is pruritus ani?

A

Itchy bottom

61
Q

What is the most common cause of rectal bleeding?

A

Haemorrhoids

62
Q

What is a likely sign of haemorrhoids?

A

Bright red blood on toilet paper

63
Q

How is diagnosis of haemorrhoids made?

A

Inspection, rectal exam and proctoscopy

64
Q

What is the management of mild haemorrhoids?

A

Just advice about avoiding constipation

Suppositories containing a local anaesthetic and steroids are helpful

65
Q

What is the management of severe haemorrhoids?

A

Rubber band ligation or injection of a sclerosant

Haemorrhoid artery ligation operation

66
Q

What is an anal fissure?

A

A tear in the skin-lined lower anal canal distal to the dentate line, which produces pain on defecation

67
Q

How is diagnosis done for anal fissures?

A

History, confirmed on perianal exam
PR exam often nor possible because of pain and sphincter spasm
In sever cases proctoscopy and sigmoidoscopy should be done to exclude other disease

68
Q

What is the treatment for anal fissures?

A

Local anaesthetic gel and stool softeners

Botulinum toxin in chronic fissures or lateral subcutaneous internal sphincterotomy

69
Q

How do fistula in ano usually present, and when do they heal?

A

Present as abscesses and heal after abscess is incised

70
Q

How can rectal prolapse, intussusceptions and solitary rectal ulcer syndrome be treated?

A

Treating underlying pathology

Y1 - Gatrointestinal (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions