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COMAT - Surgery > Colon/Rectum/Anus > Flashcards

Colon/Rectum/Anus Flashcards

1
Q

What often causes Appendicitis?

A

Lumen occluded by fecalith or lymphoid proliferation

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2
Q

Symptoms of Appendicitis?

A

RLQ abdominal pain
N/V
Fever with High WBC

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3
Q

If the appendix ruptures, what other signs will be present?

A

Rebound tenderness, guarding and hypotension

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4
Q

What is the imaging choice for Appendicitis? In children or pregnant mothers?

A

CT with IV contrast
– OR US/MRI for children/pregnant mothers

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5
Q

What is Ogilvie Syndrome?

A

Colonic Pseudo-obstruction

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6
Q

How will Ogilvie Syndrome present?

A

Just like a bowel obstruction – but there is NOT one

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7
Q

What will be seen on imaging with Ogilvie Syndrome?

A

Colonic dilation with small bowel unaffected
– NO obstruction

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8
Q

Colonic dilation with no obstruction seen and the small bowel is normal?

A

Ogilvie Syndrome

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9
Q

How will a Sigmoid Volvulus present?

A

Just like a bowel obstruction
= Abdominal pain/distention/constipation

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10
Q

What will be seen on X-ray with a Sigmoid Volvulus?

A

“Coffee bean” sign

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11
Q

What will be seen on CT with a Sigmoid Volvulus?

A

“Whorl sign”

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12
Q

What is the treatment for a Sigmoid Volvulus?

A

Sigmoidoscopy or Sigmoid colectomy

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13
Q

In what patients is Rectal Prolapse more common?

A

Older women with chronic constipation or who have vaginally delivered many kids

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14
Q

What will be seen on exam with Rectal Prolapse?

A

Patient bears down
–> Mass protrudes from the anus

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15
Q

How will the mass protruding from the anus look with Rectal Prolapse?

A

Mass with concentric rings

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16
Q

An Anal Fissure is a laceration that involves what layers? Is the sphincter involved?

A

Mucosa and submucosa but NOT the sphincter

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17
Q

Where does an Anal Fissure usually occur?

A

MIDLINE and posterior in the anal canal

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18
Q

An Anal Fissure will present how?

A

Constipation –> pain with pooping

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19
Q

Treatment for an Anal Fissure involves a high fiber diet and medications to do what?

A

Relax the anal sphincter because it is too tight

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20
Q

Where are Internal Hemorrhoids located? What innervates them?

A

ABOVE the pectinate line
– Autonomic innervation

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21
Q

With what type of Hemorrhoid will there be pain?

A

External Hemorrhoid

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22
Q

Where are External Hemorrhoids located? What innervates them?

A

BELOW the pectinate line
– Somatic innervation = PAIN

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23
Q

Engorged anal veins

A

Hemorrhoids

24
Q

Internal hemorrhoids are unable to be visualized with the naked eye, what is the usual treatment?

25
Q

External hemorrhoids are able to be visualized, what is the treatment if it is thrombosed?

26
Q

SIBO

A

Small Intestine Bacterial Overgrowth

27
Q

What are the symptoms of SIBO?

A

Abdominal bloating
Chronic watery diarrhea
Flatulence

28
Q

What are the symptoms of SIBO?

A

Abdominal bloating
Chronic watery diarrhea
Flatulence

29
Q

What are 2 tests for SIBO?

A
  1. Carbohydrate breath test
  2. EGD with jejunal aspirate and culture
30
Q

Treatment for SIBO?

A

Oral antibiotics

31
Q

What are some signs of Urethral trauma?

A

Blood at the tip of meatus/in urine
Pain with urination
High riding prostate

32
Q

What test should be done to assess for Urethral Trauma?

A

Retrograde Urethrogram

33
Q

What test should be done to assess for Bladder injury?

A

Retrograde Cystography

34
Q

What increases the risk for Testicular Torsion?

A

Testis fails to fuse to tunica vaginalis

35
Q

What is Testicular Torsion?

A

Twisting of spermatic cord

36
Q

If a boy has sudden scrotal pain, swelling/erythema and N/V, what 2 physical exam findings are likely present?

A

Horizontal - high riding testicle
ABSENT cremasteric reflex

37
Q

What diagnostic test should be done for testicular torsion?

A

Doppler US

38
Q

What can be seen on US with Testicular Torsion?

A

Twisting of spermatic cord
Reduced blood flow
Heterogenous echotexture = necrosis

39
Q

What is Fournier Gangrene?

A

Necrotizing fasciitis that affects the skin of the lower abdomen/scrotum/perineum

40
Q

What will be seen with Fournier Gangrene? Treatment?

A

Crepitus, redness of lower abdomen and systemic signs
–> Rapid surgical intervention

41
Q

What part of the colon is affected with Ulcerative Colitis? Symptoms?

A

Rectum and CONTINUOUS proximally
= Chronic diarrhea + hematochezia

42
Q

What 3 things can be seen in the colon with Ulcerative Colitis?

A
  1. Shallow ulcerations
  2. Mucosal and Submucosal inflammation
  3. Pseudopolyps
43
Q

What is a possible complication of Ulcerative Colitis and how will it look on imaging?

A

Toxic Megacolon
= Loss of haustra in a large bowel segment

44
Q

What is the treatment for mild UC? Moderate/severe UC?

A

Mild = 5-ASA compounds (Mesalamine/Sulfasalazine)
Moderate/Severe = TNF-alpha inhibitors
(Infliximab/Adalimumab)

45
Q

What part of the colon is affected with Crohns? Symptoms?

A

Anywhere but most often Ileus with SKIP lesions
= RLQ pain and diarrhea

46
Q

What can be seen on biopsy with Crohns Disease?

A

Noncaseating Granulomas

47
Q

What 3 things can be seen in the colon with Crohns Disease?

A
  1. Transmural Inflammation
  2. Cobblestoning
  3. Creeping fat
48
Q

What are 3 possible complications of Crohns Disease?

A

Strictures
Fistulas
Abscesses

49
Q

How do you definitively diagnose Ulcerative Colitis/Crohns?

A

Colonoscopy with biopsy

50
Q

How do you definitively diagnose Ulcerative Colitis/Crohns?

A

Colonoscopy with biopsy

51
Q

What often causes Epididymitis?

A

STI – N. Gonorrhea or Chlamydia Trachomatis

52
Q

What symptoms does Epididymitis cause?

A

Posterior testicular swelling and pain

53
Q

What improves the pain with Epididymitis?

A

Testicular ELEVATION

54
Q

What improves the pain with Epididymitis?

A

Testicular ELEVATION

55
Q

Treatment for Epididymitis?

A

Antibiotics covering STI’s
= Ceftriaxone and Doxycycline

COMAT - Surgery (13 decks)

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