colorectal x ray

Question 1

what to look for to assess penetration and coverage

Answer 1

12th rib, pubis, transverse processes - good penetration and coverage

Question 2

how to tell between large and small bowel

Answer 2

large = haustra HALF
small bowel = valvulae conniventes

Question 3

black in bowel means

Answer 3

gas

Question 4

terminology simple needed to pass

Answer 4

dilated loops of bowel

Question 5

ground glass appearance means

Answer 5

stool

Question 6

likely cause of dilated transverse colon

Answer 6

obstruction around splenic flexure

Question 7

what is more urgent to sort- small or large bowel obstruction

Answer 7

large

Question 8

3 cardinal features of bowel obstruction

Answer 8

absolute constipation (no flatus or solids), abdominal distention, pain

Question 9

why don’t you get vomiting in large bowel obstruction

Answer 9

one way ileo caecal valve (urgent to sort otherwise valve will pop and faecal peritonitis which is deadly)

Question 10

commonest causes of small bowel obstruction

Answer 10

adhesions, hernia and colon cancer

Question 11

name for an accumulation of foreign body material such as hair

Answer 11

bezoar from pica

Question 12

tumours of bowel wall

Answer 12

lymphoma in bowel wall, can get adenocarcinoma but very rare

Question 13

things that can press externally to cause obstruction

Answer 13

ascetics, gynaecological tumours, lymphoma

Question 14

majority of large bowel obstruction

Answer 14

colon cancer

less common = diverticular disease

Question 15

coffee bean shape

Answer 15

sigmoid volvulus

pain is lower than what you would imagine as these people have had chronic slow bowel for years meaning that bowels are already stretched

Question 16

treatment of volvulus

Answer 16

rigid sigmoidoscope until you get to twist, and explosion of gas and stool out of scope

or

flexible scope but that is slower

Question 17

most common type of volvulus

Answer 17

sigmoid

Question 18

classic patient with sigmoid volvulus

Answer 18

psychiatric patients or elderly patients

Question 19

why would you ask for an erect cxr having patient sat up for a few minutes

Answer 19

free gas underneath diaphragm can be visualised - means probable perforation

Question 20

what causes straight lines on xray

Answer 20

fluid

Question 21

what is apple core sign

Answer 21

bowel cancer causing narrowed lumen

Question 22

what to do with polyps

Answer 22

colonoscopy to remove as can turn into cancer

Question 23

mortality and morbidity for faecal peritonitis

Answer 23

80% mortality 100% morbidity

Question 24

what is Hartmans

Answer 24

removal of the sigmoid colon, end colostomy, staple off rectal stump

Question 25

features of a screening test

Answer 25

common problem, low risk, something you can do about it, acceptable to patients, cost effective

Question 26

what does heel prick test check for

Answer 26

PKU

Question 27

common imaging for biliary tree

Answer 27

MRCP

Question 28

management of small bowel obstruction caused by adhesions

Answer 28

drip and suck - NG tube to aspirate and give IV fluids

oral gastrograffin - osmotic laxative and used to visualise