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Y1 - Gatrointestinal > Congenital and Cancer of Lower GI > Flashcards

Congenital and Cancer of Lower GI Flashcards

1
Q

What is Meckel’s diverticulum?

A

The persistence of the vitelline duct which forms an outpouching

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2
Q

Who tends to get Meckel’s diverticulum?

A

Symptomatic cases are usually young children

x2 indicence in males

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3
Q

What are the signs/symptoms of symptomatic Meckel’s diverticulum?

A

Fresh painless rectal bleeding

Symptoms mimicking appendicitis

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4
Q

What investigations can help diagnose Meckel’s diverticulum?

A

FBC
Radioisotope scan
AXR
CT

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5
Q

What complications can Meckel’s diverticulum cause?

A

Ulceration, perforation and haemorrhage if it contains gastric mucosa
Diverticulitis and acute inflammation
Obstruction
Malignant changes (rare)

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6
Q

What is the management of symptomatic Meckel’s diverticulum?

A

Surgical removal

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7
Q

The rule of _ is helpful in Meckel’s diverticulum?

A

2s

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8
Q

What is atresia?

A

The congenital absence or abnormal closure of a body cavity

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9
Q

Who presents with atresia?

A

Newborn babies - present from birth

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10
Q

What are the signs of oesophageal atresia?

A

US shows increase in amniotic fluid

Swallowing or breathing difficulties

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11
Q

What are the signs of intestinal atresia?

A

Signs of obstruction
Green bile vomit
Swollen abdomen

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12
Q

What are the signs of biliary atresia?

A

Jaundice

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13
Q

What is the treatment for atresia?

A

Surgery

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14
Q

What is meconium?

A

A newborn’s first stool

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15
Q

What is meconium ileus?

A

Intestinal obstruction caused by meconium that is difficult to pass because it is too sticky

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16
Q

Who tends to get meconium ileus?

A

90% of patients have cystic fibrosis

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17
Q

What are the signs/symptoms of meconium ileum?

A

Meconium is slow to pass
Green bile vomit
Swollen abdomen

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18
Q

What is omphalocele?

A

The intestinal loop does not return to the abdomen during development and instead herniates out into the umbilical cord and is covered in peritoneum

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19
Q

What is the treatment for omphalocele?

A

Surgery

20
Q

What is gastrochisis?

A

Protrusion of abdominal contents through a hole in the anterior abdominal wall lateral to the umbilical cord, not covered in peritoneum

21
Q

What is the treatment for gastroschisis?

A

Surgery

22
Q

What causes intestinal malrotation?

A

The intestines aren’t anchored to the back wall correctly and can move and twist

23
Q

What are Ladd’s bands?

A

Abnormal tissue that can wrap around and cause obstructions of the small intestines

24
Q

What is a volvulus?

A

Where a loop of the intestine is wrapped around its own mesentery

25
Q

Who presents with intestinal malrotation?

A

Kids, 90% before age of 1

Most have other deformities of the GI tract

26
Q

What are the symptoms of intestinal malrotation?

A

Vomiting of green bile
Abdominal pain and the drawing of legs to the chest
Abdominal distension
Failure to thrive

27
Q

How is intestinal malrotation diagnosed?

A

Vomiting of green bile is assumed malrotation until proven otherwise
Contrast AXR is diagnostic

28
Q

What is the management for intestinal malrotation?

A

Ladd’s procedure

29
Q

What is the process of Ladd’s procedure

A
  1. Reduction of midgut volvulus
  2. Complete dissection of Ladd’s bands
  3. Base of mesentery is widened
  4. Prophylactic appendectomy because basically all these patients get appendicitis
30
Q

What is intussusception?

A

One segment of the intestine is pushed inside another, blocking the intestine

31
Q

Where does intussusception commonly happen?

A

Ileocaecal junction

32
Q

Who is intussusception most common in?

A

Children, particularly under three
Most have other anatomical abnormalities
Adults with perevious abdominal surgery

33
Q

What symptom of intussusception is an exam buzzword?

A

Blood and mucous stool, described as ‘red-current jelly stool’ or resembling cranberry sauce

34
Q

What are the symptoms of intussusception?

A

Blood and mucous stool
Vomiting and diarrhoea
Lethargy
Abdominal mass

35
Q

What investigations are used in intussusception?

A

USS
AXR/CT
Air or barium enema

36
Q

What is the treatment for intussusception?

A

Enema fixes 90% by increasing pressure which pops the intussusception out
Surgical release

37
Q

What is an anal fissure?

A

Small tear in the mucosa that lines the anus

38
Q

Who are anal fissures more common in?

A

The very young or old

39
Q

What are the causes for anal fissures?

A 
Passage of large/hard stools
Chronic diarrhoea
Anal intercourse
Childbirth
IBD
Anal cancer
HIV
TB 
Syphillis
40
Q

What are the symptoms/signs of anal fissures?

A

Pain during or after bowel movements
Bright red blood on paper after wiping
Visible crack in skin or small lump

41
Q

What is the conservative treatment for anal fissures?

A

Topical nitroglycerin
Topical anaesthetic
Botox injection

42
Q

What is the surgical treatment for anal fissures?

A

Lateral internal sphincterotomy - small incision made into the sphincter muscles

43
Q

What is the major type of colerectal carcinoma?

A

Adenocarcinoma

44
Q

What are the risk factors for colorectal carcinomas?

A 
Smoking
Red meat
Low fibre diet
IBD
Familiar adenoma polyposis
Lynch syndrome
45
Q

What are the symptoms of colorectal cancer?

A 
Anaemia
Pain
Change in bowel habits
Tenesmus
Abdominal mass
46
Q

What are the investigations used for colorectal carcinoma?

A

Colonoscopy
Flexible sigmoidoscopy
Capsule endoscopy
CT colonography

Y1 - Gatrointestinal (31 decks)

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