Brainscape's Knowledge GenomeTM

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


See full index

Gastrointestinal > Disease of the Small Intestine > Flashcards

Disease of the Small Intestine Flashcards

1
Q

what is mesenteric ischaemia?

A

ischaemia of the mesenteric artery restricting blood flow to SI

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

what causes mesenteric ischaemia?

A

arterial occlusion e.g. atherosclerosis, non-occlusive perfusion insufficiency (shock, strangulation, obstructed venous return e.g. hernia)

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

types of mesenteric ischaemia…

A

chronic, acute

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

what is chronic mesenteric ischaemia

A

usually superior MA and presents with abdominal cramps

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

where does acute mesenteric ischaemia affect the most?

A

small bowel usually infarcted but colon survives

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

what is the pathogenesis of small bowel ischaemia due to Mesenteric ischaemia?

A

hypoxia of mucosa > mural infarct > transmural infarct > gangrene > perforation > sepsis

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

common complications of mesenteric ischaemia?

A

fibrosis, stricture, chronic ischaemia, gangrene, perforation & sepsis

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

presentation of SB ischaemia?

A

severe, poorly localised pain
shock
inc amylase

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

colon ischaemia presentation?

A

left sided pain, CVD, shock, vasculitis

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

why should you be weary of mesenteric ischaemia?

A

may be hard diagnosis - no signs on X-ray. note if pt is taking high dose of analgesia

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

ix for mesenteric ischaemia?

A

CT angiography, bloods (lactate & amylase ^), endoscopy

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

tx for mesenteric ischaemia?

A

resect, re-anastomose, embolectomy of sup. mesenteric artery

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

bowel obstruction is described as?

A

peristalsis is disrupted and dilation of bowel proximal to obstruction

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

types of bowel ob pointers?

A

upper ie. small bowel: acute epigastric pain, hours of onset, vomit

large bowel: more gradual, colicky abdominal pain, distension, vomit

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

true/false…

upper GI obstruction more likely to have faeculent vomit

A

false…

lower GI obstruction more likely to have faeculent vomit

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

pathophysiology of bowel obstruction?

A

fluid, gas > arterial & venous blockage > ischaemia > perforation > sepsis

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

what are the 4 aetiological factors of bowel obstruction and an example for each?

A

within lumen- gall stones, bezoar
within wall- tumour, crohn’s
outside wall- adhesions, hernia, intussusception
arterial: atherosclerosis

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

symptoms of bowel obstruction?

A

colicky pain, absolute constipation, vomit, burping, abdominal distension, no bowel sounds

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

describe vomit associated with bowel obstruction?

A 
proximal= earlier and semi digested food with little bile
distal= opposite & faeculent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

signs of bowel obstruction?

A

abdominal distension, visible peristalsis, lack of tenderness, mass may be palpable, hyperressonant, check for hernias,

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

ix to see state of patient?

A

urinalysis, bloods

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

diagnosis of bowel obstruction

A

supine AXR, contrast CT abdomen

23
Q

tx for bowel ob?

A

ABC, analgesia, fluids & K, NG tube drainage, anti-thromboembolic measures

24
Q

what is tx for bowel ob after 72 hrs of medical tx?

A

surgical tx…

laparotomy & antibis

25
Q

what antibiotics are given for bowel ob?

A

gent & metronidazole

26
Q

why are fluid with K given?

A

pt is usually hypokalaemic and alkalotic

27
Q

what should be noted about the admin for all medication in bowel ob?

A

must all be given IV

28
Q

what are 2 main conditions can result from bowel ob?

A

adynamic bowel obstruction & strangulation w perforation

29
Q

what are 2 types of dynamic bowel obstructions?

A

paralytic ileus and oglivies syndrome?

30
Q

what is a paralytic ileus, symptoms and tx?

A

failure of peristalsis (due to surgery, diabetic keto acidosis, peritonitis)
s/s: similar to bowel ob
tx: drip & suck

31
Q

what is Ogilvie’s syndrome, causes and ix?

A

acute dilation of colon (w/o obstruction) in acutely unwell pts
causes: coronary artery bypass grafts, pneumonia etc
ix: ACR & CT
Tx: colonic decompression

32
Q

explain strangulation as a complication of bowel ob?

A

proportion of bowel becomes trapped so venous return obstructed

  • may progress to infarct / perforation
  • pain, sepsis, shock
  • tx: surgery
33
Q

how to check for perforation?

A

s/s: generalised peritonism

ix: erect CXR, CT

34
Q

what is coeliac disease?

A

autoimmune inflammation of mucosa in response to gluten

35
Q

hypersensitivity to ___ mediated by T cells that are found in intraepithelial lymphocytes (IELs) cause Coeliac’s

A

gliadin

36
Q

pathophysiology of coeliacs?

A

less enterocytes due to IEL damage > loss of villous structures > loss of surface area> reduction in absorption and a flat duodenal mucosa

37
Q

what is coeliac’s associated with?

A

dermatitis herpertiformis and childhood diabetes (T1)

38
Q

histological findings of coeliacs?

A

villus atrophy & crypt hypertrophy

39
Q

ix for coeliac?

A

duodenal endoscopy & biopsy*, serology (anti-TTG antibody)

40
Q

s/s of coeliac?

A

non specific (wt loss, bloating, failure to thrive etc)

41
Q

tx of coeliac disease?

A

gluten free diet, vitamin supplements

42
Q

complications of coeliacs?

A

t-cell lymphomas, small bowel carcinoma, gall stones common, ulcerative-jejenoilleitis

43
Q

3 microscopic signs of ulcerative-jejenoilleitis ?

A

fibrinopurulent debris, base of inflamed granulation tissue, fibrotic scar tissue

44
Q

complications of ulcerative-jejenoilleitis?

A

perforation, haemorrhage, stenosis, gastric metaplasia > H.Pylori

45
Q

what is intestinal failure?

A

inability to maintain adequate nutrition/ fluid stats via intestines

46
Q

classes of intestinal failure?

A
  • acute
  • T1
  • T2
  • T3
47
Q

type 1 intestinal failure description?

A

self-limiting
s: vomiting, dysphagia, diarrhoea
A: pancreatitis, obstruction
T: replace fluids, parenteral nutrition, PPIs

48
Q

T2 intestinal failure description…

A

prolonged PN support needed (weeks, months)
A: sepsis, crohn’s, SMA, radiation, adhesions, fistulas
T: PN & enteral feeding

49
Q

T3 intestinal failure description…

A

chronic
A: small bowel syndrome, crohn’s & SBS, dysmotility, malabsorption
T: home PN, transplant, glucagon-like-peptide2

50
Q

when would you consider transplant for intestinal failure?

A

T3 intestinal failure with liver disease

51
Q

ix for intestinal failure?

A

bloods (dec albumin), dec vitamins & zinc

52
Q

most common aetiology for intestinal failure?

A

ischaemia, malabsorption, SBS

53
Q

what is SBS?

A

<50cm of bowel

due to frequent resections (e.g. Crohn’s/infarct)

54
Q

in non-occlusive ischamia most damage is as a result of…

A

tissue reperfusion

Gastrointestinal (24 decks)

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