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Gastrointestinal > Diseases of Appendix > Flashcards

Diseases of Appendix Flashcards

1
Q

what is appendicitis?

A

infection of the appendix

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2
Q

aetiology of appendicitis?

A

unknown, obstruction of lumen, bacterial/viral

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3
Q

pathology of appendicitis?

A

inflammation of appendix causes greater omentum to stick to appendix and small bowel creating a large inflamed mass

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4
Q

risk factors for appendicitis

A

age, immunosuppression, diabetes, absence of omentum

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5
Q

pathogenesis of appendicitis?

A

obstruction of lumen > mucosal inflammation & lymphoid hyperplasia > build up of mucus and exudate > venous obstruction > ischaemia > perforation

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6
Q

symptoms of appendicitis?

A

central abdominal pain that shifts to right iliac fossa, sore to cough, anorexia, flushed

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7
Q

acute presentation of appendicitis may look like…

A

vomit, pain, RIF tenderness, inc WCC

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8
Q

signs of appendicitis?

A

mild pyrexia, tachy, localised pain, guarding, Rosving’s, Psoas, obsturator

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9
Q

what is the localised pain called with appendicitis?

A

McBurney’s point

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10
Q

what is Rosving’s sign?

A

pressing on left exacerbated pain in right

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11
Q

what is Psoas sign?

A

keeps right hip flexed

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12
Q

what is Obsturator sign?

A

flexing hip and internal rotation causes pain

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13
Q

ix for appendicitis

A

bloods (CRP-c reactive protein & WCC)*, USS, CXR, urinalysis

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14
Q

what ix would you do with acute presentation of appendicitis?

A

lilopsoas test

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15
Q

what score is applied to appendicitis to assess severity?

A 
MANTRELS 
Migration of pain to RIF
Anorexia 
Nausea
Tenderness 
Rebound pain 
Elevated temp & pulse
Leukocytosis 
Shift of WCC to left
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16
Q

what is the tx for appendicitis?

A

4As

  • Analgesia
  • Antipyretics
  • Appendectomy/ laparoscopy
  • Antibiotics
17
Q

what are the complications for appendicitis?

A

PRAFS

  • peritonitis
  • rupture
  • abscess (appendix mass, abscess, pelvic abscess)
  • fistula
  • sepsis
18
Q

ddx for appendicitis in kids?

A

gastroenteritis, mesenteric adenitis, meckel’s diverticulum, intusussuception, henoch-schonlein purpura, lobar pneumonia

19
Q

ddx for appendicitis in adults?

A

adults: terminal ileitis, ureteric colic, pancreatitis, perforated ulcer

20
Q

ddx for appendicitis in women?

A

women: ovarian cyst, ectopic pregnancy

21
Q

ddx for appendicits in elderly?

A

elderly: sigmoid diverticulitis, carcinoma of caecum

22
Q

what is the epidemiology of carcinoid of appendix?

A

1/300-400

23
Q

s/s of carcinoid of appendix?

A

asymptomatic finding

24
Q

pathology of carcinoid of appendix?

A

occurs in crypts of lieberkuhn

25
Q

tx for carcinoid of appendix?

A

surgical resection-appendicectomy/ right hemicolectomy

Gastrointestinal (24 decks)

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