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Surgery > Fiser ABSITE Ch. 35 Small Intestine > Flashcards

Fiser ABSITE Ch. 35 Small Intestine Flashcards

1
Q

Function of: Small intestine? Large intestine?

A

Nutrient and water absorption; Water absorption

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2
Q

Duodenum anatomy: -Retroperitoneal portions? -Vascular supply?

A

-2nd and 3rd -Superior (off GDA) and inferior (off SMA) pancreaticoduodenal arteries

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3
Q

Jejunum: -Anatomy? -Function?

A

-100 cm long, long vasa recta, supplied by SMA -90% of water, 95% NaCl absorption

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4
Q

Ileum: -Anatomy -Function

A

-150 cm, short vasa recta, SMA supply -B12, folate and bile acid absorption

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5
Q

Short gut syndrome: -Diagnostic tests -Treatment

A

-Sudan red (fecal fat) -Schilling test (radiolabeled B12) -Fat restriction, PPI, lomotil

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6
Q

How much small bowel needed to survive with TPN in short gut?

A

75 cm or 50 cm with competent ileocecal valve; Meckel’s diverticulum (rule of 2’s)//2 FEET from ileocecal valve; 2 years old; 2% of population; 2 types of tissue (pancreatic, gastric)

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7
Q

How does Meckel’s present?

A

Bleeding in children. Obstruction in adults.

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8
Q

Segmental resection in Meckel’s?

A

-Neck > 1/3 of luminal diameter -Complicated diverticulitis -Diverticulitis involves base

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9
Q

Perianal disease in Crohn’s:

A

-First presentation in 5% -Presents as SKIN TAGS -Treat with FLAGYL

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10
Q

Medical treatment of Crohn’s

A

-Loperamide and 5-ASA -Steroids for acute flares -anti-TNF-alpha inhibitors for steroid-resistant or fistulas; 90% will need surgery

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11
Q

What cell type produces serotonin?

A

Kulchitsky (enterochromaffin) cells

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12
Q

Serotonin metabolism

A

Part of the amine precursor uptake decarboxylase (APUD) system. 5-HIAA is a breakdown product that can be measured in urine.

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13
Q

Carcinoid tumors release:

A

NAME?

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14
Q

Symptoms of carcinoid syndrome and treatment:

A

NAME?

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15
Q

Detection and localization of carcinoid?

A

Detect - Chromogranin A level; Localize - Octreotide scan

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16
Q

Small bowel carcinoid

A

Increased risk of MULTIPLE primaries and second unrelated malignancies

17
Q

Carcinoid treatment

A

Depends on location: -Appendix:

18
Q

Peutz-Jeghers syndrome

A

NAME?

19
Q

Risk factors for duodenal adenocarcinoma

A

-FAP -Gardner’s -von Recklinghausen -polyps -adenomas

20
Q

Leiomyosarcoma location

A

Extraluminal jejunum and ileum

21
Q

Small bowel lymphoma

A

-Ileum -Associated with: Wegener’s, AIDS, celiac sprue, SLE, Crohn’s -NHL B cell type -Wide en bloc resection, NO WHIPPLE

22
Q

Most common stomal infection?

A

Candida

23
Q

Treatment of diversion colitis (Hartmann’s pouchitis)?

A

Short chain fatty acid enemas

24
Q

Most common cause of stoma stenosis?

A

Ischemia

25
Q

Most common cause of fistula near stoma site?

A

Crohn’s

26
Q

Ileostomy increases risk of?

A

Gallstone; Uric acid kidney stones

27
Q

Most common cause of appendicitis?

A

Hyperplasia - children; Fecalith - adults

28
Q

Mucous papillary tumor of appendix

A

Appendix mucocele - should open to not spill contents - can get PSEUDOMYXOMA PERITONEI with rupture - SBO from peritoneal tumor spread MCC of death

29
Q

Causative organism in typhoid

A

Salmonella

30
Q

Treatment of typhoid enteritis

A

Bactrim

31
Q

Symptoms of typhoid

A

NAME?

32
Q

SMA eventually branches into?

A

Ileocolic artery

33
Q

Intestinal brush border

A

Maltase, Sucrase, Limit dextrinase, Lactase

34
Q

Cell types of small bowel: Absorptive cells

A

Goblet (mucin), Paneth (secretory granules, enzymes), Enterochromaffin (APUD, 5-HT release), Brunner’s glands (alkaline solution), M cells (APCs), Peyer’s patches

35
Q

Migrating motor complex

A

Phase I - rest, Phase II - acceleration and gallbladder contraction, Phase III - peristalsis (motilin acts now), Phase IV - deceleration

Surgery (33 decks)

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