Brainscape's Knowledge GenomeTM

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


See full index

Gastro Yr 2 > General surgery in GI tract > Flashcards

General surgery in GI tract Flashcards

1
Q

how to interpret abdominal pain

A

SOCRATES pain assessment
PMHx/ DHx/ SHx
Investigations - bloods/ urinalysis/ imaging/ endoscopy
Management - ABCDE/ conservative/ surgical

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

RUQ pain

A

biliary colic
cholecystitis
acute hepatitis

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

Epigastrium pain

A

acute gastritis
peptic ulcer disease
acute pancreatitis

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

LUQ pain

A

Peptic ulcer

acute pancreatitis

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

RLQ pain

A

acute appendicitis
colitis
IBD

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

Suprapubic/ central pain

A

early appendicitis

bowel obstruction

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

LLQ pain

A

diverticulitis
colitis
IBD

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

what is bowel ischaemia presentation

A

sudden crampy pain
bloody, loose stool
fever - signs of septic shocl

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

risk factors for bowel ischaemia

A 
age over 65
cardiac arrythmias
sickle cell disease
vasculitis
shock - hypotension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is acute mesenteric ischaemia

A

small bowel - usually occlusive due to thromboemboli

SUDDEN ONSET

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

what is ischaemic colitis

A

large bowel - usually due to non-occlusive low flow states

MILD/ GRADUAL ONSET

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

What are the investigations of bowel ischaemia

A

Bloods - lactic acidosis
Imaging - disrupted flow/ vascular stenosis/ detects
Endoscopy - ulceration of mucosa/ oedema

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

what is the conservative management of bowel ischaemia?

A 
IV fluid resuscitation
Bowel rest - nil by mouth
broad spectrum AB - sepsis
anticoagulation
serial abdo examination + repeat imaging
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the surgical management of bowel ischaemia?

A

exploratory laparotomy - resection of necrotic bowel

endovascular revasculisation - balloon angioplasty - in patients without signs of ischaemia

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

presentation of acute appendicitis?

A

periumbilical pain that migrates to RLQ
anorexia
nausea

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

Clinical signs of appendicitis

A

mcburney’s point - tenderness in RLQ
Blumberg sign - rebound tenderness in RIF
Rovsing sign - RLQ pain on palpitation of LLQ
Psoas sign - RLQ pain on flexion of right hip against resistance
Obturator sign - RLQ pain on passive internal rotation of hip

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

Investigations for acute appendicitis

A

Bloods - raised neutrophils/ CRP/ urinalysis + electrolyte imbalance
Imaging - CT/USS/MRI
Diagnostic laparoscopy - persistent pain + inconclusive imaging

18
Q

what is the criteria for appendicitis

A

alvarado score

more than/ equal to 7 = likely

19
Q

conservative management of appendicitis

A

IV fluids
analgesia
PO AB

20
Q

Surgical management of appendicitis

A

Laparoscopic appendicectomy

Open appendicectomy

21
Q

what is bowel obstruction

A

intestinal obstruction - restriction of the normal passage of intestinal contents

22
Q

what are the main groups of bowel obstruction

A

paralytic - stops working (irritation of the ileus)

Mechanical

23
Q

most common cause of small bowel obstruction

A

adhesions

neoplasia

24
Q

most common cause of large bowel obstruction

A

colorectal carcinoma

volvulus - intestine twists around itself and the mesentery that supports it, creating an obstruction

25
Q

presentation of bowel obstruction

A

abdo pain
vomiting
absolute constipation
abdominal distention

26
Q

how is bowel obstruction diagnosed

A

presence of symptoms
examination should always include a search for hernia + abdo scars
simple or strangulating

pain changes from colicky to continuous

27
Q

where are common areas for hernias

A 
epigastric
umbilical
incisional
inguinal
femoral
28
Q

how does a hernia occur

A

neck of sac turns to strangulated hernia - lack of venous return = dead bowel

29
Q

investigations for bowel obstruction

A

Bloods:
- metabolic acidosis (lactate)
- electrolyte imbalance - vomiting
WCC/ CRP is usually normal

Imaging:
- CXR/ AXR - dilated bowel loops
CT abdo/ pelvis - dilatation of proximal loops

30
Q

conservative management for bowel obstruction

A

nil by mouth
IV fluids - correction of electrolyte imbalance + analgesia
NG tube for decompression
catheter for monitoring output
introduce gradual food intake if abdo pain improves

31
Q

what is gastrograffin

A

osmolar iodinated contrast agent - can resolve adhesional small bowel obstruction

32
Q

what are the surgical interventions for bowel obstruction

A

exploratory laparoscopy/ laparotomy
restoration of intestinal transit
bowel resection with primary anastomosis
endoscopic stenting

33
Q

when do you implement surgical interventions for bowel obstruction

A

signs of sepsis
closed loop obstruction !!
persistent bowel obstruction for more than 2 days despite conservative management
complete bowel obstruction with ischaemia

34
Q

what is a GI perforation presentation

A

sudden onset with severe abdo pain
abdo rigid + guarding
nausea + vomiting
Pain aggravated by movement

35
Q

investigations for a GI perforation

A

bloods - lactic acidosis + elevation of urea + creatinine

Imaging - free air on CXR/ CT abdo

36
Q

conservative management for GI perforation

A 
NG tube
IV fluid resus
Broad spectrum Abx
IV PPI
catheter
analgesia
37
Q

surgical management for GI perforation

A

exploratory laparoscopy/ laparotomy
primary closure of perforation
resection of perforated segment
LAVAGE

38
Q

what is sigmoid volvulus

A

Large, elongated, relatively atonic colon, particularly in the sigmoid segment

large bowel obstruction

39
Q

conservative management for sigmoid volvulus

A

sigmoidoscope passed with patient lying in left lateral position + soft rubber rectal tube passed along sigmoidoscope + untwists volvulus + flatus + liquid faeces released

40
Q

what to do if conservative management doesn’t work for sigmoid volvulus

A

exploratory laparoscopy + sigmoid colectomy with end colostomy (hartmann’s procedure)

41
Q

what is portal pyaemia

A

septic thrombophlebitis of portal venous system

Gastro Yr 2 (7 decks)

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