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AB 4th Year General Surg + GI > General Surgery - Intestines > Flashcards

General Surgery - Intestines Flashcards

1
Q

what is a paralytic ileus?

A

adynamic bowel due to no peristaltic contractions

no mechanical obstruction

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2
Q

risk factors for paralytic ileus?

A

abdo surgery

electrolyte imblances

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3
Q

Tx for paralytic ileus?

A

NG tube decompression

Fluids

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4
Q

what happens in pseudo obstruction? how to manage?

A

mechanical GI obstruction with no cause found

AXR and decompress

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5
Q

features of bowel obstruction?

A

pain
vomiting
abdo distension
tinkling bowel sounds

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6
Q

what is a volvulus?

A

mobile loop of bowel that has rotated on its mesentery

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7
Q

common sites of volvulus?

A

sigmoid colon

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8
Q

Ix for volvulus? what is the sign?

A

AXR

coffee bean appearance

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9
Q

Tx for volvulus?

A

sigmoidoscopy + flatus tube

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10
Q

risk factors for mesenteric ischaemia?

A

AF

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11
Q

what 3 types of mesenteric ischaemia exist?

A

acute mesenteric
chronic
chronic colonic

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12
Q

what causes chronic ischaemia?

A

low flow state and atheroma

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13
Q

Ix for mesenteric ischaemia?

A 
FBC
ABG (metabolic acidosis)
AXR (gassless abdo)
CT/MRI angio
colonoscopy + biopsy (for chronic colonic)
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14
Q

what causes chronic colonic mesenteric ischaemia?

A

low flow in IMA
ischaemic colitis results
e.g bloody diarrhoea

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15
Q

Tx for mesenteric ischaemia?

A

fluids
Abx
heparin
surgery (revascularise/resect)

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16
Q

features of appendicitis?

A 
fever
diarrhoea
umbilical abdo pain localising to RIF
mcburney's point 
rosving's sign
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17
Q

most common position of the appendix?

A

retrocaecal

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18
Q

what anatomical landmark helps distinguish the appendix during surgery?

A

taenia coli (smooth muscle) converge at the base

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19
Q

what is the appendixes blood supply and why is it high risk?

A

appendicular artery

sole mesentery so high risk of gangrene if interrupted

20
Q

Ix for appendicitis?

A 
FBC
U+Es
CRP
IV fluids
CT/US
21
Q

Tx for appendicitis?

A

appendicectomy

Abx if perforated - gent + met

22
Q

what are colonic polyps?

A

adenomas arising from the colonic mucosa

can become neoplastic

23
Q

features of polyps?

A 
bleeding 
mucus
tenesmus 
anaemia
asymptomatic
24
Q

what genetic conditons are at risk of polyps?

A

FAP

peutz jegher syndrome

25
Q

Ix and Tx for polyps?

A

colonoscopy

biopsy/removal

26
Q

what is the screening regime after polyp removal?

A 
low = 5
medium = 3
high = 1
27
Q

what type is most common for colorectal cancer?

A

adenocarcinoma

28
Q

risk factors for colon cancer?

A 
polyps
meat
low fibre diet
smoking 
alcohol 
Hx of cancer
FHx
29
Q

left side symptoms for colorectal cancer?

A 
bleeding
mucus
altered habit
tenesmus
mass
30
Q

right side symptoms for colorectal cancer?

A

weight loss
anaemia
abdo pain

31
Q

what type of anaemia results from blood loss?

A

iron deficiency

microcytic (low MCV)

32
Q

Ix for colorectal cancer?

A

FBC
FIT
colonoscopy
CT

33
Q

what is CAE used for?

A

confirms presence of disease in colorectal cancer

NOT a screening test

34
Q

what are the Dukes stages?

A

A - muscularis mucosae
B - extension throughout
C - LNs
D - metastases

35
Q

Tx for colorectal cancer?

A 
hemicolectomy 
anterior resection (rectum + diseased bowel)
36
Q

at what Dukes stage can chemo be added?

A

C - LNs involved

37
Q

who gets bowel screening?

A

50-74yrs

every 2 years

38
Q

what is diverticular disease?

A

herniations of mucosa and submucosa through the colonic wall (outpouchings)

39
Q

what is meckel’s diverticulum? where is it found?

A

outpouching due to incomplete regression of the viteline duct

above ileocaecal valve

40
Q

Ix for diverticular disease?

A

colonoscopy

CT

41
Q

features of diverticular disease?

A

abdo pain worse after eating
bleeding
bloating

42
Q

Tx for diverticular disease?

A

high fibre diet

hartmann’s

43
Q

what happens in hartmann’s procedure?

A

rectosigmoid colon resected
anorectal stump closed
end colostomy out tummy

44
Q

what is a complication of diverticular disease? Tx?

A

diverticulitis
fluids, Abx
may need CT guided abscess drainage

45
Q

features of peritonitis?

A

shock
guarding
rebound tenderness
no bowel sounds

AB 4th Year General Surg + GI (13 decks)

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