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Surgical Foundations > GI > Flashcards

GI Flashcards

1
Q

What pressure is defined as increased intraabdominal pressure due to abdominal compartment syndrome?

A

> 25mmHg

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2
Q

What are the risk factors for abdominal compartment syndrome? (5)

A
  1. packing remaining in the abdomen after initial laparotomy
  2. bowel edema caused by massive crystalloid resuscitation
  3. reperfusion injury,
  4. ongoing intraabdominal bleeding
  5. primary fascial closure
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3
Q

What is Borchsrdts triad

A

Enesis followed byretching
Epigastric fistension
Failure to pass an NGT

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4
Q

Boerhaaves Syndrome

A

Esophageal perforation

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5
Q

Budd chiari syndrome

A

Thrombosis of hepatic veins

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6
Q

What is Mirizzi syndrome

A

Extrinsic obstruction of the common hepatic bile duct from a gallstone in the gallbladder or cystic duct

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7
Q

Referring syndrome

A

Hypo kalemia
Hypomagnasemia
Hypophosphatemia

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8
Q

Short gut syndrome

A

<200cm of viable small bowel

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9
Q

What are the causes of post-operative pancreatitis? (6)

A

Manipulation of the pancreas during surgery
Low blood flow (i.e. CPB)
Gallstones
Hypercalcemia
Medications
Idiopathic

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10
Q

What is the initial treatment of post-operative pancreatitis?

A

NPO
Aggressive fluid resuscitation
NGT PRN

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11
Q

What causes short bowel syndrome?

A

Malabsorption and diarrhea resulting from extensive bowel resection (<200cm)

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12
Q

What is the initial treatment for short bowel syndrome?

A

TPN early
Small meals chronically

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13
Q

What is blind loop syndrome?

A

Bacterial overgrowth in the small intestine

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14
Q

What are the surgical causes of B12 deficiency?

A

Blind loop syndrome
Gastrectomy (due to decreased secretion of intrinsic factor)
Excision of the terminal ileum

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15
Q

What is dumping syndrome?

A

Deliver of hyperosmotic chyme to the small intestine causing massive fluid shifts in the bowel

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16
Q

What causes abdominal compartment syndrome (2)?

A

Increased intra-abdominal pressure after laparatomy
Massive IVF resuscitation

17
Q

How do you measure the intra-abdominal pressure?

A

Read the intrabladder pressure (a foley catheter hooked up to the manometry after instillation of 50-100cc water)

18
Q

What is the intra abdominal pressure that requires treatment?

A

> /= 25mmHg if there are signs of compromise

19
Q

What is the treatment for abdominal compartment syndrome?

A

Decompressive laparatomy

20
Q

What are the signs and symptoms of pseudomembranous colitis?

A

Diarrhea
Fever
Hypotension/tachycardia

21
Q

What is the treatment for pseudomembranous colitis?

A

Flagyl
PO vancomycin refractory to flagyl

22
Q

What is an acute abdomen?

A

Acute abdominal pain so severe the patient seeks medical attention?

23
Q

34-year-old in the ICU s/p laparotomy with fascia closed,
decreased urine output, increased peak airway pressure,
decreased CVP, normal chest x-ray, normal EKG

A

Abdominal comparment syndrome

24
Q

What is the parrot’s beak or bird’s beak sign?

A

Sigmoid volvulus on barium enema

25
Q

What is the best way to visualize the biliary and gallbladder?

A

U/S

26
Q

What conditions can mask abdominal pain?

A

Steroids
Diabetes
Paraplegia

27
Q

How is the free air ruled out if the patient cannot stand?

A

Left lateral decubitus

28
Q

What is the differential diagnosis for the patient with AIDS and abdominal pain?

A

CMV
Kaposi’s sarcoma
Lymphoma
TB
Mycobacterium Avium Intracellulare

29
Q

What endocrine problems cause abdominal pain?

A

Addisonian Crisis
DKA

30
Q

What are the 4 complications of hernias

A

Pain
SBO
Bowel necrosis
Incarceration/strangulation

31
Q

What is the difference between incarcerated and strangulated hernia?

A

Incarcerated: Swollen or fixed within the hernia sac (incarcerated = imprisoned); may cause
intestinal obstruction (i.e., an irreducible hernia)

Strangualted:Incarcerated hernia with resulting ischemia; will result in signs and symptoms
of ischemia and intestinal obstruction or bowel necrosis (Think: strangulated
= choked)

32
Q

What are the boundaries of the hesselback’s triangle?

A

Inferior epigastric vessels
Inguinal ligament
Lateral border of the rectus sheath

Hernia here is called the inguinal hernia

33
Q

What is the difference between direct vs indirect inguinal hernia?

A

Direct inguinal hernia: within the floor of the hesselbach’s triangle (does not traverse the internal ring).

Indirect inguinal hernia: hernia through the internal ring of the inguinal canal then travelling donwards to the external ring

34
Q

IS the risk of strangulation higher

A

Surgical Foundations (18 decks)

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