GI

Question 1

SCORES FOR GI BLEEDS

Answer 1

GLASCOW BLACHFORD - upper GI BLEED

OAKLAND SCORE - LOWER GI BLEED

Question 2

signs of bowel obstruction

Answer 2

1. Abdo pain
2. vomiting
3. obstipation
   4.constipation
4. abdominal distention
   6.fecal vomitting

Question 3

large vs small obstruction

Answer 3

larger: N+v is more of a late sign
constipation happens earlier

small:more n+v
valvulae coniventes seen
constipation occurs later (as poo is already in the distal colon can still be pooed out)

Question 4

if you suspect bowel obstruction what investigations

what supportive care can be done?

Answer 4

abdominal x ray

ct abdo

analesia
NG tube -decompress

Question 5

third spacing

Answer 5

fluid moves from intravascular space to interstial space(waste) so now you have less flid in the blood

Question 6

most common cause of large bowel obstruction

Answer 6

malignacy

Question 7

difference in vomitting patterns in bowl obstrcution

Answer 7

early - smalll bowel
late- larger

Question 8

what are we worried about in bowel obstruction

Answer 8

1. perforatin
2. toxic megacolon
3. third spacing !!- these pateints may need LOADS OF FLUIDS

Question 9

all patients with suspected bowel onstruction should have a

Answer 9

NG TUBE INSERTED

Question 10

hartmans

Answer 10

is a procedure that usually done on the sigmoid colon, usually and emergency when you have diverticulitis and there has been a perforation so you resect the dodgy bowel and make it a colostomy and the rectum stump you tie off!

Question 11

how can diverticuliar disease lead to bowel obstruction and which part is most affected

Answer 11

1. because repeated bouts of inflammation can cause strictures!
2. sigmoid colon

Question 12

divericultis symptoms

Answer 12

1. left iliac fossa pain
2. blood diarhea
   3.vomitting
3. fever
4. history of diverticular diseas

Question 13

CEA IS for

bets investigation for bowel obstruction

Answer 13

colon cancer marker

CT with contrast to see

Question 14

tinkling bowel sounds

Answer 14

found in bowel obsrcution, high pitched