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EMS 2 > GI Surg Condition > Flashcards

GI Surg Condition Flashcards

1
Q

Diverticular disease- Eti

A

DiverticuliItis- acute illness due to points of weakness in near blood supply
Free perforation- infection into peritoneal cavity, may abscess
95% in sigmoid colon sue to increased pressure

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2
Q

Diverticular disease- Sx

A
  • LLQ pain
  • Constipation
  • Bloating
  • Subjective fever
  • Tachy, abd tenderness, leukocytosis
  • Maroon or bright red hematochezia in > 50
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3
Q

Diverticular disease- Dx

A

CT scan

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4
Q

Diverticular disease- Tx

A
  • Mild- abx
  • Elective colonoscopy after 4-6 weeks
  • Operation- Free perforation (sigmoid resection) or abscess (percutaneous drainage)
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5
Q

Appendicitis- Eti

A
  • Blockage in lining of appendix leading to infection
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6
Q

Appendicitis- Sx

A
  • RLQ tenderness with guarding
  • Malaise followed by periumbilical pain, localizes to RLQ followed by fever
  • McBurney point
  • Anorexia, nausea, vomiting
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7
Q

Appendicitis- Dx

A
  • US or CT scan
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8
Q

Appendicitis- Tx

A
  • Operation to remove

- Abx- Cephalosporin

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9
Q

Cholecystitis/ cholelithiasis- Eti

A
  • cholithiasis- having a gall stone

- Cholecystitis- stuck, bile can’t get out

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10
Q

Cholecystitis/ cholelithiasis- Sx

A
  • Epigastric pain to RUQ radiating to back and shoulder
  • Exacerbated by fatty foods
  • Abrupt onset of pain, cessation over mins to hrs
  • Bloating and flatulence
  • Murphy sign
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11
Q

Cholecystitis/ cholelithiasis- Dx

A

Ultrasound

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12
Q

Cholecystitis/ cholelithiasis-Tx

A
  • Laparoscopic cholecystectomy if symptomatic
  • Abx
    Choledocholitiasis- ERCP
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13
Q

Hernia- Eti

A
  • Abnormal protrusion of an organ through abd cavity
  • Can be reducible, incarcerated or strangulated (loss of blood supply)
  • Higher risk in men
  • Right side more common
  • Femoral more common in women
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14
Q

Hernia- Sx

A
  • Bulge, pain of ache

- Protrusion in canal on exam

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15
Q

Hernia-Tx

A
  • Reduce the sac and repair the defect

- Can watch and wait but doesn’t get better on own

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16
Q

Hernia- Dx

A
  • Diagnostic tests unnecessary

- Clinical exam

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17
Q

Ruptured spleen- Eti

A
  • Direct blow or trauma to abd

- Mono, AIDS, malaria, leukemia, sickle cell

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18
Q

Ruptured spleen- Sx

A
  • Pain and tenderness radiating to left neck or shoulder (Kehr’s sign)
  • LUQ at 9th-10th rib
  • Shock, falling hematocrit
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19
Q

Ruptured spleen- Dx

A
  • Ultrasound- multi view

- CT in stable pts

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20
Q

Ruptured spleen- Tx

A

Emergent splenectomy

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21
Q

Perforated bowel- Eti

A

Appedicitis, diverticulits

  • Blunt trauma
  • ASA or NSAID OD
22
Q

Perforated bowel- Sx

A
  • Sudden explosive onset of severe mid to lower abd pain
  • Shock
  • Rigid, tender abd
23
Q

Perforated bowel- Dx

A
  • Abd XR
24
Q

Perforated bowel- Tx

A
  • Crystalloid fluids
  • Abx
  • Remove infected material
  • Repair
25
Q

Peritonitis- Eti

A

Perforation of abd wall

- D/t trauma, diverticulits, pancreatitis

26
Q

Peritonitis- Sx

A
  • Abrupt pain, distension, fever
  • Diminished bowel sounds
  • Rebound tenderness
27
Q

Peritonitis- Dx

A

Examine fluid- bacteria, lactic acid

28
Q

Peritonitis- Tx

A
  • Exploration, debridement and drainage

- Abx x 14 days

29
Q

Bowel obstruction- Sx

A
  • Constipation or obstipation
  • Distention and tenderness
  • Abd pain
  • N/V
30
Q

Bowel obstruction- Dx

A
  • CT with contrast
31
Q

Bowel obstruction- Tx

A
  • Resection and decompression
32
Q

Colon CA- Eti

A
  • Screen at age 50 q 10 yrs
  • Yearly fecal occult
  • Adenocarcinoma most common
33
Q

Colon CA- Sx

A
  • Blood in feces
  • Weakness and anemia
  • Change in bowel habits
  • Dyspepsia
34
Q

Colon CA- Dx

A
  • Colonoscopy and biopsy of polyps
35
Q

Colon CA- Tx

A
  • Resection of lesion and lymph
  • CEA levels pre and post op
  • Colonoscopy at 6 mo, 12 mo, 3 yrs, 5 yrs
36
Q

Volvulus- Eti

A
  • Rotation of bowel loops around fixed point
  • Ischemia, gangrene
  • Sigmoid most common
37
Q

Volvulus- Sx

A
  • Colicky abd pain
  • Spasms
  • Distension, tympany
  • High pitched bowel sounds
38
Q

Volvulus- Dx

A
  • XR: loss of haustra, kidney bean appearance

- Bird beak sign, loop distension

39
Q

Volvulus- Tx

A
  • Decompression with sigmoidoscopy

- Fluid resuscitation

40
Q

Umbilical hernia- Eti

A
  • W>M
41
Q

Umbilical hernia- Sx

A
  • Increased size

- Sharp pain with coughing or sneezing

42
Q

Umbilical hernia- Dx

A

Clinical

43
Q

Umbilical hernia- Tx

A
  • Repair to avoid incarceration

- Mesh

44
Q

Inguinal hernia- Eti

A
  • M>W

- Indirect > direct

45
Q

Inguinal hernia- Sx

A
  • Bulge and pain in inguinal canal

- Aching

46
Q

Femoral hernia- Eti

A
  • Prone to incarceration/ strangulation
  • W>M
  • Descend through femoral canal beneath inguinal ligament
  • Difficult to reduce
47
Q

Femoral hernia- Sx

A
  • Asymptomatic until incarcerated
  • Small bulge in medial thigh
  • Colicky abd pain
48
Q

Femoral hernia- Tx

A
  • Open laparoscopy
49
Q

Incisional hernia- Eti

A
  • Complication of laparotomy

- COPD, steroids, wt, smoking

50
Q

Incisional hernia- Sx

A
  • Bulging, pain, ache at incision site

- Protrusion and obstruction at surgical site

51
Q

Incisional hernia- Tx

A
  • Recurrence is common

- Mesh repair

EMS 2 (14 decks)

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