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Question 1

types of intestinal ischemia

Answer 1

occlusive
non occlusive
mesentric ischemia

Question 2

mesentric vasular ischemia

Answer 2

arteioocculsive
atrial fibrillation due to emboli/ thrombus
recent mi
valvular heart ds
recent cardiac/ vascular catherisation

non occlusive / intestinal andgina

    aging 
   high dose vasopressor use 
    carcinogenic shock
     septic shock
     venous thrombosis 
   hypercoaguable state 
    protein c, s defiecy
   antithrombin deficiency 
   polycythemia vera
    carcinoma

Question 3

most common location of intestinal ischemia

Answer 3

Collateral vessels within the colon meet at the splenic flexure and descending/sigmoid colon. These areas, which are inherently at risk for decreased blood flow, are known as Griffiths’ point and Sudeck’s point, respectively

Question 4

features in acute mesentric ischemia

Answer 4

early 
    acute abdominal pain 
    vomiting 
     trainsient diarrhoea 
    anorexia
    bloody stools 
    abdominal distension 

later
perotinitis

Question 5

thumb printing on xray

Answer 5

bowel wall edema

Question 6

gold standard for mesentric ischemia

Answer 6

angiography

Question 7

triad of chronic intestinal ischemia

Answer 7

abdominal pain
food phobia
weight loss

Question 8

esophageal motility disorders

Answer 8

Esophageal motility disorders 
•Primary esophageal motility disorders
 Achalasia, “vigorous” achalasia 
Diffuse and segmental esophageal spasm 
Nutcracker esophagus 
Hypertensive lower esophageal sphincter
 Nonspecific esophageal motility disorders 

•Secondary esophageal motility disorders
Collagen vascular diseases: progressive systemic sclerosis, polymyositis and dermatomyositis, mixed connective tissue disease, systemic lupus erythematosus, etc.
Chronic idiopathic intestinal pseudoobstruction Neuromuscular diseases
Endocrine and metastatic disorders

Question 9

esophageal disorders

Answer 9

Manometric characteristics of the primary esophageal motility disorders
•Achalasia
Incomplete
lower esophageal sphincter (LES) relaxation (<75% relaxation) Aperistalsis in the esophageal body Elevated LES pressure ≤26 mmHg Increased intraesophageal baseline pressures relative to gastric baseline
•Diffuse esophageal spasm (DES) Simultaneous (nonperistaltic contractions) (>20% of wet swallows)Repetitive and multipeaked contractions Spontaneous contractionsIntermittent normal peristalsis Contractions may be of increased amplitude and duration
•Nutcracker esophagus Mean peristaltic amplitude (10 wet swallows) in distal esophagus ≥180 mmHg Increased mean duration of contractions (>7.0 s) Normal peristaltic sequence
•Hypertensive lower esophageal sphincter Elevated LES pressure (≥26 mmHg)Normal LES relaxation Normal peristalsis in the esophageal body
•Ineffective esophageal motility disorders Decreased or absent amplitude of esophageal peristalsis (<30 mmHg)Increased number of nontransmitted contractions