Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI II > Lecture 9: GI Bleeds and GI/Abdominal Emergencies > Flashcards

Lecture 9: GI Bleeds and GI/Abdominal Emergencies Flashcards

1
Q

Herniations or saclike protrusions of the mucosa through the muscularis at points of nutrient artery penetration defines what?

A

Diverticulosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Periumbilical pain out of proportion to tenderness (i.e., pt is writhing in pain, but PE isn’t impressive) is characteristic of what GI problem?

A

Acute Mesenteric Ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What will abdominal XR show in patient with Acute Mesenteric Ischemia?

Characteristic sign?

A
  • Bowel distention and Air-fluid levels
  • Thumb-printing (submucosal edema)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the diagnostic study of choice for Acute Mesenteric Ischemia?

Early celiac and mesenteric ________ is recommended?

A
  • CT angiography = study of choice
  • Early celiac and mesenteric arteriography is recommended
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which procedure is indicated in Acute Mesenteric Ischemia to restore intestinal blood flow obstructed by embolus or thrombosis or to resect necrotic bowel?

A

Laparotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Ischemic colitis is characterized by what symptoms and signs?

A

Severe lower abdominal pain followed by rectal bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Abdominal XR of ischemic colitis will show what?

A
  • Colonic dilation
  • Thumb-printing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Differentiate acute mesenteric ischemia from ischemic colitis?

A
  • AMI = periumbilical pain out of proportion to tenderness
  • IC = severe LOWER abdominal pain followed by rectal bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Although iron-deficiency anemia is associated with occult GI blood loss, why is it also a common finding in pre-menopausal women?

A
  • Menstruation
  • Pregnancy-associated iron loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Most common cause of Acute Liver Failure?

A

Acetaminophen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Toxic Megacolon carries a high risk for what complication?

Treated how?

A
  • Perforation
  • Treatment w/ surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Perforated Viscus refers to what?

Significant why?

A
  • Any hollow organ (esophagus, stomach, intestine, uterus, bladder) perforation
  • EMERGENCY SURGERY!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Perforated viscus is visualized with what imaging modality?

What is seen?

A
  • CT or plain XR
  • Free air under diaphragm or air in mediastinum (Pneumoperitoneum = below diaphragm and Pneumomediastinum = above diaphragm)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Low grade fever is typical of appendicitis, but what is a high-grade fever or rigors (chills) suggestive of?

A
  • Appendiceal perforation
  • Septic thrombophlebitis (pylephlebitis) = rare
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Psoas sign vs. Obturator sign for Appendicitis?

A

Psoas sign - pain on passive extension of the right hip

Obturator sign - pain w/ passive flexion and IR of the right hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Moderate ________ with _______ is a common lab finding in appendicitis

A

Moderate leukocytosis with neutrophilia is a common lab finding in appendicitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are 2 useful imaging modalities for the diganosis of appendicits?

A
  1. Ultrasound
  2. CT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the most common symptoms/signs of Intestinal Obstruction?

A
  • Colicky abdominal pain
  • N/V –> Feculent vomiting (common)
  • Abdominal distention
  • Absence of flatus or stooling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How is the diagnosis of intestinal obstruction made?

A

Plain radiographs or CT scan

20
Q

What is the treatment for Intestinal Obstruction?

If due to adhesions?

A
  • NG tube decompression and fluid resuscitation
  • Urgent laparotomy for lysis of adhesions (LOA) must be performed before bowel ischemia develops
21
Q

In terms of hernias, what does irreducible mean?

A

Hernia contents cannot be manipulated back into abdominal cavity

22
Q

Patient has abnormal vital signs with a tender, firm, irreducible mass (hernia) this indicates what is occuring to the bowel and what treatment needs to be done?

A
  • Bowel is infarcted/dying
  • Needs emergent surgery!
23
Q

Condition in which there is neurogenic failure or loss of peristalsis in the intestine in the absence of any mechanical obstruction describes?

A

Acute paralytic ileus

24
Q

Direct vs. Indirect Inguinal Hernia?

A
  • Direct = occurs near the opening of the inguinal canal
  • Indirect = occurs AT the opening of the inguinal canal
25
Q

What are 5 precipitating factors for Acute Paralytic Ileus?

A
  1. Surgery
  2. Peritonitis
  3. Electrolyte abnormalities
  4. Meds
  5. Severe medical illness
26
Q

Acute Colonic Pseudo-obstruction (Ogilvie Syndrome) is characterized by what?

Arises when?

A
  • Severe abdominal distention —> MASSIVE dilation of CECUM or RIGHT colon (megacolon)w/no mechanical obstruction
  • Arises in post-op state or w/ severe medical illness
27
Q

The risk of rupture of abdominal aortic aneurysms is related to what?

A
  • Size
  • >5cm = 20-40% chance of rupture
28
Q

AAA’s are often asymptomatic and instead discovered how?

A
  • Routine exam as a palpable, pulsatile, expansive, and nontender mass
  • As incidental finding via abdominal imaging study for something else
29
Q

What is typically a signal of AAA about to rupture?

Is there usually a warning before AAA’s rupture?

A
  • Aneurysmal pain
  • More often, acute rupture occurs without prior warning and this complication is always life threatening
30
Q

Which signs/symptoms occur with rupture of AAA and this requires?

A
  • Acute pain and hypotension
  • Emergency operation
31
Q

Who needs to be screened for AAA’s and what imaging modality is used?

A
  • Men age 65-75 yo who have ever smoked
  • Abdominal ultrasound
32
Q

Most common cause of AAA?

A

Atherosclerosis

33
Q

Which finding on transvaginal US with serum beta-hCG >2000 milli-units/mL is indicative of ectopic pregnancy?

A

No intrauterine pregnancy

34
Q

What are 4 conditions that predispose to an ectopic pregnancy?

A
  1. Hx of infertility
  2. Pelvic inflammatory diseae
  3. Ruptured appendix
  4. Prior tubal surgery
35
Q

In the US, what is one of the most common causes of maternal death during the first trimester?

A

Undetected ectopic pregnancy

36
Q

Which symptom occurs in almost every case of ectopic pregnancy?

A

Severe lower quadrant pain (right- or left- sided) generally 6-8 wks after last period

37
Q

Ovarian torsion is most often due to?

A

Rupture, bleeding, or torsion of ovarian cysts

38
Q

How serious is an Ovarian Torsion?

A

Surgical emergency requiring prompt diagnosis to preserve ovarian function

39
Q

The majority of ovarian torsions occur on what side?

A

Right side

40
Q

What is the classic presentation for a patient presenting with an Ovarian Torsion?

A
  • Sudden-onset, SEVERE, unilateral, lower abdominal pain
  • May develop after episodes of exertion
  • N/V common
41
Q

What is the primary imaging/diagnostic modality use for suspected Ovarian Torsions?

Most commonly shows what?

A
  • Transvaginal US w/ doppler
  • Ovary >4cm in size due to cyst, tumor, or edema
42
Q

Which finding needs to be considered in males with acute scrotal pain due to it being a urologic emergency?

A

Testicular torsion

43
Q

Testicular torsion has a bimodal age presentation with peaks occuring during what 2 stages of life?

A
  1. Immediate neonatal period
  2. Early puberty
44
Q

What is the most common age for boys presenting with testicular torsions?

A

Between 12-18 yo

45
Q

What is the standard of care for prenatal torsions in neonates?

Salvageable?

A
  • Not salvageable
  • May be taken to OR on a semi-elective basis when infant is a few months of age to decrease the anesthesia risk
46
Q

Which imaging modality is the diagnostic study of choice for Testicular Torsion?

A

Doppler US

GI II (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions