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Finals - General Surgery > Lower GI pathology > Flashcards

Lower GI pathology Flashcards

1
Q

When should a 2WW for colorectal cancer be considered?

A

> 40 with unexplained weight loss and abdominal pain

> 50 with unexplained rectal bleeding

> 60 with iron deficiency anaemia or change in bowel habit

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2
Q

What investigations should be carried out to diagnose a patient with colorectal cancer?

A

FOB testing if 2WW is not indicated

Bloods

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3
Q

What is ileus?

A

Condition affecting small bowel where peristalsis ceases to occur temporarily.

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4
Q

What is pseudo-obstruction?

A

A functional obstruction of the large bowel where patients present with intestinal obstruction but no mechanical cause is found.

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5
Q

What is the difference between ileus and pseudo obstruction?

A

Ileus is in the small bowel pseudo-obstruction is in the large bowel.

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6
Q

What can cause an ileus?

A

Open abdominal surgery - handling of the bowel ceases it’s function

Inflammation/infection in or near the bowel - e..g peritonitis, appendicitis, pancreatitis or pneumonia

Electrolyte imbalances - hyponatraemia or hypokalaemia

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7
Q

Clinical presentation of ileus?

A

Bilious vomiting

Abdominal distention

Diffuse abdominal pain

Constipation

Lack of flatulence

ABSENCE of bowel sounds

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8
Q

What is the management of ileus?

A

Treat underlying cause

Supportive care - NBM, inserting an NG tube, providing IV fluids to prevent dehydration and correct electrolyte imbalances, mobilise the patient, consider TPN.

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9
Q

What are haemorrhoids?

A

Enlargement of the anal vascular cushions

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10
Q

Where positions on a clock face are haemorrhoids usually located?

A

3, 7 and 11 o clock

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11
Q

Describe 2nd and 3rd degree haemorrhoids.

A

2nd degree: haemorrhoid protrudes on straining and spontaneously retracts on relaxing

3rd degree: haemorrhage protrudes on straining and requires reducing manually.

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12
Q

What procedure involves fitting a tight band around the base of a haemorrhoid to cut off the blood supply?

A

Rubber band ligation

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13
Q

What common medication increases the risk of diverticulosis and diverticular haemorrhage?

A

NSAID’s

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14
Q

What blood results may be deranged in acute diverticulitis?

A

Raised inflammatory markers

Raised white blood cell count

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15
Q

What oral antibiotic do the NICE clinical knowledge summaries suggest for uncomplicated acute diverticulitis?

A

Co-Amoxiclav

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16
Q

What dietary changes do the NICE clinical knowledge summaries suggest in the management of uncomplicated acute diverticulitis?

A

Only taking liquids (no oral solids) until symptoms improve

17
Q

What section of the GI tract is included in the midgut?

A

Distal part of the duodenum to the first half of the transverse colon

18
Q

What arteries supply the foregut, midgut and hindgut?

A

Foregut: coeliac artery, midgut: superior mesenteric artery and hindgut: inferior mesenteric artery

19
Q

What is the “classic triad” of chronic mesenteric ischaemia?

A

Central colicky abdominal pain after eating, weight loss and abdominal bruit on auscultation

20
Q

What is complicated diverticulitis?

A

Diverticular disease with inflammation AND a complication such as obstruction, bleeding, perforation, abscess, fistula

21
Q

What cardiac condition is a key risk factor for acute mesenteric ischaemia?

A

Atrial fibrillation

22
Q

What can be seen on a venous blood gas in acute mesenteric ischaemia?

A

Metabolic acidosis and a raised lactate

23
Q

What three types of cancer are more prevalent than bowel cancer in the UK?

A

Breast, prostate and lung cancer

24
Q

What is the inheritance pattern of familial adenomatous polyposis (FAP)?

A

autosomal dominant

25
Q

What tumour suppressor gene is malfunctioning in FAP?

A

Adenomatous polyposis coli (APC)

26
Q

What procedure involves removing the entire length of the large intestine?

A

Panproctocolectomy

27
Q

What is the descriptive name for Lynch syndrome and how it is inherited?

A

Hereditary non polyposis colorectal cancer (HNPCC) and it is inherited in an autosomal dominant fashion.

28
Q

What test is used in the bowel cancer screening program in England?

A

Faecal immunochemical tests

29
Q

What is the gold standard investigation for suspected bowel cancer?

A

Colonoscopy

30
Q

What tumour marker relates to bowel cancer?

A

Carcinoembryonic antigen (CEA)

31
Q

What part of the colon is removed in a Hartmann’s procedure?

A

Rectosigmoid colon

32
Q

What is formed from a section of small bowel in patients with a urostomy?

A

Iléal conduit

Finals - General Surgery (13 decks)

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