Lower GI Tract

Question 1

What is acute appendicitis?

Answer 1

Sudden onset inflammation of the appendix possibly caused by an obstruction of the appendix

Question 2

What are the signs/symptoms of acute appendicitis?

Answer 2

Pain (right, lower abdomen), n+v, reduced appetite.

Tenderness and guarding, fever, high WCC

Question 3

How do you treat an acute appendicitis?

Answer 3

Open/laparoscopic surgery, antibiotics

Question 4

What is C.diff infection?

Answer 4

When antibiotics change the balance of C.diff bacteria found in the gut causing it to multiply. The resulting toxins make people ill - diarrhoea, pain, fever

Question 5

What are complications associated with C.diff infection?

Answer 5

“psedomembraneous colitis” (inflammation of the gut) - diarrhoea, toxic megaoclon, bowel perforation, sepsis and death

Question 6

Treatment of C.diff infection

Answer 6

Clindamycin, Ciprofloxacin, Vancomycin, Metronidazole

Question 7

What is inflammatory bowel disease?

Answer 7

Chronic inflammatory conditions including Crohn’s and Ulcerative Colitis (Idiopathic)

Question 8

Management of IBD?

Answer 8

Steroids, aminosalicytes, immunosuppressants, biological agents.
Surgery: colorectal/resection (+/- stoma formation/ileostomy)
Strictureplasty

Question 9

What are the risk factors of Bowel Cancer?

Answer 9

age, family history, inherited conditions, Ashkenazi Jewish, benign polyps > cancer, IBD

Question 10

What is the National Bowel Cancer Screening Programme?

Answer 10

60-75 years

“Faecal Occult Blood Test”. Look for polyps and cancer

Question 11

Signs and Symptoms of Bowel Cancer

Answer 11

Blood from back passage/in stools, change in normal bowel habit, iron deficiency anaemia, weight loss, abdo pain, lump in back passage, bowel obstruction

Question 12

Treatment for Bowel Cancer

Answer 12

Surgery - open or laparoscopic, colectomy

Chemo, radiotherapy