Other Diseases Flashcards
What is peritonitis?
Inflammation of the peritoneum
Causes of peritonitis?
- Underlying GI condition
- Perforated organ
- Peritoneal dialysis
- Ascites
- TB (rarely)
What is the difference between localised and generalised peitonitis?
Localised due to acute inflam of an organ - hits against body wall
Generalised - irritation of peritoneum due to infection (perforation) or chemical irritation (perforated ulcer)
Signs and symptoms of peritonitis
- Rigid abdo
- Rebound tenderness (when you lift hand quickly - causes more pain - rarely done in practice)
- Distended abdo (if related to ascietes)
- Fever
Invx of peritonitis?
Erect CXR
Abdo paracentesis
Management of peritonitis
Resuscitate (NG tube, IV fluids, antibiotics)
Surgery
What is Peutz-Jeghers Syndrome?
Autosomal dominant condition characterised by hamartomatous (bengin?) GI polyps and mucocutaneous hyperpigementation - look at pics - wont be nice and symmetrical - will be blotchy (in BAME patients may have racial mucocutaneous hyperpigementation naturally)
Why is Peutz-Jeghers syndrome bad?
93% will devlop cancer
What is EBV and how is EBV spread?
Epstein-Barr virus Saliva
EBV is normally asymptomatic - if it becomes symptomatic what does it become known as?
Infectious mononucleosis
Orally how may EBV present?
Leukoplakia
Pharyngitis
Tonsilitis
How is EBV treated?
Almost always self-limiting
Rest
Fluids
Analgesias
If EBV is misdiagnosed and a course of antibiotics given, what may appear?
Widespread rash which will disappear on withdrawal of antibiotics
How is EBV diagnosed?
Monospot - a test for antibodies
How may EBV present in GI system?
Hepatomegaly
Splenomegaly
What is necrotising enterocolitis?
GI wall invaded by bacteria in premature babies
bacteria invades wall -> wall necrosis -> bowel contents leak into peritoneum -> peritonitis
Symptoms of necrotising entercoloitis?
Poor feeding
Abdo distension
Bile stained vomit
Sepsis
What are anal fissures?
Small tear in anal??
Who is most likely to get anal fissures?
Very young and old
What are two types of anal fissure causes and give 3 examples of each
Traumatic
- Childbirth
- Anal intercourse
- Hard stool and straining
Non-traumatic
- IBD
- Anal cancers
- HIV
Symptoms of anal fissures? (2)
Bright red blood on paper after wiping
Visible small crack on skin
When does a fissure become chronic?
After 8 weeks
Management of anal fissure?
Acute -
Topical nitroglycerin or lidocaine - to relax
Surgery - for chronic/recurrent
Symptoms of appendictis?
Abdo pain - move from umblical to RIF
Signs of infection (fever, tachycardia, nasuea)
Signs of appendicits?
- Rovsing (pressing on LIF causes pain on the RIF)
- Psoas (patient keeps right hip flexed)
What is McBurneys point and what is it associated with?
1/3 of way between ASIS and … ADD
Appendicitis
What are 4A’s of appendicular treatment?
- Analgesia (NSAIDS)
- Antipyretcis (NSAIDS)
- Antibiotics (normal surgical prophylaxis)
- Appendectomy
What is bowel obstruction?
Blockage of bowel leading to
- accumulation of fluid/gas
- ischaemia
- perforation
What are the 3 types of bowel obstruction
Intraluminal
Luminal
Extraluminal
Symptoms of bowel obstruction?
Colicky central abdo pain Absolute constipation Vomiting (more proximal obstrcution - quicker vomiting) Borborygmus (stomach sounds) Abdo distension
Invx of bowel obstruction (3)
Tinkling bowel sounds - big one
AXR followed by contrast CT
ABGs/bloods
How to treat bowel obstruction?
Drip and suck
- IV fluids (drip)
- NG tube (suck)
Analgesia for pain
What is ischaemic colitis?
What causes it and where does it most commonly take place?
Commonest problem of bowel ischaemia (abdo angina)
ADD
Most commonly due to atherosclerosis
Splenic flexture
Who gets ischaemic colitis?
More common in elderly
ADD
fat folk - increased pressure by increased fat in abdo
Management of ischemic colitis?
Mild cases - self resolve Major cases (or suspected to pass to true ischemia of bowel) - embolectomy (bypass of afflicted artery) - colectomy assorted if area of bowel damaged
What is bowel ischemia/infarction? What causes it?
Death of colonic tissue due to lack of blood supply
Obstruction or severe narrowing of artery
Difference in presentation of acute small bowel ischaemia and ischaemic colitits?
Both present with acute abdo pain
Ischaemic colitis will have bloody stool unlike acute small bowel ischaemia
