overview of GIT pathology

Question 1

haematemensis

Answer 1

vomiting blood

Question 2

melaena

Answer 2

black, malodorous

altered blood in the stool, indicates bleeding proximally lower

Question 3

haematochezia

Answer 3

bright red blood

indicates bleeding distally or massive blood

Question 4

occult blood

Answer 4

not visible blood
detectable biochemically
may have occult anaemia

Question 5

abdominal distension

Answer 5

intra,uminal or free peritoneal gas

Question 6

peritonitis

Answer 6

redness/swelling of abdomen

Question 7

caplet meduse

Answer 7

spiderweb looking marks

vessels radiating

Question 8

occlusion of arteries cause

Answer 8

ischaemia and infarction

Question 9

occlusion of arteries may be due to

Answer 9

thrombosis, embolism, vasculitis

Question 10

5 causes of obstruction of the bowel

Answer 10

obsruction 
herniation 
adhesions 
intussusception 
vovolus

Question 11

intussusception

Answer 11

part of the tube goes into the other part

telescoping

Question 12

herniation

Answer 12

can cause part of ischaemia

Question 13

adhesion

Answer 13

two loops of bowel sticking together due to inflammation or some other damage process

Question 14

volvulus

Answer 14

twisting

Question 15

consequences of inflammation

Answer 15

ulceration
haemorrhage
perforation

Question 16

chronicity of inflammation

Answer 16

architectural changes in epithelium
fibrosis/scarring of lamina proprietary and muscle
hyperplasia of muscle wall

Question 17

acute appendicitis

Answer 17

inflammation of the vermiform appendix

Question 18

epidemiology of acute appendicitis

Answer 18

slightly more common in males

Question 19

aetiology of acute appendicitis

Answer 19

obstruction of the lumen by:
idiopathic 
faecalith 
normal stool 
lymphoid hyperplasia 
neoplasm

Question 20

pathophysiology of acute appendicitis

Answer 20

obstruction leads to stasis, increase in intraluminal pressure
bacterial multiplication with pus formation
distension of lumen
involvement of the wall by acute inflammation may resolve, but often local ischaemia occurs and appendix becomes necrotic, leading to perforation, leaking of the bowel contents with peritonitis, abscess formation and severe systemic illness

Question 21

presentation of acute appendicitis

Answer 21

onset over hours 
constant mid abdominal pain 
shifts to right lower quadrant 
worse on movement 
loss of appetite (anorexia)
nausea and vomiting 
commonly teens to middle aged

Question 22

clinical signs acute appendicitis

Answer 22

low grade fever

diminished bowel sounds, tachycardia, leukocytosis

Question 23

Rovsing sign

Answer 23

press on left side of the abdomen and pain occurs on the right lower quadrant

Question 24

mallory-weiss tear, boerhaave syndrome

Answer 24

tear or perforation of oesophagus due to vomiting

Question 25

iatrogenic

Answer 25

as a result of treatment

Question 26

psuedomembranous colitis

Answer 26

overgrowth of C. difficile due to treatment with antibiotics