Part 1 GI...I'm doing it in parts...I don't want a deck over 100

Question 1

What is ileus?

Answer 1

Loss of normal propulsive function of the bowel in absence of mechanical obstruction
Associated with a variety of conditions

Question 2

What causes a hernia? What can a hernia cause?

Answer 2

Defect in peritoneal wall –> protrusion of serosal lined pouch of peritoneum

External herniation can cause blood flow obstruction

Question 3

What are bowel adhesions?

Answer 3

Fibrous bands of scar tissue b/w bowel segments, the abdominal wall, or operative site –> obstruction and/or internal herniation

Have an underling cause (surgery, infection, injury)
Rarely congenital

Question 4

What is a volvulus?

Answer 4

Complete twisting of a loop of a bowel about its mesenteric base

Question 5

Where would you most likely see a volvulus?

Answer 5

Colon

Question 6

What causes a volvulus?

Answer 6

Developmental anomalies–malrotation

Occurs in children OR adults

Question 7

What is a intussusception?

Answer 7

A constricted segment telescopes into distal segment

Question 8

What causes intussusception in infants/kids?

Answer 8

Underlying anatomic defect

Question 9

What causes intussusception in older kids/adults?

Answer 9

Intraluminal tumor/mass

Question 10

Where does stenosis commonly occur in the GI tract?

Answer 10

Esophagus
Small Bowel
Anus…imperforate anus

Question 11

What is an omphacele?

Answer 11

Incomplete closure of the abdominal musculature…abdominal viscera herniate into a ventral membranous sac

Question 12

What is gastroschisis?

Answer 12

Basically an omphacele but defect involves all layers of the abdominal wall

Question 13

What is Meckel’s diverticulum?

Answer 13

True diverticulum (composed of all 3 layers)

Due to failed involution of the vitelline duct

Question 14

What are the “rules of 2” for Meckel’s diverticulum?

Not from Nelson…but seemed like a place to put it

Answer 14

2% of population
2' from ileocecal valve
2 types of heterotopic tissue (gastric or pancreatic)
2" in length
2yo

Question 15

Which type of heterotopic tissue causes more problems?

Answer 15

Gastric

Question 16

What are some complications of Meckel’s diverticulum?

Answer 16

Ulceration
Perforation
Hemorrhage
Fistula formation to the bladder
Intussusception

Question 17

Where do the ulcers general form due to Meckel’s diverticulum?

Answer 17

Adjacent ileum

Question 18

What is the typical presentation of Hirschsprung’s disease?

Answer 18

Male
Failure to pass meconium in neonatal period
Obstructive constipation, abdominal distention, and vomiting in older kids

Question 19

What are the pathological anomalies of Hirschsprung’s disease?

Answer 19

Arrested migration of neural crest cells from cecum to rectum; OR
Ganglion cells undergo premature death
Loss of function of tyrosine kinase RET