Session 10: Group Work Flashcards
Describe two risk factors for developing an aortic aneurysm.
Smoking
Male
Age
Hypertension
Obesity
Hyperlipidaemia
Genetics like Marfan’s
Explain how the anatomical position of the ruptured aorta results in this patient initially having a normal blood pressure.
Aorta would drain into the retroperitoneal space which is very confined and tamponades the bleed for a little bit to control the BP for a little while.
This is not sustainable however.
Describe two other common causes of massive life threatening blood loss that bleed into:
Peritoneal cavity:
Gut lumen:
PC - Ectopic pregnancy, peptic ulcers
The gut lumen - peptic ulcers
The blood supply to the foregut is a direct branch off the aorta.
Name this artery and is three main branches.
Coeliac trunk
Left gastric artery
Splenic artery
Common hepatic artery
Briefly describe what a mesentery is.
A double fold of peritoneum where you will find blood vessels as well as nerves running through to supply viscera of the gut.
It also connects the GI viscera to the posterior abdominal wall.
Briefly explain why C. diff infection is precipitated by antibiotics.
Antibiotics will disturb the normal flora and imblanace will ensue. This causes C. diff which is normally a part of the normal flora to proliferate and overgrow.
C. diff won’t have as much competition for resources like glucose, dietary fibres and other nutrients making it grow excessively.
In simple terms explain how C. diff causes diarrhoea.
Release enterotoxins that causes secretion of ions into the gut lumen. This leads water to follow.
There is an excessive amount of water found in the lumen and diarrhoea ensues.
Why is C. diff so prevalent within the hospital environment?
C. diff produces spores that can live in aerobic environments for months which means it can be outside of a body well after a patient has left the hospital.
Also alcohol does not kill the C. diff so appropriate hand washing with soap is needed to get rid of it.
In uncomplicated cases of C. diff what is an appropriate treatment regime?
Metronidazole or oral vancomycin.
Fluid replacement
Why might the use of probiotics be useful adjunct in the treatment of C. diff infection?
Because it used to repopulate the normal flora of the gut lumen in order for other bacteria to competete for the resources that C. diff is proliferating in.
This causes C. diff to be constrained and stop growing.
State the features on the X-ray that help you determine which part of the intestines is small intestines.
Central small bowel with complete rings that are valvulae conniventes
The patient’s condition deteriorates and she starts to develop abdominal guarding and a temperature of 37.9 degrees.
What might have occurred and would this change your subsequent management of this patient?
Inflammation has caused perforation and subsequent peritonitis.
Analgesics and antibiotics and then prepare for surgery.
Discuss the causes of small bowel obstruction using the headings below.
2 for each group:
Extrinsic:
Bowel wall lesions:
Intra-luminal:
ASH-VITA
Extrinsic - Volvulus, adhesion
Bowel wall lesions: Tumours and inflammation
Intra-luminal: Foreign bodies and intussussception
Discuss two common causes of large bowel obstruction indicating their relative prevalence.
Colon cancer causing stenosis
Diverticular disease
Discuss what features on plain radiography can help to differentiate between small and large bowel obstruction?
Large bowel is found laterally and have incomplete rings called haustra.
