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GI System > Session 9- Gastrointestinal Emergencies > Flashcards

Session 9- Gastrointestinal Emergencies Flashcards

1
Q

what is peritonitis

A

inflammation of the serosal membrane that lines the abdominal cavity

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2
Q

how can peritonitis occur

A

breakdown of the peritoneal membranes leading to foreign substances entering cavity

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3
Q

what is the posterior abdominal wall

A

posterior aspect of the peritoneal cavity

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4
Q

when is spontanous bacterial peritonitis most commonly seen

A

seen in patients eith end stage liver disease- patients with cirrhosis

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5
Q

what is SBP

A

spontaneous bacterial peritonitis is an infection of ascitic fluid that cannot be attributed to any intra-abdominal, ongoing inflammatory, or surgically correctable condition

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6
Q

what is ascites

A

pathological collection of fluid within the peritoneal cavity

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7
Q

how does ascites form in cirrhosis

A

portal hypertension
-causing increased hydrostatic pressure in the veins draining the gut
decreased liver function resulting in less albumin produced
-decreased oncotic pressure

NET MOVEMENT OF FLUID INTO PERITONEAL CAVITY

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8
Q

SECONDARY PERITONITIS

A

a result of an inflammatory process in the peritoneal cavity secondary to inflammation, perforation or gangrene of an intra-abdominal or retroperitoneal structure

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9
Q

common causes of secondary bacterial peritonitis

A

peptic ulcer disease
appendictis
divetivulitis
post surgery

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10
Q

non-bacterial causes of secondary peritonitis

A

tubal preganancy
ovarian cyst that burts
blood in peritoneal cavity

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11
Q

what is intussusception

A

when one part of the gut tube telescopes into an adjacent section

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12
Q

what causes small bowel obstrucions

A

intra-abdominal adhesions
hernia
IBD

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13
Q

causes from of large bowel obstruction

A

colon cancer
diverticular disease
volvulus

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14
Q

what is volvulus

A

part of the colon twists around its mesentery

most common in sigmoid colon and caecum

results in obstruction

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15
Q

when do you get vomiting in small vs large bowel obstrcutio

A

relatively early in small

relatively late in large

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16
Q

when do you gte constipation in small vs large bowel obstruction

A

relatively early in large

relatively late in small

17
Q

what is acute mesenteric ischaemia

A

symtomatic reduction in blood supply to teh GI tract

18
Q

what causes an acute occlusion

A

arterial embolism in SMA

19
Q

what causes non-occlusive mesenteric ischaemia

A

low cardiac output

20
Q

what causes mesenteric venous thrombosis

A

systemic coagulatopathy

malignancy

21
Q

who is predisposed to an acute mesenteric ischaemia

A

females

people who have had a history of peripheral vascular disease

22
Q

where do you have pain in acute mesenteric ischaemia

A

left sded because the blood supply to the splenic flexture is there and this is a vulnerable area- watershed area

23
Q

what causes 20-50% of upper GI bleeding

A

peptic ulceration

24
Q

portal drainage of oesophageal vein

A

left gastric vein then portal vein

25
Q

systemic drainage of oesophagus

A

oesophageal veins drain into azygous vein, drains intO svc

26
Q

what is the firs reposne to oesophagel varices

A

band ligation

27
Q

what do you do if band ligation doesnt work

A

TIPS- transjugular intrahepatic portosystemic shunt

  • an expandable metal is placed within the liver
  • bridges the portal vein to an hepatic vein
  • decompresses the portal vein pressure
  • reduction in variceal pressure
  • reduction in ascites
28
Q

drug treatment of oesophageal varices

A

terlipressin- reduces portal venous pressure

29
Q

what is an abdominal aortic aneurysn

A

permanent pathological dilation of the aorta with a diameter >1.5 times the expected AP diameter of that segment

30
Q

pathoohysiogoly of AAA

A

degeneration of the media layer of arterial wall

31
Q

where are most AAAS

A

infrarenal

32
Q

what happens when an AAA ruptires

A

transient hypotension

-syncope, then blood fills up in the retroperitoneal space and can act as a tamponade and compress thw aorta

33
Q

non surgical treatment of AAA

A

smoking cessation

hypertension control

GI System (16 decks)

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