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gi missing > session 9- GI emergencies > Flashcards

session 9- GI emergencies Flashcards

1
Q

what is peritonitis

A

inflammation of the serosal membrane lining the abdominal cavity

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2
Q

what is primary peritonitis

A

spontaneous bacterial peritonitis. infection of gastric fluid that cannot be attributed to a specific cause.

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3
Q

how does liver cirrhosis cause primary peritonitis

A

portal hypertension causes increased hydrostatic pressure in veins. decreased albumin due to decreased liver function causes increased intravascular oncotic pressure. this causes net movement of fluid into peritoneal cavity.

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4
Q

symptoms of primary peritonitis

A

diffuse abdominal pain, fever, vomiting. white cell count above 250, lie very stilll

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5
Q

what causes secondary peritonitis bacterial

A

peptic ulcer disease, appendicitis, diverticulitis, post surgery

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6
Q

what causes secondary peritonitis non bacterial

A

tubal pregnancy that bleeds, ovarian cyst

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7
Q

treatment peritonitis

A

control infectious source w surgery, eliminate bacteria and toxins, maintain organ system function

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8
Q

what is a bowel obstruction

A

mechanical or functional problem that inhibits normal movements of gut content.

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9
Q

causes of bowel obstruction

A

intussception and intestinal atresia in children. adhesions and incarcerated hernias in adults

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10
Q

what is intussusception

A

when one part of gut tube telescopes into adjacent section. can cause prolapse out of rectum. causes impaired lymphatic and venous drainage and therefore oedema.

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11
Q

treatment intussusception

A

air enema, surgery

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12
Q

symptoms intussusception

A

abdo pain, vomiting, haematochezia

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13
Q

symptoms small bowel obstruction

A

nausea, vomiting, abdo distension, absolute constipation

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14
Q

cause of small bowel obstruction

A

intraabdominal adhesions, damage to mesothelium, incarcerated groin hernias, IBS eg chrons

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15
Q

symptoms small bowel obstruction

A

crampy intermittent abdo pain, abdo distension, absent bowel sounds, hernia presence

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16
Q

large bowel obstruction casues

A

colon cancer, diverticular disease, sigmoid volvulus.

17
Q

symptoms large bowel obstruction

A

cancer- gradual. volvulus- sudden

abdo distension, crampe pain, nausea

18
Q

what is a volvulus

A

part of the colon twisting around mesentery. causes obstruction

19
Q

compare small vs large obstruction

A

small has vomiting then constipaiton, large is constipation then vomiting.

20
Q

what is acute mesenteric ischaemia

A

symtomatic reduction in blood supply to GI tract.

21
Q

cause of acute mesenteric ischaemia

A

acute occlusion caused by SMA embolism. non occulsive caused by low cardiac output or mesenteric venous thrombosis.

22
Q

symptoms acute mesenteric ischaemia

A

abdo pain disproportionate to findings, nausea and vomiting, left sided pain

23
Q

investigations acute mesenteric ischaemia

A

blood tests for metabolic acidosis/increased lactate. erect chest x ray, CT angiography

24
Q

treatment acute mesenteric ischaemia

A

surgery to resect ischameic bowel, thrombolysis/angioplasty

25
Q

what is peptic ulcer

A

disruption in gastric/duodenal mucosa that extends through muscularis mucosa

26
Q

what is the most common peptic ulcer and what blood vessel does it affect

A

duodenal, gastroduodenal artery

27
Q

where in stomach to gastric ulcers occur

A

lesser curve

28
Q

what is the portal and systemic drainage of an oesophogeal varicies

A

portal- left gastric>portal vein

systemic- azygous> SVC

29
Q

how to treat oesophageal varices

A

TIPS inserted. expandable metal in liver that bridges portal vein to hepatic vein to decompress the portal vein pressure and reduce variceal pressure and therefore ascites. or terlipressin

30
Q

what is an AAA

A

permanent pathological dilation of aorta with diameter greater than 3 cm.

31
Q

cause of AAA

A

degeneration of media layer of arterial wall caused by degeneration of elastin and collagen. lumen dilates

32
Q

risk factors AAA

A

male. age, smoking

33
Q

symptoms expanding AAA

A

nausea, urinary frequency, back pain

34
Q

symptoms AAA rupture

A

abdo pain, back pain, pulsatile abdo mass, transient hypotension, sudden CVS collapse

35
Q

diagnosis AAA

A

physical exam shows pulsatile abdo mass, ultrasonopgraphy detects free peritoneal blood, CT scan, plain x rays

36
Q

treatment AAA

A

smoking cessation, hypertension control, endovascular repair, open surgical repair

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