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SURGERY BOARDS > small intestines > Flashcards

small intestines Flashcards

1
Q

length of small intestines

A

6meters

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2
Q

mostly retroperitoneal

A

duodenum

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3
Q

mesodermally derived structures

A

parietal and visceral peritoneum

peritoneal cavity

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4
Q

extracoelomic herniation

A

5th week AOG

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5
Q

s.i. retracted back to abdominal cavity; undergoes 270 degree counterclockwise rotation around the SMA

A

10th week AOG

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6
Q

MC SURGICAL d/o of the small intestines

A

small bowel obstruction

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7
Q

cardinal signs of partial/complete sbo

A

vomiting
obstipation
distention
crampy abdominal pain

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8
Q

signs of strangulated SBO

A

Abdominal pain disproportionate to pe findings
tachycardia and leukocytosis
marked acidosis and hyperkalemia

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9
Q

triad radiographic findings SBO

A

DAP
dilated bowel loops >3cm
air fluid level
paucity of air in the colon

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10
Q

high pitched mettalic tinkling sound (water dripping into a large hollow container)

A

air fluid level in sbo

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11
Q

slushing soung (succusion splash)

A

SBO

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12
Q

Thickened small bowel loops
thumb printing sign
Pneumatosis intestinalis
pneumoperitoneum

A

strangulated SBO

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13
Q

can distinguish between ileus and mechanical SBO

A

CT scan

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14
Q

c or u shaped loop of bowel with its mesenteric vessels converging towards the point of constriction

A

closed loop obstruction

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15
Q

gold standard imaging to differentiate between partial and complete obstruction

A

Small bowel series/ enteroclysis

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16
Q

contraindications to non surgical treatment for SBO

A 
Suspected ischemia
large bowel obstruction
closed loop obstruction
strangulated hernia
perforation
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17
Q

abnormal communication between two epithelialized surfaces

A

fistula

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18
Q

most small bowel fistula are

A

post op complications

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19
Q

intestinal fistulas are usually spontaneous and are difficult to diagnose

A

internal fistulas

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20
Q

direct communication between the intestine and the skin of the abdominal wall

A

external fistula

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21
Q

factors that inhibit spontaneous closure of fistula

A 
FRIEND
Foreign body
radiation
infection
epithelialization
neoplasm
distal obstruction
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22
Q

most ideal period of fistula closure

A

10 days to 4 months

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23
Q

adeno carcinoma of small bowel

A

duodenum

24
Q

excluding adenoca, malignant small bowel tumors are more common in

A

distal bowel- ileum

25
Q

tx for small bowel lymphoma

A

primary chemo (CHOP procedure)

26
Q

most prevalent congenital anomaly of the GIT
true diverticulum

60% w/ heterotopic mucosa (pancreas/ gastric)

A

Meckel’s diverticulum

27
Q

meckels are usually found in__

A

ileum

28
Q

persistence of vitelline and omphalomesenteric duct

A

meckel’s diverticulum

29
Q

for narrow-based meckel’s

A

diverticulectomy

wide-based- segmental resection

30
Q

mc cause of acute mesenteric ischemia

A

arterial embolus

95% with cardiac disease

31
Q

meseteric ischemia usually with atherosclerotic disease

A

arterial thrombosis

usually Along proximal SMA CLOSE TO ORIGIN

32
Q

golden period of acute mesenteric ischemia

A

6 hrs

33
Q

insidiously develop

results from atherosclerotic lesions in the main splanchnic arteries (celiac, SMA, IMA)

A

Chronic mesenteric ischemia

34
Q

treatment for NOMI (Non occlusive mesenteric ischemia)

A

vasodilators papaverine

35
Q

pigtail sign in midgut volvulus (bowel loops spiraling about the axis of the mesenteric vessels)

Abnormal C loop of duodenum in the UGIS

Cecum at RUQ

A

MALROTATION

36
Q

Tx for malrotation

A

IV hydration
NG suction
Ladd procedure

37
Q

intermittent, colicky abdominal pain
currant jelly stools
sausage-shaped mass
hyperactive bowel sounds

A

intussusception

38
Q

(+) dance sign
pseudokidney sign
target/ donut sign

A

intussusception

39
Q

tx intussusception

A

air then hydrostatic reduction barium enema

40
Q

non passage of meconium in the 1st 24 hrs of life
maternal polyhydramnios
billous emesis

A

intestinal atresia

41
Q

apple peel atresia

A

IIIB

42
Q

mucosal atresia with intact bowel wall and mesentery

A

I

43
Q

BLIND END separated by a v shaped defect

A

IIIA

44
Q

BLIND END separated by a CORD

A

II

45
Q

Multiple atresia( string of sausages)

A

IV

46
Q

Family history of cyctic fibrosis
food intolerance
billous emesis

A

meconium ileus

47
Q

soap bubble sign
ground glass appearance
microcolon and egg shell pattern
inspissated meconium

A

meconium ileus

48
Q

double bubble sign is seen in

A

duodenal atresia- mc
duodenal web
annular pancreas

49
Q

mc and lethal gastrointestinal d/o affecting preterm neonate

A

necrotizing enterocolitis

50
Q

necrotizing enterocolitis usually affects

A

terminal ileum

51
Q

indication of surgery in necrotizing enterocolitis

A

pneumoperitoneum

52
Q

most potent intestinotrophic hormones

A

GLP-2

53
Q

MOst common subtype of short bowel syndrome

A

TYPE 2- small bowel resection with partial colon resection

54
Q

best tolerated subtype of short bowel syndrome

A

TYPE 3- small int resection with SB anastomosis w/ intact colon

55
Q

presence of less than 200cm residual small bowel

A

short bowel syndrome

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