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GASTRO - RIA > surgergy > Flashcards

surgergy Flashcards

1
Q

3 causes of early post op pyrexia (0-5 days)

A
  • Physiological systemic inflammatory reaction
  • pneumonia/atelectasis
  • UTI?IV line infection
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2
Q

3 causes of late causes of post op pyrexia

A
  • surgical site/wound infection
  • PE/DVT
  • anastamotic leak
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3
Q

what is an anastomotic leak?

A

leak of bowel contents at surgical site

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4
Q

presentation of anastomotic leak?

A
  • abdo pain
  • pyrexia
  • tachycardia
  • more than 5 days post op
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5
Q

what is post op ileus

A

pseudo-obstruction of the bowel due to a loss of peristalsis post op

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6
Q

when does post op ileus present?

A

within few days

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7
Q

presentation of post op ileus?

A
  • N & V
  • abdominal distension
  • abdominal pain
  • failure to open bowels
  • hiccups
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8
Q

management of post op ileus

A
  • NG tube: drip & suck
  • IV electrolyte replacement
  • NBM
  • IV fluid/nutrition
  • mobilise to encourage peristalsis
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9
Q

triad of mesenteric ischaemia?

A
  • high lactate
  • soft & non tender abdomen
  • Cardiovascular disease
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10
Q

what bowel does mesenteric ischaemia typically affect

A

small bowel

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11
Q

2 conditions that involve ischaemia to lowe GI tract?

A
  • mesenteric ischaemia

- ischaemic colitis

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12
Q

what part of bowel does ischaemic colitis affect?

A

large bowel

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13
Q

presentation of ischaemic colitis

A

bloody diarrhoea

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14
Q

markings visible on small bowel and describe them?

A

valvulae conniventes - cross entire width of bowel

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15
Q

name 3 causes of bowel obstruction

A
  • hernias
  • cancer
  • adhesions
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16
Q

what are Valvulae conniventes

A

mucosal folds that form lines that extend the full width of the small bowel

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17
Q

name or markings seen on large bowel?

A

haustra

18
Q

Abdominal xray – coffee bean sign

A

sigmoid volvulus

19
Q

air under diaphragm

A

pneumoperitoneum

20
Q

blood supply to the ascending colon?

A

2 branches of the superior mesenteric artery (ileocolic & right colic arteries)

21
Q

3 branches of the ileocolic artery

A
  • colic
  • anterior caecal
  • posterior caecal
22
Q

3 branches that supply the transverse colon and what do they branch from?

A

left, middle & right colic artery

right & middle colic arise from the superior mesenteric

left colic arise from the inferior mesenteric

23
Q

blood supply to the descending colon?

A

left colic artery (branches off from the inferior mesenteric)

24
Q

arterial supply of the sigmoid colon?

A

sigmoid arteries - branches of the inferior mesenteric artery

25
Q

symptoms of haemorrhoids

A
  • constipation
  • painless bright red bleeding
  • sore/itchy anus
  • feeling a lump around or in anus
26
Q

what causes a thrombosed haemorrhoid

A

strangulation at base of haemorrhoid causing thrombosis in the haemorrhoid - can be extremely painful

appears as purple, very tender swollen lumps around anus

27
Q

what are diverticula?

A

pouches in bowel wall

28
Q

what is diverticulosis?

A

the presence of diverticula without symptoms

29
Q

risk factors for diverticulosis

A
  • age
  • low fibre diet
  • obesity
30
Q

signs & symptoms of diverticulitis

A
  • fever
  • LIF pain
  • diarrrhoea
  • PR blood/mucus
  • N&V
31
Q

complications of diverticulitis?

A
  • haemorrhage
  • perforation
  • abscess
  • fistula
  • ileus/obstruction
32
Q

diagnostic investigation for AAA

A

CT angiogram

33
Q

3 most common causes of acute pancreatitis

A
  • post ERCP
  • Alcohol
  • Gall stones
34
Q

score used to assess severity of acute pancreatis

A

Glasgow score

35
Q

outline the glasgow score

A
  • PaO2 < 8kPa
  • Age > 55 years
  • Neutrophils: WCC > 15
  • Calcium < 2
  • Renal function: Urea > 16
  • Enzymes (LDH > 600 or AST/ALT>200)
  • Albumin <32
  • Sugar: Glucose > 10
36
Q

management of sigmoid volvulus

A

decompression via rigid sigmoidoscopy & flatus tube insertion

37
Q

anorectal pain and a tender lump on the anal margin

A

thrombosed haemorrhoid

38
Q

Dukes classifcation __ if involves lymph nodes?

A

C

39
Q

dukes __ if invading bowel wall

A

B

40
Q

when is a one off flexy sigmoidoscopy done & why?

A

at age 55: to detect & treat polyps to reduce future risk of colorectal cancer

GASTRO - RIA (10 decks)

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