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Y1 - Gatrointestinal > Surgical Lower GI > Flashcards

Surgical Lower GI Flashcards

1
Q

What is appendicitis?

A

Inflammation or infection of the appendix

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2
Q

In appendicitis caused by obstruction, what is the most common cause?

A

Faecolith

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3
Q

Who is the classical exam patient with appendicitis?

A

Young child or teenager

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4
Q

What are the symptoms and signs of appendicitis?

A

Abdominal pain - umbilical to RIF shift
Signs of infection (Fever, nausea, tachycardia)
Rosving’s (pressing on LIF causes pain in RIF)
Psoas - patient keeps right hip flexed
Mcburney’s point - point of max pain

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5
Q

What investigations are done to diagnose appendicitis?

A

Clinical diagnosis
Ultrasound for women and children
Bloods - CRP and WCC

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6
Q

What pre-surgical care is done for appendicitis?

A

Analgesia
Antipyretics
Antibiotics

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7
Q

What is the surgical procedure done in appendicitis?

A

Laparoscopic appendectomy

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8
Q

What is bowel obstruction?

A

Blockage of the bowel leading to accumulation of fluid or gas, ischaemia or perforation

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9
Q

What are some causes of bowel obstruction?

A 
Gallstones
Food/faeces
Bezoar
Tumours
Crohn's
Radiation
Adhesions
Herniation
Masses
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10
Q

What are the symptoms of bowel obstruction?

A 
Colicky central abdominal pain
Absolute constipation
Vomiting
Borborygmus
Abdominal distension
Tinkling bowel sounds
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11
Q

What investigations can help diagnose bowel obstruction?

A

AXR or contrast CT
ABGs and bloods
Laparotomy if suspected complication

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12
Q

What pre-surgical treatment is given for bowel obstruction?

A

IV fluids
NG tube
Analgesia for pain

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13
Q

What is ischaemic colitis?

A

Inflammation but not total tissue death due to ischaemia

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14
Q

What are the causes of ischaemic colitis?

A 
Atherosclerotic narrowing in intestinal blood vessels (most common)
Hypotension
Obstruction
Cocaine and meth
Iatrogenic
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15
Q

Who tends to get ischaemic colitis?

A

Elderly
Those with coagulopathy or AF
Intra-abdominal masses

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16
Q

What are the symptoms of ischaemic colitis?

A 
Abdominal pain/cramping
Fresh blood in stool
Urgency
Diarrhoea
Nausea
17
Q

What investigations can diagnose ischaemic colitis?

A

US/AXR/CT to view bowel
CT/MRI angiography
Colonoscopy

18
Q

What is the management for minor cases of ischaemic colitis?

A

Self resolve
Analgesia
IV fluid
Fix cause

19
Q

What is the management for major cases of ischaemic colitis or prophylaxis of total ischaemia?

A

Embolectomy

Colectomy

20
Q

What is true bowel ischaemia?

A

Bowel tissue dies due to lack of blood supply

21
Q

What is the common cause of true bowel ischaemia?

A

Atherosclerosis

22
Q

What are the symptoms of true bowel ischaemia?

A

Sudden severe abdominal pain
Blood in stool
Forceful/painful bowel movements

23
Q

What investigation can diagnose true bowel ischaemia?

A

Exploratory laparotomy

CT/MRI angiography

24
Q

What is the management for true bowel ischaemia?

A

Colectomy to remove infarcted tissue

Restore vasculature as best as possible

25
Q

What is a general complication post-op?

A

One affecting any of the body systems

26
Q

What is a local complication post-op?

A

One specific to the operation

27
Q

What are the CVD post-op complications?

A

MI
Haemorrhage
DVT

28
Q

How does a post-op haemorrhage present?

A

Obvious blood
Tachycardia
Hypotension
Oliguria

29
Q

What are the respiratory post-op complications?

A

Atelectasis (failure of lungs to expand, causing collapse and infection)
Pneumonia
PE due to DVT

30
Q

What are the GI post-op complications?

A

Ileus
Anastomotic dehiscence
Adhesions
Short gut syndrome

31
Q

What are adhesions?

A

The formation of scar tissue that can cause organs to stick to each other

32
Q

What is short-gut syndrome?

A

Malabsorption due to insufficient residual small bowel

Leads to metabolic abnormalities

Y1 - Gatrointestinal (31 decks)

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