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SURGICAL DISEASES > TH3 ACUTE GASTRO BLEEDING/ PEPTIC ULCER > Flashcards

TH3 ACUTE GASTRO BLEEDING/ PEPTIC ULCER Flashcards

1
Q

HEMATOMESIS?

A

VOMITING BLOOD
DARK/ BROWN MATERIAL (coffee grounds)
> due to Hb > reduced > HEMATIN by HCl

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2
Q

MELENA

A

TARRY BLACK STOOL
> GI BLEEDING PRESENTED WITH MELENA

> at least 50ml of blood in intestine for > 8hrs

> source of bleeding = proximal to flexura coli hepatica

> BLACK COLOUR = IRON SULPHITE > produced by bacterial disintegration of Hb

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3
Q

HEMATOCHESIA?

A

> defecation of blood
rectrorhagia
intestinal bleeding distal to flexura coli hepatica

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4
Q

ACUTE UPPER GASTRO INTESTINAL BLEEDING?

A

> ESOPHAGUS
STOMACH
DUODENUM

> haemorrhage proximal to LIGEMENTUM TREITZ (duodenum-jejunum connection)

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5
Q

WHICH 2 DISEASE PRESENTS HEMATOCHESIA WITH MASSIVE HEMORRHAGE?

A

ULCERUS COLITIS
LARGE INTESTINAL DIVERTICULOSIS

> FRESH BLOOD IN STOOL
BLOODY DIARRHOEA

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6
Q

WHAT IS TYPICAL BLEEDING IN CASE OF HEMORRHOIDS?

A

RECTAL BLEEDING
> fresh blood not mixed with stool
> during defecation or immediately after defecation

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7
Q

WHAT IS MALLORY WEISS SYNDROME?

A

LINEAR TEARING OF ESOPHAGEAL MUCOSA DUE TO REPEATED VOMITING

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8
Q

MOST COMMON CAUSE OF UPPER GASTRO INTESTINAL BLEEDING?

A

PEPTIC ULCER

> cause of more than 2/3 of GI bleeding

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9
Q

MAIN METHOD FOR DX GI BLEEDING?

A

EMERGENCY UPPER ENDOSCOPY

oesophago-gastro-duodenoscopy

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10
Q

WHICH CLASSIFICATION IS USED TO DETERMINE THE ENDOSCOPIC SEVERITY OF STOMACH + DUODENAL ULCER BLEEDING?

A 
FOREST CLASSIFICATION  (6)
1a - spurting bleeding
1b - oozing bleeding 
2a - visible vessel 
2b - adherent dot 
2c - black spots
3 - clear base
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11
Q

COMPLICATION OF PEPTIC ULCER?

A 
> HEMORRHAGE 
> PERFORATION 
> GASTRIC OUTLET OBSTRUCTION 
> PENETRATION + FISTULA 
> MALIGNANT CHANGE IN PEPTIC ULCER
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12
Q

MOST COMMON COMPLICATION OF PEPTIC ULCER?

A

HEMORRHAGE

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13
Q

WHICH ARE THE PHASES OF MANAGEMENT IN PEPTIC ULCER?

A 
MANAGEMENT OF HEMORRHAGE 
> 5 PHASES 
1. resuscitation 
2. diagnosis 
3. immediate control of bleeding 
4. prevention of re-bleeding 
5. prevention of recurrent bleeding in future
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14
Q

WHAT DOES PEPTIC ULCER PERFORATION MEAN?

A

EXACERBATION OF PEPTIC ULCER > CAUSING NECROSIS + PERFORATION WITH SPILLAGE OF CAUSTIC GASTRIC CONENT INTO PERITONEUM

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15
Q

CLASSIFICAL RADIOLOGICAL SIGN OF PERFORATED PEPTIC ULCER?

A

PNEUMOPERITOENUM
> AIR IN PERITONEAL CAVITY
> air seen under diaphragm > X RAY

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16
Q

CLINICAL PRESENTATION OF PERFORATED PEPTIC ULCER?

A

SUDDEN + SEVERE EPIGASTRIC PAIN

> PHYSICAL EXAMINATION > RIGIDITY OF ABDOMINAL MUSCULATURE

17
Q

AFTER PEPTIC ULCER PERFORATION, WHICH IS THE NEXT DISEASE RELATED WITH PERFORATION + AIR UNDER DIAPHRAGM ON X RAY?

A

PERFORATED DIVERTUCULUM OF COLON

18
Q

TYPES OF GASTRIC OUTLET OBSTRUCTION?

A

ACUTE

CHRONIC

19
Q

WHAT IS THE CAUSE OF ACUTE GASTRIC OUTLET OBSTRUCTION?

A

EDEMA + INFLAMMATION OF PYLORIC CHANNEL

20
Q

WHAT IS THE CAUSE OF CHRONIC GASTRIC OUTLET OBSTRUCTION?

A

REPEATED EPISODES OF ULCERATION + HEALING

> LEAD TO PYLORIC SCARRING + FIXED STENOSIS FORMED WITH GASTRIC OUTLET OBSTRUCTION

21
Q

WHICH IS THE DX METHOD FOR GASTRIC OUTLET OBSTRUCTION?

A

UPPER ENDOSCOPY

> CONFIRMS NATURE OF OBSTRUCTION

22
Q

EXPLAIN PENETRATION + FISTULA FORMATION IN PEPTIC ULCER?

A 
REPEARED EPISODES OF ULCERATION + HEALING > lead to adhesion between stomach + adjacent organs
- pancreas
- biliary tree
-
- transverse colon
23
Q

WHICH ORGAN MOST COMMONLY AFFECTED BY ULCER PENETRATION?

A

PANCREAS

> body, tail or head

24
Q

MOST COMMON TYPE OF FISTULA FORMATION IN PEPTIC ULCER?

A

GATROCOLIC FISTULA

> gastric ulcer of greater curvature > cause gastrocolic fistula

25
Q

CLINICAL PRESENTATION OF PEPTIC ULCER PERFORATION TO PANCREAS?

A

CONTINUES, MODERATE - SEVERE PAIN
> RADIATED TO BACK
> PAIN LOOSES ITS CHARACTERISTIC + WORSE BY FOOD

> NOT RELIEVED BY ANTIACID DRUGS

26
Q

SEVERE COMPLICATION THAT MAY CAUSE ULCER PENETRATION TO PANCREASE?

A

ACUTE PANCREATITIS

SURGICAL DISEASES (13 decks)

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