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GI System > Session 7- Distal GI pathology > Flashcards

Session 7- Distal GI pathology Flashcards

1
Q

pathophysiology of diarrhoea

A

unwanted substance in gut stimulates secretion and motility

colon is overwhelmed and cannot absorb the quantity of water it recieves from ileum

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2
Q

secretetory diarrhoea

A

toxin in gut lumen therefore water is secreted inside. Too much secretion of ions

persists despite fasting

increased stool osmolality

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3
Q

osmotic diarrhoea

A

water moves into gut becaue there are molecules present that have a high osmotic pressure.
stops when fasting

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4
Q

why do you get diarrhoea if you have lactose intolerance

A

as the lactose isnt broken don it acts as a osmotic pressure drawing water in and the gets fermented in Large intestine

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5
Q

constipation

A

hard stools
difficulty passing stools
inability to pass stools

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6
Q

risk factors of constipation

A

female
certain meds
low levels of activity
age

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7
Q

treatments of constipation

A

psychological support
increased fluid intake
increased activity and fibre
laxatives

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8
Q

what is the appendix

A

diverrticulum off the caecum

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9
Q

how does the appendix differ from the colon structuly

A

has a complete longitudinal layer of muscle whereas colon has incomplete bands called teniae coli

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10
Q

blood supply to appendix

A

comes up through mesentery- mesoappendix- from the ileocolic branch of SMA

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11
Q

why is the location of the appendix important

A

changes the presentation of acute appendicitis

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12
Q

cause if appendicitis

A

blockage of appendicel lumen creates a higher pressure in the appendix
-this causes venous pressure to rise which blocks arterial supply -> ischeamia

a viral or bacteral infection causes the lymphoid tissue to hypertrophy to the point that they obstruct the lumen

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13
Q

presentation of appendicitis

A

poorly localised per-umbilical pain
anorexia
nausea/ vomiting
low grade fever

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14
Q

where is pain felt normally in appendicitis

A

right iliac fossa

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15
Q

where is mcburneys point

A

2/3 of the way from umbilicus to ASIS

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16
Q

what is rebound tenderness

A

push into right iliac fossa let go and it should hurt more when let go than when pressure is applied

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17
Q

diagnosis of appendicitis

A

blood test- raised WBC
history and physical examination

pregnancy test- ectopic preg

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18
Q

treatment if appendicitis

A

appendectomy - open or laproscopic

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19
Q

what is diverticula

A

outpouchings of mucosa and submucosa herniate through muscularis layers where nutrient vessels penetrate bowel wall

20
Q

what causes diverticulitis

A

increased intra-luminal pressure

21
Q

what is diverticular disease

A

when the patientexeriences pain bt there s no inflammaion

22
Q

what is acute diverticulitis

A

when the diverticula become inflammed or perforate due t the entrance being blocked by faeces which allows bacterial invasion

23
Q

uncomplicated diverticulitis

A

inflammation and small abcesses confined to colonic wall

24
Q

complicated diverticulitis

A

larger abceses fistula perforation

25
Q

symptoms of acute diverticulitis

A

abdominal pain at site of inflammation
-left lower quadrant

fever
bloating
constipation
haematochezia

26
Q

signs of acute diverticulitis

A

localosed abdominal tenderness
distension
reduced bowel sounds
signs of peritonitis

27
Q

treatment of acute dverticultis

A

abitibiotcs
fluid resusciation
analgesia

surgery if perforation or large abcesses need to be frained

28
Q

what is the superior rectal artery a continuation of

A

inferior mesenteric artery

29
Q

blood supply to rectum

A

superior rectal
middle rectal
inferior rectap

30
Q

where is the start of the anal canal

A

proximal border of the anal sphincter complex

31
Q

in what direction does the rectum point

A

anteriorly

32
Q

what changes the direction of te rectum

A

pubo-rectalis

33
Q

what way doe sthe anal canal point

A

posteriorly

34
Q

what are anal cushions

A

complex netwoek of blood vessels

the anus contains a complex venous plexus which is divided into three areas of tissues and play a role in anal continence

35
Q

nerve supply to external anal sphincter

A

pudental nerve

36
Q

what is the dentate line

A

junction of hindgut and proctodaeum

37
Q

what lies above the dentate line

A

visceral pain receptors

columnar epithelium

38
Q

what is below the dentate line

A

somatic pain receptors

stratified squamous epithelia

39
Q

what are internal haemorrids

A

above dentate line
caused by loss of connective tissue support
painless
bleed bright red blood

40
Q

treatment of internal haemorrhoids

A

hydration
avoid straining
surgery

41
Q

external haemorroids

A

below dentate line

swelling of anal cushions which may thrombose

42
Q

anal fissure

A

linear tear in the anoderm caused by passing of hard stool

haematochezia

43
Q

cause of anal fissure

A

reduced blood flow to anal mucosa

high internal anal sphincter tone

44
Q

treatment of anal fissure

A 
warm bath
medication
hydration
fibre
analgesia
45
Q

melaena

A

black tarry stools

offensive smelling - due to hb being altered by digestive enzymes and gut bacteria

46
Q

causes of maleana

A 
upper GI bleed 
peptic ulcer disease
varicel bleeds 
oesophageal cancer 
upper GI malignancy

GI System (16 decks)

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