6: Diseases of the small bowel and appendix Flashcards Preview

Gastrointestinal Week 4 2016/17 > 6: Diseases of the small bowel and appendix > Flashcards

Flashcards in 6: Diseases of the small bowel and appendix Deck (27):
1

What is a term used to describe the periodic pain caused by small bowel obstruction?

Small bowel colic

2

If the proximal part of the small bowel is obstructed, how will this present in the patient?

Vomiting

3

Does distension occur in proximal small bowel obstruction?

No - vomited out

4

What presents in distal small bowel obstruction?

Late vomiting

Gross abdominal distension

5

Which imaging modality can be used to diagnose small bowel obstruction?

Abdominal X-ray

6

What causes small bowel obstruction?

Adhesions

Hernias

Cancer

7

Which tube is used to remove bowel contents in the event of an uncomplicated small bowel obstruction?

NG tube

8

What are adhesions?

Scar tissue joining loops of the bowel

9

What is fluid resuscitation?

Replacement of fluids in a patient who is dehydrated for some reason

10

What is strangulation of the small bowel?

Twisting of the bowel in loops around itself, cutting off the blood supply

11

What symptom may patients present with following strangulation of the small bowel?

Constant pain

12

Why can bowel ischaemia cause sepsis?

Lack of blood flow --> no immune cell circulation --> infection

13

Where are the commonest sites for Crohn's disease?

Small bowel, terminal ileum

Anal canal

Large bowel (Crohn's colitis)

14

Which drugs are used to treat Crohn's disease?

Corticosteroids (prednisolone, budesonide, hydrocortisone, beclometasone)

Immunosuppressors (azathioprine, methotrexate)

15

What communications between viscera commonly form in Crohn's disease?

Fistulae

16

If an elderly patient presents with poorly localised pain and signs of shock/sepsis, what should you be suspicious of?

Small bowel ischaemia

17

Which true diverticulum can form in the small bowel?

Meckel's diverticulum

18

Is Meckel's diverticulum symptomatic or asymptomatic?

Tends to be asymptomatic in adults and symptomatic in children

19

What is appendicitis?

Inflammation of the appendix

20

What symptoms will be seen initially in acute appendicitis?

Nausea

Loss of appetite

Poorly localised central abdominal pain (epigastric)

21

Why is the initial pain of appendicitis diffuse and poorly localised?

Visceral afferents involved

22

As acute appendicitis progresses, the pain spreads from the epigastrium to the ___ ___ ___.

Why?

right iliac fossa

Progression to peritonitis

23

Why is the later pain of appendicitis sharp in the right iliac fossa?

Progression of peritonitis in body wall, which has somatic afferents

24

Where precisely is the pain of appendicitis felt?

McBurney's point

1/3rd of distance between ASIS and umbilicus

25

How is acute appendicitis treated?

Appendicectomy

removal of the appendix by surgery

26

Which types of tumours are found in the appendix?

Carcinoid tumours (carcinoma)

27

Where are carcinoid tumours of the appendix notorious for metastasising to?

Liver