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Flashcards in Appendix Deck (28):
1

in appendicitis, fecoliths are usually located at the ___ of the appendix

exit

2

when the intralumenal pressure inside the appendix surpasses that of the _____, ischemia occurs

vessels

3

ischemia of the appendix can cause ___ and ___

edema, necrosis

4

necrosis can lead directly to ____ or can provide a site for ____

perforation; bacterial invasion

5

if the appendix perforates, what can happen?

peritonitis and sepsis

6

the first pain felt with appendicitis is called _____ pain, and is located?

visceral pain; periumbilical region

7

as the inflammation progresses through the wall of the appendix and reaches the serosa, pain becomes localized to the ____, also known as?

RLQ; McBurney's point

8

if perforation occurs, ____ ensues, resulting in?

peritonitis; diffuse abdominal pain

9

sx of appendicitis

abdominal pain, N/V, mild fever/chills, anorexia

10

physical findings appendicitis

tachycardia, low grade fever, RLQ pain, Rovsing sign, Psoas sign, Obturator sign

11

tx of appendicitis

appendectomy + ABX (prophylactic)

12

majority of diverticula in the West are located in the _____ colon

sigmoid

13

microperforation of diverticula is due to?

inspissation with fecolith

14

diverticulitis presentation

LLQ pain, fever, constipation, leukocytosis, bowel obstruction, peritoneal signs if macroperf

15

do NOT do this on a pt with suspected diverticulitis

colonoscopy, barium enema

16

complications of macroperforation of diverticula

peritonitis, abscess, fistulas

17

complications of microperforation of diverticula

local phlegmon, segmental narrowing, stricture, obstruction

18

tx of diverticulitis

clear liquid diet, ABX against gram-neg, anaerobes; verify etiology after; surgery?

19

presentation of pseudomembr colitis

diarrhea, crampy abdominal pain, leukocytosis, can develop toxic megacolon

20

dx of PC

stool for c diff toxin (toxin A only tho); colonoscopy for pseudomembranes

21

management of PC

stop ABX, AVOID anti-diarrheals, give metronidazole/vancomycin/fidaxomycin; fecal transplant?

22

prominent lymphoid hyperplasia in the appendix is indicative of?

a normal appendix!

23

microscopic features of appendicitis

mucosal ulceration and hemorrhage; mural hemorrhage; neutrophilic infiltration of muscularis propria

24

gross features of appendicitis

erythema, surface exudate, perforation

25

microscopic features of pseudomembranous colitis

volcano lesions composed of degenerating epithelial cells, PMNs, mucin, and fibrin erupting from distended crypts; varying degrees of necrosis

26

diverticula occur at sites of colonic wall weakness, including?

portion without taeniae coli, sites where vasa recta penetrate muscularis propria

27

diverticulitis causes mucosal ____ and ____

necrosis; inflammation

28

if diverticular inflammation is sufficient, it can produce a ___ and mimic ___

mass; colon cancer