What histological types of polyps are there?
Why do people who vomit a lot become hypokalaemic?
Metabolic alkalosis causes K loss in the kidney
What questions do you want to ask in a Hx of vomiting?
Quality of the vomit
Relationship to food
Sick contacts/Travel Hx
What does pain in the setting of a bowel obstruction indicate?
What are the bands in the small bowel?
What are some complications of stoma's?
What fluids do you use to replace gastric fluid?
Hartman's or saline
What is the sensitivity and specificity of faecal occult blood for colorectal cancer?
If the vomitus is thick, brown, and faecal in nature, what do you think?
Large bowel obstruction
What are the DDx for large bowel obstruction?
Left sided colon Ca
Do you investigate a bowel obstruction?
Erect and supine Xray
FBE, UEC, Blood gas
How much fluid is produced in the GIT tract per day?
What are the DDx for small bowel obstruction?
Internal Ca - lymphoma
When is colonic stenting indicated?
Late stage malignancy that is incurable
What is the most common cause of low albumin?
Inflammation - it's an acute phase reaction
What is Hartmann's precedure?
Removal of bowel and replace temporarily
Who get volvulus?
Old people in nursing home with co-morbidities
Outline the colorectal cancer screening for at risk individuals
Category 1 - First degree relative (FDR) or SDR >55 age at diagnosis
- FOBT every 1-2 years, flexible sigmoid every 5 years
Category 2 - FDR <55 or 2 FDR or 1 FDR and 1 SDR on same side at any age
- 5 yearly colonscopy from aged 50 or 10 years younger than first diagnosis
Category 3 - Known or suspected familial syndrome (FAP or Lynch)
- Referal to specialist
Outline the follow up screening for patients found to have polyps
LOW RISK: 1-2 low risk polyps - 5 yearly colonscopy
HIGH RISK: - 3-4 polyps or >10mm polyp - 3 yearly colonscopy
MULTIPLE: >5, 5-10 = 1 yearly colonscopy, >10 = <1 yearly colonscopy
Possible incomplete excision of large or sessile polyp: colonscopy at 3-6 months