Colloquium Vomiting Flashcards Preview

Hugh's MD2 Gen Med > Colloquium Vomiting > Flashcards

Flashcards in Colloquium Vomiting Deck (19):
1

What histological types of polyps are there?

Villous 

Hamatoma

Hyperplasic

2

Why do people who vomit a lot become hypokalaemic?

Metabolic alkalosis causes K loss in the kidney

3

What questions do you want to ask in a Hx of vomiting?

Quality of the vomit

Volume

Haematemesis

Relationship to food

Associated constipation

Sick contacts/Travel Hx

 

4

What does pain in the setting of a bowel obstruction indicate?

Ischaemic bowel

5

What are the bands in the small bowel?

Plicae circulares

5

What are some complications of stoma's?

Hernia

Infection

 

7

What fluids do you use to replace gastric fluid?

Hartman's or saline

8

What is the sensitivity and specificity of faecal occult blood for colorectal cancer?

Sensitivity: 30-40%

9

If the vomitus is thick, brown, and faecal in nature, what do you think?

Large bowel obstruction

10

What are the DDx for large bowel obstruction?

Left sided colon Ca

Diverticulitis

Volvulus

 

11

Do you investigate a bowel obstruction?

Erect and supine Xray

CT

FBE, UEC, Blood gas

 

12

How much fluid is produced in the GIT tract per day?

~3L

12

What are the DDx for small bowel obstruction?

Hernia

Strictures

Internal Ca - lymphoma

Crohn's

External Ca

13

When is colonic stenting indicated?

Late stage malignancy that is incurable

15

What is the most common cause of low albumin?

Inflammation - it's an acute phase reaction

16

What is Hartmann's precedure?

Removal of bowel and replace temporarily

Anastomose later

17

Who get volvulus?

Old people in nursing home with co-morbidities

Young Africans

18

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

19

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