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Flashcards in Gastrointestinal Deck (15):
1

6 areas of the stomach?

R hypocondrium, epigastric, L hypocondrium
R lumbar, umbilical, L lumbar
R iliac fossa, hypogastric, L iliac fossa

2

Differentiating between large and small bowel?

Small bowel mucosal folds (vulvulae conniventes) extend across full width
Large bowel has haustra (sacculation) that are thicker and do not often fully cover the full width

3

What are the normal widths of the intestines on AXR?

Small: 3cm
Large: 6cm
Caecum: 9cm

4

Anatomy of the small and large intestine?

Duodenum, jejunum, ileum
Coecum, A colon, T colon, D colon, Sigmoid, Rectum

5

What are the layers of the intestines?

Mucosa (epithelium, lamina propria, muscularis interna)
Submucosa (blood vessels, submocosa/meirsners plexus)
Muscularis externa (inner circular, outer longitudinal smooth muscle, myenteric/auerbachs plexus)
Serosa/adventitia

6

Where does UC extend to?

ileocoaecal valve

7

Where is the most commonly affected area in Chrons?

Terminal ileum

8

Difference in histological findings in Crohns and UC?

Crohns is transmural affecting all 4 layers with granuloma formation
UC does not extend beyond the sub mucosa and decreased goblet cells with crypt abcesses (neutrophils in crypts)

9

Difference in endoscopy findings in Crohns and UC?

Crohns: skip lesions, cobblestone appearance
UC: continuous lesions

10

Difference in barium enema findings in Crohns and UC?

Crohns: rose thorn ulcers, strictures
UC: lead pipe colon

11

Investigations in IBD?

Colonoscopy and biopsy
Inflammatory markers
Barium enema (barium used as contrast and Xrays taken)

12

Presentation of toxic megacolon?

Abdominal distension, pain, septic

13

Causes of toxic megacolon?

UC, cdiff, shigella, cytalomegavirus

14

Investigations in toxic megacolon?

FBC (increased WCC), U&Es, lactate
AXR (massively distended colon)
CXR (air under the diaphragm indicated perforation)
Stools
CT abdo, pelvis

15

Treatment of toxic megacolon?

Resus, sepsis 6, NBM
Steroids if in UC, NG decompression if in cdiff
Surgery if no improvement in 72hrs