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Flashcards in GI Deck (22)
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1
Q

When do polyps develop in people with FAP?

A

Begin in puberty, by 30 can have 100s to 1000s
Mostly in descending colon and rectum
By 40 most will develop colorectal cancer
By 50 all of them will have

2
Q

What are extra GI manifestations found in FAP?

A

Osteomas (benign bone tumours)
Jaw cysts
Sebaceous cysts
Collectively known as Garderner’s syndrome

3
Q

What symptoms do polyps in FAP cause?

A

If large cause obstruction to intestine, abide pain and constipation
Can ulcerate, GI bleeding, iron deficiency anaemia

4
Q

What are the layers of the mucosa?

A
Epithelial (absorbs and secretes mucus and enzymes)
Lamina propria (blood and lymph vessels)
Muscularis mucosa (smooth muscle contracts/breaks down food?
5
Q

What are nonocclusive causes of bowel ischaemia? (mucosal infarcts)

A

Hypovolemia (haemorrhage or dehydration)

Low cardiac output (post MI)

6
Q

What is seen on an abdo CT in bowel ischaemia?

A

Bowel dilation
Bowel wall thickening
Intestinal pneumatosis

7
Q

What is intussusception?

A

When a part of the intestine folds in on itself causing obstruction
Most common cause of obstruction in infants
Ileocecal region (ileum fold into cecum)
Caused by: polyps/tumors (adults)
Lymphoid hyperplasia (babies)
Meckel’s diverticulim
Idiopathic

8
Q

What are the risk factors for intussusception?

A

Having had one previously
Having a sibling with intussusception
Having intestinal malrotation

9
Q

What are the signs of intussusception?

A
Intermittent abdominal pain 
Guarding 
Vomiting 
Hard, sausage like mass in abdomen 
Iscahemia- infarction 
Red currant jelly stool 
Sepsis, fever 
Obstruction  - large mass 
Volvulus
10
Q

What does intussusception look like on imaging?

A

A Bulls-eye telescoped intestine on end

11
Q

What is a volvulus?

A

An obstruction caused by a loop in the intestines that twists around itself and surrounding mesentery
Sigmoid, cecal and midgut are the most common

12
Q

When do sigmoid volvulus’ occur?

A

Pregnancy
Middle-aged and elderly- constipation (Hirschsprung)
Abdominal adhesions

13
Q

When do cecal volvulus’ occur?

A

Abdominal mesentery didn’t develop normally
Colon can flop around freely
Fetus/stool

14
Q

When do midgut volvulus’ occur?

A

Babies and small children

Abnormal intestinal development

15
Q

What are the complications of a volvulus?

A

Bowel obstruction
Infarction
Sepsis (cardiovascular collapse)

16
Q

What does a volvulus look like on imaging?

A

Abdo x-ray- Looks like a bent inner tube/coffee bean

Barium enema- birds beak

17
Q

What causes colonic diverticular?

A

Low fibre diet
Fatty foods and red meat
Marfan syndrome and Ehlers danlos

18
Q

What causes diverticulitis?

A

Ledged fecalith
Erosion (from high pressures)
Not associated with rectal bleeding (diverticulosis)
Fistula (cosovesicular (bladder))

19
Q

What causes appendicitis?

A

Obstruction: fecalith, seeds, pinworm infections, lymphoid hyperplasia

20
Q

What occurs if the appendix ruptures?

A

Peritonitis- rebound tenderness abdominal guarding

Abscess (periappendical)

21
Q

What can trigger symptoms of IBS?

A

Fructose and lactose
Visceral hypersensitivity
Diarrhoea/flatus

22
Q

What is a risk factor for IBS?

A

Gastroenteritis (norovirus, rotavirus)

Stress