protective for UC ?
dietary fatty acids SMOKING appendectomy < 20
risk factors for UC ?
dietary arachinodinic acid dietary linoleic acid (corn oil) NSAID stress/depression Postmenopausal hormone use
risk factor for Crohns disease?
dietary animal protein NSAID stress/depression Oral contraceptive use smoking appendectomy
protective for Crohn's Disease
dietary fiber Vitamin D
Diseases/complications of Crohn's Disease
Stricture Fistulas Intraabdominal or Perianal abscess
disease/complication of UC
primary sclerosing cholangitis (independent)
histo of Crohn's Disease
Granulomas, clumps of inflammatory cells in 30% patients
histo of UC
grandular atrophy with crypt distortion hypertrophy of muscularis mucosa
morphology of UC vs. Crohn's Disease
UC - pseudopolyps - ulceration and raised mucosa *Mucosa and Submucosa involved Crohn's Disease - cobblestoning = walls are thick
painful red nodules, mosquto bites Parallels Bowel disease
ulceration and skin necrosis Independent from bowel disease
inner eye infection Independent from bowel disease
Primary Sclerosis Cholngitis bile duct is narrowed - can process to cirrhosis and increased risk of cancer *Ulcerative Colitis
anastomosis between Left Gastric Vein + Azygos Vein
from bleeding at anatomosis between superior rectal vein + middle/inferior rectal vein
anterior abdominal wall has enlarged veins anastmosis between paraumbilical veins + abdominal tributaries easily palpated
between colic vein + lumbar vein
what are 4 anatomoses that are related to portal hypertesion
1. esophageal varices - L gastric + azygos vein 2. caput medusa - paraumbilical veins + abdominal tributaries 3. internal hemorrhoids (superior rectal + midddle/inferior rectal veins) 4. retroperitoneal anastomoses - colic vein and lumbar vein
undescended testis orchidopexy done to remove testis from abdomen
stimulation of inner thigh causes elevation o corresponding testis into inguinal canal. genitofemoral nerve
fluid in processus vaginlias
blood in tunica vaginalis
enlarged testicular veins
protrusion is lateral to the inferior epigastric artery. goes through inguinal canal congenital/infants
protrusion is medial to inferior epigastric artery. goes through Hesselbach's Triangle.
air in the peritoneum - ascends to top of cavity trapped air below diaphragm on the right is pathological normal to see air on the left (stomach)
fluid in peritoneum? Males and females?
fluid DESCENDS and collects in different places in male/female female - fluid goes to Retouterine Pouch male - Rectovesical Pouch
narrowing of the esophagus failure of LES to relax
esophageal carcinoma sign?
is there is a rough, irregular change in diameter of the esophagus - called a Filling Defect or Eaten Apple SIgn Esophageal cancer sign
what happens if LES herninates into thorax?
stomach contents leak Lower Esophageal Sphincter is already weak
gall stones vs. kideny stones imagin
gall stones - NOT seen on xray - do ultrasound or CT kidney stones - are radio-opaque so do Cray
referred pain from kidney stone? dx kidney stones? vs appendicitis
T11-L2 - flank region to scrotal region kidneys are retroperitoneal so will not have the Rebound Tenderness Appendicitis will cause rebound tenderness