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Path 2 Block 1 > GIT 3 > Flashcards

GIT 3 Flashcards

1
Q

sudden complete obstruction of blood flow
all layers involved
focal recurrent infarction possible

A

ischemic bowel dz = ischemic colitis = gangrene of intestine

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2
Q

ischemic colitis causes

A
  1. thrombotic
    a) arterial - LV of heart - MI, DM, HTN, IE, paradoxical embolism
    b) venous - hyper coagulable states - popliteal vein
  2. internal/external herniation
  3. vasculitis - PAN, Henoch Schonlein purpura
  4. nonexclusive ischemia - cardiac failure, shock, dehydration, vasoconstrictive drugs
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3
Q

watershed areas in ischemic colitis

A

splenic flexure and retro sigmoid area

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4
Q

MC branch in ischemic colitis

A

superior mesenteric artery

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5
Q

actual gangrene with bloody diarrhea

A

acute ischemia

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6
Q 
can predict 
prod stricture (wall thickening), hemosiderin in intestine after surgery 
temporary pain in abdomen 
any pt with heart condition with pain in abdomen after eating
A

chronic ischemia

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7
Q

50% familial cases
10% Down syndrome
mut RET gene

A

Hirschsprung - megacolon

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8
Q

caused by absence of migration of neural crest cells

A

Hirschsprung - megacolon

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9
Q

types of Hirschsprung - megacolon

A

rectum and sigmoid = short

entire colon = long

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10
Q

painless blood in stool for kids

A

meckels

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11
Q 
2%
2 inch
2 feet away 
male
2 yo
A

meckels

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12
Q

failed involution of vitelline duct

A

meckels

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13
Q

painless blood in stool in adults

A

diverticulosis

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14
Q

MC for diverticulosis

A

sigmoid

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15
Q

increase intra abdominal pressure - bugle of vasa recta
over 60 yo
decrease fiber

A

diverticulosis

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16
Q

infection of vasa recta in diverticulosis with fecal matter

A

diverticulitis

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17
Q

where do colonic diverticula arise?

A

muscularis propria where vasa recta enters

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18
Q

fluid levels seen in

A

SBO

19
Q

cecum and AC are distended in

A

LBO

20
Q

small bowel

bulges in groin area become more prominent when coughing straining or standing

A

inguinal hernia

21
Q

painful bulge commonly disappears when laying down

can cause intestinal obstruction

A

inguinal hernia

22
Q

strangulated - incarcerated hernia results in

A

gangrene

pain non reducible

23
Q

large bowel
sigmoid
complete obstruction - neither air or stool will pass
coffee bean appearance

A

volvulus

24
Q

complications of volvulus

A

ischemia

gangrene of intestine - bloody stool

25
Q

small bowel
MC ileocecal junction
age 0-12 months

A

intussusception

26
Q

causes

  • diarrhea
  • due to enlarged payer patches

proximal invaginate into distal

A

intussusception

27
Q

current jelly stool - necrotic mucosa following gangrene (looks like smudge on CT)
sausage shaped

looks like target on CT

A

intussusception

28
Q

acute infection of peritoneum

results in obstruction, strangulation and gangrene

A

peritonitis

29
Q

secondary to infection in the abdomen and is characterized by fever, malaise, pain in the right to left hypochondrium and shoulder pain

A

subphrenic abscess

30
Q 
acute appendicitis
acute cholecystitis
acute PID
dialysis 
pancreatitis
A

local peritonitis

31
Q

perforated appendix
perforated ulcer
e coli
bacteroides

A

generalized peritonitis

32
Q

abdominal pain and guarding
rebound tenderness
painful ascites

A

peritonitis

33
Q

hypothesis: decrease serum protein
50% morbidity
e coli, klebsiella: cirrhosis and nephrotic syndrome

C/F
fever, chills, nausea, vomiting, abdominal tenderness, malaise, painful ascites

A

spontaneous bacterial peritonitis

34
Q

occurs in cecum or right colon
C/F - bleeding
mix of thin and thick walled vessels

A

angiodysplasia = arteriovenous malformation

35
Q

angiodysplasia with family history

A

osler weber rendu

36
Q

adult px presents feeling weak
iron def anemia
cough - causes bleeding

increase EPO

A

angiodysplasia

37
Q

cause: obstruction - fecalith, gallstone, ball of worms (oxyuriasis vermicularis), mucinous tumor

A

acute appendicitis

38
Q

MC cause of acute appendicitis in kids

A

lymphoid hyperplasia

39
Q

MC cause of acute appendicitis in adults

A

fecalith
gallstone
worms

40
Q 
shows gangrene on outside 
CBC - left neutrophilia 
CT for Dx
Increase LAP
reactive myeloid hyperplasia in BM
A

acute appendicitis

41
Q

complications of acute appendicitis

A

vomiting
rupture
venous thrombosis
umbilical pain

42
Q

d/d for acute appendicitis

A

meckels

crohns

43
Q

mech behind hemorrhoids

A

increase hydrostatic pressure (increase venous pressure)

Path 2 Block 1 (4 decks)

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