GIT 3

Question 1

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

Answer 1

ischemic bowel dz = ischemic colitis = gangrene of intestine

Question 2

ischemic colitis causes

Answer 2

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

Question 3

watershed areas in ischemic colitis

Answer 3

splenic flexure and retro sigmoid area

Question 4

MC branch in ischemic colitis

Answer 4

superior mesenteric artery

Question 5

actual gangrene with bloody diarrhea

Answer 5

acute ischemia

Question 6

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

Answer 6

chronic ischemia

Question 7

50% familial cases
10% Down syndrome
mut RET gene

Answer 7

Hirschsprung - megacolon

Question 8

caused by absence of migration of neural crest cells

Answer 8

Hirschsprung - megacolon

Question 9

types of Hirschsprung - megacolon

Answer 9

rectum and sigmoid = short

entire colon = long

Question 10

painless blood in stool for kids

Answer 10

meckels

Question 11

2%
2 inch
2 feet away 
male
2 yo

Answer 11

meckels

Question 12

failed involution of vitelline duct

Answer 12

meckels

Question 13

painless blood in stool in adults

Answer 13

diverticulosis

Question 14

MC for diverticulosis

Answer 14

sigmoid

Question 15

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

Answer 15

diverticulosis

Question 16

infection of vasa recta in diverticulosis with fecal matter

Answer 16

diverticulitis

Question 17

where do colonic diverticula arise?

Answer 17

muscularis propria where vasa recta enters

Question 18

fluid levels seen in

Answer 18

SBO

Question 19

cecum and AC are distended in

Answer 19

LBO

Question 20

small bowel

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

Answer 20

inguinal hernia

Question 21

painful bulge commonly disappears when laying down

can cause intestinal obstruction

Answer 21

inguinal hernia

Question 22

strangulated - incarcerated hernia results in

Answer 22

gangrene

pain non reducible

Question 23

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

Answer 23

volvulus

Question 24

complications of volvulus

Answer 24

ischemia

gangrene of intestine - bloody stool

Question 25

small bowel MC ileocecal junction age 0-12 months

Answer 25

intussusception

Question 26

causes - diarrhea - due to enlarged payer patches proximal invaginate into distal

Answer 26

intussusception

Question 27

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

Answer 27

intussusception

Question 28

acute infection of peritoneum results in obstruction, strangulation and gangrene

Answer 28

peritonitis

Question 29

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

Answer 29

subphrenic abscess

Question 30

``` acute appendicitis acute cholecystitis acute PID dialysis pancreatitis ```

Answer 30

local peritonitis

Question 31

perforated appendix perforated ulcer e coli bacteroides

Answer 31

generalized peritonitis

Question 32

abdominal pain and guarding rebound tenderness painful ascites

Answer 32

peritonitis

Question 33

hypothesis: decrease serum protein 50% morbidity e coli, klebsiella: cirrhosis and nephrotic syndrome C/F fever, chills, nausea, vomiting, abdominal tenderness, malaise, painful ascites

Answer 33

spontaneous bacterial peritonitis

Question 34

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

Answer 34

angiodysplasia = arteriovenous malformation

Question 35

angiodysplasia with family history

Answer 35

osler weber rendu

Question 36

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

Answer 36

angiodysplasia

Question 37

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

Answer 37

acute appendicitis

Question 38

MC cause of acute appendicitis in kids

Answer 38

lymphoid hyperplasia

Question 39

MC cause of acute appendicitis in adults

Answer 39

fecalith gallstone worms

Question 40

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

Answer 40

acute appendicitis

Question 41

complications of acute appendicitis

Answer 41

vomiting rupture venous thrombosis umbilical pain

Question 42

d/d for acute appendicitis

Answer 42

meckels | crohns

Question 43

mech behind hemorrhoids

Answer 43

increase hydrostatic pressure (increase venous pressure)