Flashcards in Large Bowel Disorders Deck (50)
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1
Acquired by 20% of patients through fecal-oral transmission in a hospital setting
Antibiotic associated colitis (Clostridium difficile infection)
2
Signs and symptoms include: Moderate greenish, foul-smelling watery diarrhea. Mild LLQ tenderness. Stool has mucus but seldom blood. Fever up to 40C (104F)
Antibiotic Associated Colitis(C.diff)
3
Treatment for Antibiotic Associated Colitis(C.diff)
D/C antibiotics. 1st Metronidazole(Flagyl) 500mg TID x 10-14/d. If fails, Vancomycin 125mg PO QID (more expensive). Probiotics
4
If appendicitis is left untreated, how soon does gangrene and perforation develop?
within 36 hrs
5
Most common abdominal surgical emergency
appendicitis
6
Classic h/o of appendicitis
periumbilical pain followed by nausea
7
point just below the middle of a line connecting the umbilicus and the anterosuperior iliac spine.
McBurney's point
8
Pain in the right lower quadrant with palpation of the left lower quadrant
Rovsing sign
9
evaluated by passively flexing the right hip and knee and internally rotating the hip
obturator sign
10
evaluated by placing patient in either the supine or the left lateral decubitus position and extending the right leg at the hip
psoas sign
11
Has become the most important imaging study in patients with ATYPICAL presentations of appendicitis
CT scans
12
condition of having diverticula of the colon. more common in the sigmoid colon. associated w/low fiber, high intake of fat/red meat, obesity, lack of excercise
diverticulosis
13
which are outpocketings of the colonic mucosa and submucosa through weaknesses of muscle layers in the colon wall (Mucosal layer herniates thru muscularis layer)
diverticula
14
H/O includes: chronic constipation, some pts may c/o cramping, bloating, flatulence, and irregular defecation
diverticular disease
15
PE may reveal LLQ tenderness and palpable sigmoid/descending colon
diverticular disease
16
Treatment for diverticular disease
Bulk in diet to get one BM per day at minimum
17
Swelling and inflammation of diverticulum in the intestinal wall
diverticulitis
18
erosion of the diverticular wall by increased intraluminal pressure or inspissated stool within a diverticulum; inflammation and focal necrosis ensue, resulting in perforation
diverticulitis
19
Signs and symptoms include: achy LLQ pain, N/V, low grade fever, palpable mass, distention, stool occult blood, leukocytosis
diverticulitis
20
CI during initial stages of diverticulitis due to risk of perforation
barium enema or colonoscopy
21
test of choice in pts suspected of having acute diverticulitis
CT scan
22
Outpatient treatment for diverticulitis
clear liquid diet, analgesia, Augmentin or Flagyl + Cipro x 7 days
23
Inpatient treatment for diverticulitis (ie the elderly, immunosuppressed, those with significant comorbidities, and those with high fever or significant leukocytosis)
IV fluids, NG tube, IV abx. Surgery- Drainage of abscess, temp or perm colostomy
24
Most common form of congenital abnormality of the small intestine, resulting from an incomplete obliteration of the vitelline duct in 5th week of fetal development
Meckel's Diverticulum
25
Occurs on the antimesenteric border of the ileum, usually 60cm proximal to the ileocecal valve
Meckel's Diverticulum
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2% of the population, 2 feet from the ileocecal valve, and is about 2 inches long, 2% of patients develop a complication over their lifetime, present by age 2
rule of twos for Meckel's Diverticulum
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3 most common complications for Meckel's Diverticulum
GI bleeding, inflammation of diverticulum, intestinal obstruction
28
Part of the intestines has prolapsed into another section of intestine. Usually occurs at the terminal ileum (ileocecal)
intussusception
29
predominate cause of intestinal obstruction in persons aged 3 months to 6 years
intussusception
30