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Flashcards in Lower GI Deck (20)
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1

What is acute appendicitis ?

sudden onset inflammation of the appendix

2

What can cause appendicitis?

- obstruction of appendiceal lumen by a fecalith (poo), calculus, tumour or worms
- this causes an increased intraluminal pressure and bacteria invasion

3

What is the difference between visceral and parietal pain?

visceral - referred pain, pain in a different location
parietal - pain more localised

4

What are the symptoms of appendicitis?

- pain centrally and then moves down to the right iliac fossa

5

What is peritonitis?

when appendix is inflamed it comes into contact with the abdominal wall causing localised peritonitis (inflammation of the peritoneum)
- all the cavity can become inflamed in other conditions

6

What is the treatment of appendicitis ?

- removing by surgery
- sometime antibiotics

7

What is anti-biotic associated colitis/ pseudomembraneous colitis?

-Acute inflammation of the colon
- characterised by the formation of adherent inflammatory pseudomembranes overlying the site of mucosal injury

8

What are the causes of antibiotic associated colitis/ pseudomembraneous colitis?

- c.diff that has over grown after competing bowel organisms were eliminated by broad spectrum antibiotics

9

What are the symptoms of antibiotic associated colitis/ pseudomembraneous colitis?

- fever
- lower abdominal tenderness

10

What are the treatments for antibiotic associated colitis/ pseudomembraneous colitis?

- consult microbiologist
- stop current antibiotics
- possibly introduce new antibiotics (specific)
- hydrate patient
- move to side room

11

What is inflammatory bowel disease?

- chronic inflammation conditions of unknown reason affecting the GI tract
- two main forms:
- crohns disease
- ulcerative colitis

12

What is Crohns disease?

- It affects from mouth to anus
- especially effects ileum and colon
- it is not continuous along tract, more patches that it affects
- transmural inflammation (affects whole thickness of the wall)

13

What are the complications of crohns disease?

- can have fistula formation
- can fuse bowel to other places ( can get fecal matter passing to other places)

14

What symptoms may a patient present with in Crohns disease? (includes some complications)

- anaemia
- malabsorption: fat, vitamins A D E K, bile salts
- fistulas
- extra-intestinal: skin, eyes, joints
- increased risk of bowel carcinoma
- bowel obstruction and perforation

15

What is ulcerative colitis?

- affects colon only
-Starts in rectum spreads proximally
- Continuous disease
(No skip lesions)
- Mucosal disease
(No transmural involvement)
- May involve whole colon
also appendix

16

What are the complications of ulcerative colitis?


- Anaemia: iron deficiency from blood loss
- Electrolyte loss from diarrhoea
- Extra-intestinal disease: skin, eyes, joints, bile ducts (PSC)
- Increased risk of carcinoma: related to duration and severity of disease
- Need for surveillance for dysplasia

17

What contributes to cancer in the GI tract?

- genetics
FAP, lynch syndrome
- chronic inflammation
UC, Crohns
- dietary factors

18

What are the symptoms of bowel cancer? these normally only appear when cancer has developed?

- depends on the site of the lesion
- PR bleed
- altered bowel habit
- iron deficiency anaemia
- weight loss
- disease can be advanced at the time of the presentation

19

How do we screen for bowel cancer?

- in 60-75 year olds
- faecal occult blood test
- if positive refer for colonoscopy
- look for polyps
- see if adenomas or carcinomas
- refer for definitive treatment

20

What is the TNM staging process?

T - primary TUMOUR size
N - how many lymph NODES affected
M - any distant metastasis