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Flashcards in small intestine Deck (58):
1

Where is calcium primarily absorbed

duodenum

2

produced by D cells

somatostatin

3

Produced by G cells

Gastrin

4

Produced by I cells

Cholecystokinin

5

Produced by M cells

Motilin

6

Produced by L cells

1. peptide YY
2. Glucagon like peptide

7

Produced by S cells

Secretin

8

Inhibits Gi secretion, motility and splanchnic perfusion

somatostatin

9

Stimulates exocrine pancreatic secretion, stimulate intestinal secretion

secretin

10

Stimulate exocrine pancreatic secretion, stimulate gallbladder emptying

cholecystokinin

11

stimulate intestinal motility

motilin

12

stimulate intestinal proliferation

glucagon like peptide 2

13

inhibit intestinal motility and secretion

peptide YY

14

Most common cause of small bowel obstruction

intraabdominal adhesion

15

What portion of the duodenum is compressed in superior mesenteric artery syndrome

3rd portion of duodenum

16

What is the confirmatory test of small bowel obstruction

abdominal series

17

Triad of small bowel obstruction in radiograph

1. dilated small bowel loops >3 cm
2. air fluid level
3. paucity of air in the colon

18

What is another name for acute colonic pseudo obstruction

ogilvie syndrome

19

treatment of ogilvie syndrome

IV neostigmine
Iv atropine to counteract bradycardia

20

What is the normal temporal pattern of GI motility

24 hours - small intestine
48 hours - gastric motility
3 - 5 days - colonic motility

21

Inraoperative measure to reduce ileus

1. minimize handling of bowel
2. laparoscopic approach
3. avoid exxcessive intraoperative fluid administration

22

Post operative measures to reduce ileus

1. early enteral feeding
2. epidural anesthesia, if indicated
3. avoid excessive IV fluid administration
4. correct electrolyte abnormality
5. consider M opioid antagonist

23

Treatment of crohn's disease

Sulfasalazine + steroids

24

Treatment of ulcerative colitis

Sulfasalazine + steroids

25

Earliest leion of crohn's disease

aphthous ulcer

26

This is pathognomonic of crohn's disease: encroachment of mesenteric fat onto the serosal surface of the bowel

fat wrapping

27

Lead pipe colon (lacks hautral markings)

ulcerative colitis

28

Most common area affected by crohn's disease

distal ileum

29

Most common cause of enterocutaneous fistula

iatrogenic

30

What is a low output fistula

less than 200 ml/day

31

What is a high output fistula

more than 500 ml/day

32

90% of fistula are going to close within how many weeks interval

5 weeks

33

Most useful initial test in a fistula

CT scan

34

Fistula usually manifest in how many post operative days

5th to 10th post operative day

35

What are the factors that inhibit closure of fistula?

FRIEND

36

Most common benign neoplasm of small intestine

Adenoma

37

Most common location for primary adenocarcinoma and adenoma in small bowel

duodenum

38

Most common location of GIST

stomach (60 - 70%)

39

Most common mode of presentation of adenocarcinoma in the small bowel

Partial small bowel obstruction

40

What is the most commonly affected area of radiation enteritis

Terminal Ileum

41

Most accurate way to diagnose radiation enteritis

enteroclysis

42

Treatment of radiation enteritis

supportive therapy

43

Most common heterotropic muscosa of meckel's diverticulum

gastric mucosa (60%)

44

Most prevalent congenital anomaly of the GI tract

Meckel's diverticulum

45

Pathology of Meckel's Diverticulum

Failure of ophalomesenteric (vitelline) duct to undergo obliteration during the 8th week of gestation

46

Most common sign of meckel's diverticulum

bleeding in pediatrics
intestinal obstruction in adults

47

Treatment of meckel's diverticulum

diverticulectomy

48

It is the most sensitive test to detect jejunoileal diverticula

enteroclysis

49

Most common's of acute mesenteric ischemmia

1. MCC - arterial embolus
2. Most common source - heart
3. most common location - SMA

50

Golder period of mesenteric ischemia

3 hours - intestinal sloughing
6 hours - full thickness intestinal infarction

51

Most common symptom of chronic mesenteric ischemia

postprandial abdominal pain

52

Diagnostic exam of choice for itussuception

CT scan: Target Sign

53

Where can the base of the appendix always be found

confluence of the taenia

54

What is a constant symptom of appendicitis

anorexia

55

What is the most common surgical emergency in pregnancy

appendicitis
-usually occurs in 2nd trimester

56

Most consistent sign of appendicitis in pregnant woman

pain in right side of the abdomen

57

Most common carcinoid appendiceal tumor

carcinoid - appendix (50%)

58

Treatment of carcinoid tumor

< 2 cm at distal appendix - appendectomy
> 2 cm at base - right hemicolectomy