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Surgery PLE COPY > small intestine > Flashcards

small intestine Flashcards

1
Q

Where is calcium primarily absorbed

A

duodenum

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2
Q

produced by D cells

A

somatostatin

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3
Q

Produced by G cells

A

Gastrin

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4
Q

Produced by I cells

A

Cholecystokinin

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5
Q

Produced by M cells

A

Motilin

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6
Q

Produced by L cells

A
  1. peptide YY 2. Glucagon like peptide
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7
Q

Produced by S cells

A

Secretin

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8
Q

Inhibits Gi secretion, motility and splanchnic perfusion

A

somatostatin

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9
Q

Stimulates exocrine pancreatic secretion, stimulate intestinal secretion

A

secretin

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10
Q

Stimulate exocrine pancreatic secretion, stimulate gallbladder emptying

A

cholecystokinin

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11
Q

stimulate intestinal motility

A

motilin

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12
Q

stimulate intestinal proliferation

A

glucagon like peptide 2

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13
Q

inhibit intestinal motility and secretion

A

peptide YY

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14
Q

Most common cause of small bowel obstruction

A

intraabdominal adhesion

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15
Q

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

A

3rd portion of duodenum

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16
Q

What is the confirmatory test of small bowel obstruction

A

abdominal series

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17
Q

Triad of small bowel obstruction in radiograph

A
  1. dilated small bowel loops >3 cm 2. air fluid level 3. paucity of air in the colon
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18
Q

What is another name for acute colonic pseudo obstruction

A

ogilvie syndrome

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19
Q

treatment of ogilvie syndrome

A

IV neostigmine Iv atropine to counteract bradycardia

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20
Q

What is the normal temporal pattern of GI motility

A

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

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21
Q

Inraoperative measure to reduce ileus

A
  1. minimize handling of bowel 2. laparoscopic approach 3. avoid exxcessive intraoperative fluid administration
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22
Q

Post operative measures to reduce ileus

A
  1. early enteral feeding 2. epidural anesthesia, if indicated 3. avoid excessive IV fluid administration 4. correct electrolyte abnormality 5. consider M opioid antagonist
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23
Q

Treatment of crohn’s disease

A

Sulfasalazine + steroids

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24
Q

Treatment of ulcerative colitis

A

Sulfasalazine + steroids

25
Q

Earliest leion of crohn’s disease

A

aphthous ulcer

26
Q

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

A

fat wrapping

27
Q

Lead pipe colon (lacks hautral markings)

A

ulcerative colitis

28
Q

Most common area affected by crohn’s disease

A

distal ileum

29
Q

Most common cause of enterocutaneous fistula

A

iatrogenic

30
Q

What is a low output fistula

A

less than 200 ml/day

31
Q

What is a high output fistula

A

more than 500 ml/day

32
Q

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

A

5 weeks

33
Q

Most useful initial test in a fistula

A

CT scan

34
Q

Fistula usually manifest in how many post operative days

A

5th to 10th post operative day

35
Q

What are the factors that inhibit closure of fistula?

A

FRIEND

36
Q

Most common benign neoplasm of small intestine

A

Adenoma

37
Q

Most common location for primary adenocarcinoma and adenoma in small bowel

A

duodenum

38
Q

Most common location of GIST

A

stomach (60 - 70%)

39
Q

Most common mode of presentation of adenocarcinoma in the small bowel

A

Partial small bowel obstruction

40
Q

What is the most commonly affected area of radiation enteritis

A

Terminal Ileum

41
Q

Most accurate way to diagnose radiation enteritis

A

enteroclysis

42
Q

Treatment of radiation enteritis

A

supportive therapy

43
Q

Most common heterotropic muscosa of meckel’s diverticulum

A

gastric mucosa (60%)

44
Q

Most prevalent congenital anomaly of the GI tract

A

Meckel’s diverticulum

45
Q

Pathology of Meckel’s Diverticulum

A

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

46
Q

Most common sign of meckel’s diverticulum

A

bleeding in pediatrics intestinal obstruction in adults

47
Q

Treatment of meckel’s diverticulum

A

diverticulectomy

48
Q

It is the most sensitive test to detect jejunoileal diverticula

A

enteroclysis

49
Q

Most common’s of acute mesenteric ischemmia

A
  1. MCC - arterial embolus 2. Most common source - heart 3. most common location - SMA
50
Q

Golder period of mesenteric ischemia

A

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

51
Q

Most common symptom of chronic mesenteric ischemia

A

postprandial abdominal pain

52
Q

Diagnostic exam of choice for itussuception

A

CT scan: Target Sign

53
Q

Where can the base of the appendix always be found

A

confluence of the taenia

54
Q

What is a constant symptom of appendicitis

A

anorexia

55
Q

What is the most common surgical emergency in pregnancy

A

appendicitis -usually occurs in 2nd trimester

56
Q

Most consistent sign of appendicitis in pregnant woman

A

pain in right side of the abdomen

57
Q

Most common carcinoid appendiceal tumor

A

carcinoid - appendix (50%)

58
Q

Treatment of carcinoid tumor

A

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

Surgery PLE COPY (16 decks)

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