small intestines

Question 1

length of small intestines

Answer 1

6meters

Question 2

mostly retroperitoneal

Answer 2

duodenum

Question 3

mesodermally derived structures

Answer 3

parietal and visceral peritoneum

peritoneal cavity

Question 4

extracoelomic herniation

Answer 4

5th week AOG

Question 5

s.i. retracted back to abdominal cavity; undergoes 270 degree counterclockwise rotation around the SMA

Answer 5

10th week AOG

Question 6

MC SURGICAL d/o of the small intestines

Answer 6

small bowel obstruction

Question 7

cardinal signs of partial/complete sbo

Answer 7

vomiting
obstipation
distention
crampy abdominal pain

Question 8

signs of strangulated SBO

Answer 8

Abdominal pain disproportionate to pe findings
tachycardia and leukocytosis
marked acidosis and hyperkalemia

Question 9

triad radiographic findings SBO

Answer 9

DAP
dilated bowel loops >3cm
air fluid level
paucity of air in the colon

Question 10

high pitched mettalic tinkling sound (water dripping into a large hollow container)

Answer 10

air fluid level in sbo

Question 11

slushing soung (succusion splash)

Answer 11

SBO

Question 12

Thickened small bowel loops
thumb printing sign
Pneumatosis intestinalis
pneumoperitoneum

Answer 12

strangulated SBO

Question 13

can distinguish between ileus and mechanical SBO

Answer 13

CT scan

Question 14

c or u shaped loop of bowel with its mesenteric vessels converging towards the point of constriction

Answer 14

closed loop obstruction

Question 15

gold standard imaging to differentiate between partial and complete obstruction

Answer 15

Small bowel series/ enteroclysis

Question 16

contraindications to non surgical treatment for SBO

Answer 16

Suspected ischemia
large bowel obstruction
closed loop obstruction
strangulated hernia
perforation

Question 17

abnormal communication between two epithelialized surfaces

Answer 17

fistula

Question 18

most small bowel fistula are

Answer 18

post op complications

Question 19

intestinal fistulas are usually spontaneous and are difficult to diagnose

Answer 19

internal fistulas

Question 20

direct communication between the intestine and the skin of the abdominal wall

Answer 20

external fistula

Question 21

factors that inhibit spontaneous closure of fistula

Answer 21

FRIEND
Foreign body
radiation
infection
epithelialization
neoplasm
distal obstruction

Question 22

most ideal period of fistula closure

Answer 22

10 days to 4 months

Question 23

adeno carcinoma of small bowel

Answer 23

duodenum

Question 24

excluding adenoca, malignant small bowel tumors are more common in

Answer 24

distal bowel- ileum

Question 25

tx for small bowel lymphoma

Answer 25

primary chemo (CHOP procedure)

Question 26

most prevalent congenital anomaly of the GIT true diverticulum 60% w/ heterotopic mucosa (pancreas/ gastric)

Answer 26

Meckel's diverticulum

Question 27

meckels are usually found in__

Answer 27

ileum

Question 28

persistence of vitelline and omphalomesenteric duct

Answer 28

meckel's diverticulum

Question 29

for narrow-based meckel's

Answer 29

diverticulectomy wide-based- segmental resection

Question 30

mc cause of acute mesenteric ischemia

Answer 30

arterial embolus | 95% with cardiac disease

Question 31

meseteric ischemia usually with atherosclerotic disease

Answer 31

arterial thrombosis usually Along proximal SMA CLOSE TO ORIGIN

Question 32

golden period of acute mesenteric ischemia

Answer 32

6 hrs

Question 33

insidiously develop | results from atherosclerotic lesions in the main splanchnic arteries (celiac, SMA, IMA)

Answer 33

Chronic mesenteric ischemia

Question 34

treatment for NOMI (Non occlusive mesenteric ischemia)

Answer 34

vasodilators papaverine

Question 35

pigtail sign in midgut volvulus (bowel loops spiraling about the axis of the mesenteric vessels) Abnormal C loop of duodenum in the UGIS Cecum at RUQ

Answer 35

MALROTATION

Question 36

Tx for malrotation

Answer 36

IV hydration NG suction Ladd procedure

Question 37

intermittent, colicky abdominal pain currant jelly stools sausage-shaped mass hyperactive bowel sounds

Answer 37

intussusception

Question 38

(+) dance sign pseudokidney sign target/ donut sign

Answer 38

intussusception

Question 39

tx intussusception

Answer 39

air then hydrostatic reduction barium enema

Question 40

non passage of meconium in the 1st 24 hrs of life maternal polyhydramnios billous emesis

Answer 40

intestinal atresia

Question 41

apple peel atresia

Answer 41

IIIB

Question 42

mucosal atresia with intact bowel wall and mesentery

Answer 42

I

Question 43

BLIND END separated by a v shaped defect

Answer 43

IIIA

Question 44

BLIND END separated by a CORD

Answer 44

II

Question 45

Multiple atresia( string of sausages)

Answer 45

IV

Question 46

Family history of cyctic fibrosis food intolerance billous emesis

Answer 46

meconium ileus

Question 47

soap bubble sign ground glass appearance microcolon and egg shell pattern inspissated meconium

Answer 47

meconium ileus

Question 48

double bubble sign is seen in

Answer 48

duodenal atresia- mc duodenal web annular pancreas

Question 49

mc and lethal gastrointestinal d/o affecting preterm neonate

Answer 49

necrotizing enterocolitis

Question 50

necrotizing enterocolitis usually affects

Answer 50

terminal ileum

Question 51

indication of surgery in necrotizing enterocolitis

Answer 51

pneumoperitoneum

Question 52

most potent intestinotrophic hormones

Answer 52

GLP-2

Question 53

MOst common subtype of short bowel syndrome

Answer 53

TYPE 2- small bowel resection with partial colon resection

Question 54

best tolerated subtype of short bowel syndrome

Answer 54

TYPE 3- small int resection with SB anastomosis w/ intact colon

Question 55

presence of less than 200cm residual small bowel

Answer 55

short bowel syndrome