Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Surgery > Surgery ( Adynamic Bowel Obstruction) > Flashcards

Surgery ( Adynamic Bowel Obstruction) Flashcards

(212 cards)

Start Studying
1
Q

Congenital megacolon/ Hirschsprung disease

A

Loss of ganglion cells in both aurebach & mesissner’s plexus of variable portion of the rectum and colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Mc site of hirschsprung disease

A

Rectum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hirschsprung disease a/w

A

Down syndrome

Men 2A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Factor implicated in the hirschsprung diseases

A

GLial derived neurotrophic factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Squirt sign

A

Hirschsprung disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

IOC for hirschsprung disease

A

Full thickness rectal biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

IHC for hirschsprung disease

A

Acetylcholinesterase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Name of the surgery for the Hirschsprung diseases

A

Swenson
Suave
Duhamel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

IOC of mesenteric ischemia

A

Ct angiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

MC cause of the Mesenteric ischemia

A

Acute mesenteric artery embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Mc source of the embolism

A

Atrial fibrillation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Embolectomy done by

A

Fogarty catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Thumb print sign on x ray suggestive of

A

Bowel ischemia/ ischemic colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Mc cause of paralytic ileus

A

Post operative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Mc cause of prolonged paralytic ileus

A

Hypokalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which part firstregains motility after the bowel surgery

A

Jejunum / small instestine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Ogilvie syndrome/ primary colonic psudeo obstruction mx

A

Catchpole regimens - Iv neostigmine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Higher chances if skin excoriation seen with

A

Ileostomy> colostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pouts like

A

Ileostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Same level as that of skin

A

Colostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Placement of the stoma ?

A

Outer border of the rectus abdominus
Away from the bony landmarks
Along the spinoumbilical line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Earliest complications of the stoma

A

Necrosis of stoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Overall most common complication of stoma

A

Skin excoriation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Mc long term complication of colostomy

A

Para stomal herniation

Loop colostomy > end colostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Short bowel syndrome
< 200 cm of small intestine
26
Mc cause of short bowel syndrome
Superior mesenteric artery embolism
27
Mx of short bowel syndrome
Total parental nutrition Drugs - gastic empty inhibitor- Teduglutide Bile acids - cholestyramine Anti motility- Loperamide Sx - Bianchi & step procedure
28
Mc site involve in the Crohn disease
Terminal ileum
29
Mc gene involve in the Chron’s disease
NOD2/Card 15 gene
30
Hallmark feature of crohn disease
Anorectal fistula formation
31
Creeping fat is feature of
Crohn disease
32
All the layer of bowel ( Transmural) involved in
Crohn disease
33
Type of granuloma present in the crohn disease
Non- caseating granuloma
34
Earliest manifestation of Crohn’s disease!?
Apthous ulcer
35
String sign of kantor present in!?
Crohn’s disease
36
Marker of the Crohn’s disease !?
Stool calprotectin
37
Antibody present in the Crohn’s disease
ASCA ( Anti saccharomyces cerevisiae antibody)
38
Cobble stone mucosa appearance is feature of
Crohn’s disease
39
IOC of Crohn’s disease
Colonoscopy + biopsy
40
Mx of the Crohn’s disease
Steroids (Doc) Azathioprine Mycophenolate Infliximab ( TNF alpha antagonist)
41
Risk factor for the Crohn’s disease
Smoking | Increased consumption of refined diet
42
Crohn’s disease and ulcerative colitis are a/w increase……..
Risk of cancer
43
Smoking is protective in
Ulcerative colitis’s
44
Mc site of ulcerative colitis
Rectum
45
Pseudo polyp is feature of
Ulcerative colitis
46
35 year old female comes with colicky pain , she told that she notice fresh bleeding in the stool and has fever , chills & Rigors and she is trying to conceives the baby but not able to do it what is the dx !?
Crohn’s disease C/f - colicky pain Hematochezia Intra abdominal abscess fever , chills , Rigors Adhesions with fallopian tube decreases the motility of fallopian tube : infertility or ectopic pregnancy
47
38 yr male comes with complain of painless bloody diarrhea 10-15 times /day on examination he has puffy eyes , pedal edema what is the dx!?
Ulcerative colitis C/f - painless bloody diarrhea + Hypoprotinemia
48
Antibody found in the ulcerative colitis’s
P-ANCA ( Peri - nuclear anti cytoplasmic antibody)
49
Ba enema - lead pipe appearance is feature of !?
Ulcerative colitis
50
Earliest radiological feature of UC !?
Mucosal granulation (mc) Other - Loss of haustration Lead pipe colon
51
IOC Of UC !?
BIOPSY
52
Doc of UC!?
Sulphasalazine. Sulphasalazine is prodrug converted into 5 ASA ( Amino salicylic acid)
53
Definitive treatment of UC!?
Total proctocolectomy
54
Mc complication of sx in the UC!?
Pouchitis
55
Mc complication a/w mortality in the case ulcerative colitis!?
Small bowel obstruction
56
All extra intestinal manifestation resolve after surgery in UC except !?
1) primary sclerosing cholangitis | 2) ankylosing spondylitis
57
To called TOXIC MEGACOLON dilated loops of bowel should be
> 6 cm
58
MC part of the colon involve in the case of toxic megacolon!?
Transverse colon
59
How to define Pseudomembranous colitis !?
Received antibiotics in previous 3 months | Or hospitalized patient > 48 hours admission
60
Mc antibiotics a/w with pseudomembranous colitis’s!?
Cephalosporins > clindamycin
61
Toxin responsible for PMC!?
Clostridium difficile toxin A/B
62
Dx test for the PMC!?
Enzyme immune assay - glutamate dehydrogenase
63
Ideal test for the PMC !?
PCR for cl. Difficle gene
64
DOC for the PMC!?
Vancomycine
65
TOC for the psudeomembranous colitis!?
Fecal transplantation
66
Most common extra intestinal manifestation of IBD !?
Arthritis CD> UC
67
Most common site of diverticular disease!?
Sigmoid colon
68
IOC of Diverticulosis!?
Barium enema ( saw tooth appearance)
69
MCC of bleeding per rectum !?
Hemmorhoids
70
MCC or bleeding per rectum in neonate!?
Intussusception
71
MCC of bleeding per rectum in elderly patients
Ca of colon
72
Hinchey classification used for !?
Diverticulitis
73
Hinchey classification!?
1 - pericolic absecss 2- pelvic abscess 3- purulent peritonitis 4- fecal peritonitis
74
IOC for the diverticulitis is !?
CECT
75
LONG term complication of diverticulitis!?
Colovesical > colovaginal fistula
76
MCC of Massive lower GI hemorrhage!?
Diverticulitis
77
Angiodysplasia !?
Dilated submucosal vein
78
Most common site of Angiodysplasia !?
Caecum
79
Dx & mx for the Angiodysplasia!?
Colonoscopy / capsule endoscopy & cauterisation
80
Angiodysplasia + Aotic stenosis
Heyde syndrome
81
Angiodysplasia + von willebrand factor gene involve!?
ADAMTS 13 gene
82
Horizontaal ulcer causes strictures lead to Bowel obstruction in case of !?
BOWEL TB
83
Longitudinal ulcer in the Bowel causes perforation in case of !?
TYPHOID
84
Most site of TB infection in BOWEL !?
Terminal ileum
85
Crohn’s stricture mx !?
Stricturoplasty Heinke mikulicz Finney
86
Goose neck deformity found in !?
Bowel TB
87
Sterlen & fleischner / inverted umberlla sign is feature of !?
Bowel TB
88
Most common site of Appendix !?
Retrocecal
89
2nd most common site of Appendix !?
Pelvic
90
Mcc cause of acute appendicitis!?
Obstruction
91
Most common cause of obstruction!?
Faecolith ( capo4)
92
Max incidence of the acute appendicitis are seen in !?
Teenagers ( male > female)
93
Scoring system used in the appendicitis
MANTRELS scoring / ALVARADO score
94
2 points to which in the MANTRELS SCORING system !?
LT -2 ``` Migration of pain - 1 Anorexia. -1 Nausea & vomiting- 1 Tenderness. -2 Rebound pain. -1 Elevated temperature- 1 Leuckocytosis - 2 Shift of white blood cell count to left -1 ```
95
McBurney’s point tenderness is feature of !?
Acute appendicitis Mc burney’s point - 2/3 rd from the umbilicus to 1/3 rd ASIS
96
Rovsing sign
Pressure on left iliac fossa - pain in right iliac fossa
97
Psoas sign / cope psoas sign!?
Pain on hyperextension of right hip or flexion of right hip against resistance
98
Obturator sign !?
Flexion & internal rotation of right hip
99
Non specific sign of appendicitis!?
Dunphy sign - pain on coughing Ten horn sign - pain on pulling right testis Aaron sign - pressure on right iliac fossa - pain in epigastrium
100
IOC OF appendicitis in adults !?
CECT
101
IOC OF appendicitis in children!?
USG
102
Base of the appendix
Junction of the 3 taenia coil
103
Perforated appendix incision!?
Lower midline incision
104
Most common complication on appendicectomy !?
Wound infection
105
Most common long term complication of the appendicectomy !?
Adhesive intestinal obstruction
106
Injury to illiohypogastric nerve during the appendicectomy increase the risk of ………. !?
Right inguinal hernia
107
Most common extrauterine abdominal emergency in pregnancy!?
Appendicitis
108
Mx of appendicular lump !?
Ochsner sherren regimen Treatment - NPO IV fluids IV antibiotics Painkillers Monitor - vital signs Temperature Size of lump Tenderness
109
Most common site of carcinoid tumor
Appendix
110
Most common malignant appendicular tumor of the appendix !?
Mucinous adenocarcinoma
111
Dx of mucinous adenocarcinoma
Imaging & HPE
112
Mx of mucinous adenocarcinoma of appendix !?
Right hemicolectomy followed by chemotherapy
113
Mc of appendicular carcinoid !?
< 2 cm size & > 2 cm from base - simple appendicectomy > 2cm & < 2 cm from base - Right hemicolectomy
114
Jelly like deposition in peritoneal cavity !?
Pseudomyxoma peritonei
115
Tumors that can give rise to pseudomyxoma peritonei !?
Primary peritoneal tumor 2 ‘ to mucinous adenocarcinoma of appendix 2’ to mucinous adenocarcinoma of ovary
116
Earliest symptoms in a patient with acute appendicitis
Periumbilical pain
117
Organisms is most commonly isolated in patient presenting with perforated appendicitis!?
Bacteroids fragilis
118
Maximum stump size that you can leave behind in order to prevent stump appendicitis??
5mm
119
Most common differential diagnosis of acute appendicitis!?
Yersinia enterocoilitica infection
120
Psuedomyxoma peritonei mx !?
Cytoreductive surgery + hyperthermic intraperitoneal chemotherapy ( paclitaxel + mitomycin c )
121
Most common type of colorectal polyps !?
Hyperplastic colorectal polyps ( not premalignant)
122
Juvenile polyposis syndrome
SMAD4 gene mutation AD condition Multiple polyps (3-100) Increased risk of cancer Mc site - rectum
123
Perioral melanosis is pathognomonic feature of ……….
Peutz jeghers syndrome
124
Gene involved in the case of peutz jeghers syndrome !?
STK-11/ LKB-1 gene on chromosome 19 Autosomal doMinant condition
125
Most common presentation of peutz jeghers syndrome!?
Bowel obstruction
126
Most common site of peutz jeghers syndrome
Jejunum
127
100 times in increase risk of cancer……… jn peutz jeghers syndrome
Pancreatic cancer
128
Type of Polyps which has the highest risk of cancer !?
Villous > tubular > sessile > pedunculate polyps
129
Haggit classification is for !?
Pedunculate polyps
130
Gardener syndrome
FAP + soft tissue sarcoma [ desmoid, osteomas, sebaceous cyst)
131
Turcot syndrome!?
FAP + brain tumor M/c - Glioblastoma M/c in children- medullablastoma
132
Dx and surgery for FAP & its complication ?,
Colonoscopy + biospy Total proctocolectomy + ileoanal pouch Mc complication- pouchitis Mcc of death following surgery- small intestine obstruction
133
Mc site of FAP !?
Rectum
134
FAP A/w with 100 % risk of ………. Cancer
Colorectal cancer
135
Hallmark feature of FAP !?
> 100 adenomatous polyps
136
Most common gene involve in the HNPCC/ LYNCH syndrome !?
MSH2 > MLH1 gene
137
HNPCC detected by the ………..
Bethesda classification
138
Lynch syndrome 1 ?
Most common Risk of colorectal cancer is increased by 70-80 %
139
Lynch 2 syndrome !?
Extra colonic cancer ``` Uterine cancer (MC ) Ovarian cancer Pancreatic cancer ```
140
Modified Amsterdam criteria used for !?
HNPCC
141
Muir Torre syndrome!?
Variant of HNPCC Benign & malignant tumors of sebaceous glands Keratocanthomas
142
Most common malignancy of GI tract !?
Colorectal cancer
143
Most site of colorectal cancer !?
Rectum
144
Most common colonic site for the colorectal cancer !?
Sigmoid colon
145
Best modality for the screening the colorectal cancer !?
Colonoscopy
146
Anemia is feature of which side of the colorectal cancer
Right sided
147
Constipation is feature of which sided colorectal cancer !?
Left sided lesion
148
Apple core deformity on barium enema is feature of
Colorectal ca
149
Distant metastasis for the colorectal ca
Liver
150
…………. 100 times risk for the colorectal cancer
Ueterosigmoid anastomosis
151
IOC for staging colorectal ca !?
Pet -ct
152
IOC for T & N rectal cancer
MRI
153
Duke staging / modified Astler coller classification is for !?
Colorectal cancer Duke A - mucosa + submucosa B- into muscle layer B2- Beyond the muscle layer C1- into muscle layer + lymph node involvement C2 - beyond muscle layer + lymph node involved D - distant metastasis 5 year survival for Duke A - 90 %
154
Mc site for the ischemic colitis!?
Splenic flexure aka Griffith point
155
If tumour is in cecum !?
Right hemicolectomy
156
If cancer is in ascending colon / hepatic flexure / transverse colon
An extended right hemicolectomy ( ileum + ileocecal junction + ascending colon/hepatic flexure/ transverse colon + MCA + right and ileocolic artery
157
If the cancer is in the splenic flexure/ descending colon
Left hemicolectomy
158
If tumour is in sigmoid colon !?
LOW anterior resection ( sigmoid + rectum ) + total mesorectal excision
159
If tumor is within 5 cm from the anal verge !?
Abdominoperineal resection & permanent end colostomy + total mesorectal excision ( to prevent recurrence rate )
160
Chemotherapy used for colorectal in advanced stage !?
FOLFOX- 5 FU , folinic acid , oxaliplatin FOLFIRI- 5 FU , folinic acid , irinotecan CAPEOX - Capecitabine , oxaliplatin
161
Mc prognostic factor for colorectal CA !?
Lymph node status
162
Colorectal cancer tum our marker !?
CEA ( carcinoembryonic antigen)
163
Mc Anal carcinoma!?
Squamous cell carcinoma
164
To determine the extent of disease in anal carcinoma !?
MRI
165
TOC for anal canal carcinoma !?
NIGRO’s carcinoma 1 month chemoradiotherapy ( 5 FU + mitomycin/ cisplatin ) Fails - APR SECTION
166
Most common position of DRE !?
Left lateral/ sims position
167
Contraindications for DRE !?
Acute anal fissure
168
Mucosal fold present in the rectum’!?
Houston valve
169
Pain can be felt on DRE !?
Below the dentate line
170
Children + H/o of bouts of diarrhea what is the dx & tx !?
Partial thickness prolapse Mucosal prolapse 1st episode - digital reposition Recurrent- sclerotherapy , Thiersch wiring
171
Full thickness prolapse involve !?
Anterior wall
172
Frail + elderly patient comes with full thickness prolapse !?
Perineal approach - Thiersch wiring - Delorme repair - Altemier repair
173
Young + fit patient comes with full thickness prolapse !?
Abdominal approach Well’s & Ripstein Rectopex Frykman Goldberg - Resection rectopexy
174
IOC IN ANORECTAL MALFORMATION
MRI
175
Most common anorectal abnormality in male !?
Rectobulbar
176
MC anorectal abnormality in female !?
Vestibular fistula
177
Mx of the anorectal malformation!?
PSARP ( posterior saggital Anorectoplasty
178
Pilonidal sinus
Aka jeep driver disease
179
Most common site of pilonidal sinus !?
Natal cleft
180
Definite surgery for the Pilonidal sinus !?
Rhomboid/ Limberg flap Kardyakis surgery Bascom procedure
181
Mcc of bleeding per rectum !?
Hemorrhoids aka piles
182
Piles is d/t !?
Bleeding from dilated vascular channels Pathology- Loss of elasticity of anal cushions
183
Sites of primary hemorrhoids!?
11 o clock , 3 O’ clock , 7 o’ clock
184
Thrombosed pile !?
Aka melgney 5 day self healing lesion Painful reddish / bluish nodule
185
…… only hemorrhoids felt on DRE !?
Thrombosed piles
186
IOC for hemorrhoids!?
Proctoscopy
187
Grades for the hemorrhoids!?
Grade 1- only bleeding no prolapse Grade 2 - prolapse but spontaneously pushed inside Grade 3 - have to pushed inside Grade 4 - Remained prolapsed
188
Grade 1 hemorrhoids mx !?
Lifestyle modification Avoid fried, fatty food , high fiber diet & increased liquid intake Laxative Sitz bath
189
Grade 2 hemorrhoids mx !?
Lifestyle + banding > sclerotherapy
190
Mc agent used in sclerotherapy is !?
Sodium tetradecyl so4
191
Grade 3 piles mx !?
Grade 2 + surgery
192
Grade 4 piles mx !?
Surgery
193
Procedure of choice in the hemorrhoids!?
Stapled haemorrhoidopexy
194
Milligan Morgan hemorrhoidectomy !?
Open hemorrhoidectomy
195
Ferguson hemorrhoidectomy !?
Closed
196
Mc complication of haemorrhoidectomy !?
Urinary retention
197
Anal fissure !?
Breach in continunity of anal epithelium
198
Mc site of anal fissure
6 o clock posterior midline
199
Mc anal fissure after vaginal delivery!?
12 o clock anterior midline
200
Mx of anal fissure
Lifestyle modification + local applications of 2 % xylocaine jelly Dilitazem cream and nitrate gel
201
Surgery if choice in anal fissure !?
Lateral anal sphincterotomy
202
Mcc of perianal abscess !?
Infection of the anal gland
203
Mx perianal abscess !?
I & D Incisin - cruciate ( diamond shaped )
204
Water can perineum ( mutliple perianal fistula ) cause !?
``` Crohn disease ( KRohn’s) Trauma ( krush) TB ( koch) Cancer ( kancer) Immunocompromised ```
205
Goodsall’s rule
For the identification of the internal opening of the ana fistula
206
IOC of anal fistula !?
MR Fistulogram
207
Most common perianal fistula acc to park’s classification!!?
Intersphincteric
208
Mx of high anal fistula!?
Seton treatment
209
Low anal fistula mx !?
Fistulotomy , fistulectomy , LIF & VAFS
210
Fistulotomy & fistulectomy not done for …….,
Inter sphincter & trans sphincteric fistulae
211
Strawberry lesion of recto sigmoid is d/t !?
Infection by spirochetes or B fusiformis
212
Meconium ileus is a presentation seen in with !?
Mucoviscidosis

Surgery (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions