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GI > Week 8 > Flashcards

Week 8 Flashcards

1
Q

If a pain shifts, what type of pain is it?

A

Visceral

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2
Q

If a pain is spreading, what type of pain is it?

A

Somatic

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3
Q

What type of pain does inflammation cause?

A

Throbbing

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4
Q

What type of pain does obstruction cause?

A

Colic

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5
Q

What does tenderness to percussion suggest?

A

Peritonism

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6
Q

What does the iliopsoas test test for?

A

Appendicitis

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7
Q

what is an acute abdomen?

A

Less than 10 days

Progressive intra-abdominal condition

Causes severe morbidity or threat to life

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8
Q

What is Rosvig’s sign?

A

Sign of appendicitis

If palpation of the abdomen makes RIF pain worse

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9
Q

What are the initial investigations for the acute abdomen?

A

Bloods

CHECK AMYLASE

ABG

Plain radiology

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10
Q

What is the Hartmann’s procedure?

A

Removal of sigmoid colon

Leave the rectum in

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11
Q

What are haemorrhoids?

A

Enlarged vascular cushions in the lower rectum and anal canal

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12
Q

If a patient comes in with painless bleeding from the rectum and itchiness, what do they have?

A

Haemorrhoids

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13
Q

When the patient is in the lithotomy position, where do haemorrhoids tend to occur?

A

Same places as the branches of the superior haemorrhoidal artery

3 o’clock

7 o’clock

11 o’clock

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14
Q

What is the HALO procedure used for?

A

Haemorrhoidal artery ligation

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15
Q

What is rectal prolapse?

A

Protruding mass from the anus, especially during defecation

Examination shows poor anal tone

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16
Q

What is the treatment for anal fissures?

A

Dietary advice and stool softeners

Lateral sphyncterotomy

Botox injection

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17
Q

What is the management for an anal fistula?

A

Laying open

Insertion of Seton

LIFT procedure

Glue

Defunctioning colostomy

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18
Q

If a patient comes in with a low grade fever, calf tenderness and shiny skin along with swelling, what do they have?

A

DVT

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19
Q

What tests should you do on a patient who you suspect has a DVT?

A

D-dimer

Doppler ultrasound

Venography

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20
Q

What can be done to prevent a DVT?

A

Compression stockings

Low-dose subcutaneous heparin

Early mobilisation

21
Q

What is atelectasis?

A

Collapse or closure of the lung resulting in reduced gas exchange

Can lead to pneumonia

22
Q

What is an ileus?

A

Paralysis of intestinal mobility

23
Q

What can cause ileus?

A

Handling of bowel

Peritonitis
Injury

Immobilisation

Hypokalaemia

Drugs

24
Q

How does an ileus present?

A

Vomiting

Abdominal distension

Dehydration

Silent Abdomen

25
Q

What is anastomotic dehiscence?

A

Breakdown of anastomosis caused by:

Poor technique

Poor blood supply

Tension on anastomosis

26
Q

What are the symptoms of an upper small bowel obstruction?

A

Acute onset (within hours)

Large volumes vomited

27
Q

What are the symptoms of a distal small bowel/large bowel obstruction?

A

Colicky abdominal pain and distension

Vomiting (possibly faeculent)

28
Q

If a patient vomits up copious amounts of bile-stained fluid, where is the obstruction?

A

Upper small bowel

29
Q

If a patient vomits up semi-digested food eaten a day or two ago with no bile, where is the obstruction?

A

Gastric

30
Q

If a patient vomits up thick, brown, foul smelling vomitus, where is the obstruction?

A

More distal

31
Q

What can chronic, incomplete obstruction lead to within the bowel?

A

Hypertrophy of the muscle of the bowel wall proximally

This gives the classic ‘colicky’ pain

32
Q

If there is a bowel obstruction, what do the bowel sounds sound like?

A

Tinkling

33
Q

What is the most useful initial investigation for a suspected bowel obstruction?

A

Supine abdominal X-ray

34
Q

In what conditions do inflammatory strictures usually occur?

A

Crohn’s disease

Diverticular disease

35
Q

What is Ogilvie’s syndrome?

A

Pseudo-obstruction

Acute dilatation of the colon in acutely unwell patients

36
Q

What 3 arteries make up the spermatic chord?

A

Testicular artery
Artery to vas
Cremasteric artery

37
Q

What 3 nerves make up the spermatic chord?

A

Ilio-inguinal
Genital branch of genito femoral
Sympathetic

38
Q

What is contained within the spermatic chord

A 
Testicular artery
Artery to vas
Cremasteric artery
Ilio-inguinal nerve
Genital branch of genito femoral nerve
Sympathetic nerve
Pampiniformvenous plexus
Vas
Lymphatics
39
Q

Where is the inguinal ring?

A

2cm above the centre of the inguinal canal

40
Q

What is an obturator hernia?

A

Cause of small bowel obstruction in elderly females

Hernia of the pelvic floor

41
Q

What is the first line investigation for cholecystitis/biliary colic?

A

Ultrasound

42
Q

What is the second line investigation for cholecystitis/biliary colic?

A

MRCP &/or ERCP

43
Q

What investigations do you do to confirm pancreatitis?

A

Bloods
SERUM AMYLASE
Ultrasound - rule out biliary problems

CT

44
Q

What is the first line investigation for perforation?

A

Erect chest X-ray

Then CT

45
Q

What is the first line investigation in appendicitis?

A

Ultrasound

46
Q

What is the first line investigation in diverticulitis?

A

CT

47
Q

What is the first line investigation in bowel gas/fluid retention?

A

If bowel source: AXR

If fluid suspected - ultrasound

48
Q

What can be used to investigate acute GI bleeding?

A

Endoscopy

CT with IV contrast

49
Q

What can be used to investigate dysphagia?

A

Endoscopy

Barium swallow

GI (22 decks)

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