Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
24 Cards in this Set
- Front
- Back
|
General theorized pathogenesis for appendicitis
|
fecolith blocks exit
Pressure grows inside appendix, growing larger thanBP Ischemia necrosis -> perforation or bacterial invasion leads to peritonitis and sepsis |
|
|
1st pain of appendicitis
|
periumbilical region
|
|
|
3 pain regions of GI tract
|
epigastrium (foregut)
periumbilical (midgut) suprapubic (hindgut) |
|
|
Why does McBurney's pt localize?
|
transmural inflammation that inflames serosal area
|
|
|
3rd sign of pain.
|
peritoneal signs, diffuse ab pain
|
|
|
Symptoms of appendicitis
|
ab pain
N/V mild fever/chills anorexia |
|
|
PE findings of appendicitis
|
tachycardia
low grade fever RLQ tenderness (rebound tenderness, rigid ab) Rovsing sign Psoas sign Obturator sign |
|
|
Most common position for appendix in appendicitis
|
retrocolonic
|
|
|
Dx eval of appendicitis
|
clinical eval
Labs: inc WBC (PMNs) US or CT (better) |
|
|
Management of appendicitis
|
broad-spectrum antibiotics
surgery |
|
|
Diverticulosis
|
presence of diverticulum
|
|
|
Diverticulitis
|
inflammation of diverticula
|
|
|
Pathogenesis of diverticulosis
|
aging or low fiber diet leads to weakening of colonic wall
|
|
|
epidemiology of diverticulosis
|
older age
predominantly Westerners mainly L-sided, not rectal |
|
|
Clinical manifestations of diverticulosis
|
majority of asymptomatic
hemorrhage stricture diverticulitis (abscess or fistula) |
|
|
What occurs in all diverticulitis?
|
microperforation, often in LLQ
|
|
|
Presentation of diverticulitis
|
constipation, fever, leukocytosis, bowel obstruction
|
|
|
Compare microperforation to macroperforation.
|
Micro has smaller diverticula w/ strictures
Macro can have peritonitis, abscesses, and fistulas |
|
|
What is contraindicated in diverticulitis?
|
barium enema
EGD |
|
|
Management of diverticulitis
|
clear liquid diet
antibiotics v/ Gram-, anaerobes check etiology surgery for recurrent, end colostomy |
|
|
Strong associations of C.diff
|
antibiotics
hospitalization debilitating states |
|
|
2 toxins of C.diff
|
Toxin A: enterotoxin, causes mucosal inflammation
Toxin B: direct cytotoxin, more potent |
|
|
Presentation of C.diff
|
diarrhea (inflammatory)
leukocytosis toxic megacolon in <3% |
|
|
Management of Pseudomembranous colitis
|
stop Abx
avoid anti-diarrheals metronidazole, vancomycin |
