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30 Cards in this Set
- Front
- Back
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where is the mc location for diverticulosis?
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sigmoid colon
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what is the test of choice for diverticulosis diagnosis?
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barium enema
(abdominal x-ray usually normal) |
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what is the test of choice for diverticulitis diagnosis?
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CT w/ oral and IV contrast
(barium enema/colonoscopy contraindicated) |
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what are the common complications of diverticulitis?
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abscess
colovesical fistula obstruction free colonic perforation |
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what is the initial treatment of diverticulitis?
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IV antibiotics
bowel rest (NPO) IV fluids (if sxs persist >3d, consider sx) |
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how is angiodysplasia (AV malformations, vascular ectasia) of the colon diagnosed?
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colonoscopy
(preferred over angiography) |
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how is angiodysplasia (AV malformations, vascular ectasia) of the colon treated?
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colonoscopic coagulation
(R-hemicolectomy if bleeding persists) |
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what is the classic presentation of acute mesenteric ischemia?
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severe abdominal pain disproportionate to physical findings
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what are signs of intestinal infarction?
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hypotension
tachypnea lactic acidosis fever altered mental status (ultimately leading to shock) |
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what lab value should you check if you suspect acute mesenteric ischemia?
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lactate level
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what is the definitive diagnostic test of acute mesenteric ischemia?
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mesenteric angiography
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what will you see on barium enema in a pt with acute mesenteric ischemia?
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thumbprinting
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what is the thumbprint sign?
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a finding on a lateral C-spine radiograph that suggests epiglottitis
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what is the therapy of choice for all arterial causes of acute mesenteric ischemia?
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papaverine (vasodilator) into the SMA during arteriography
(relieves occlusion and vasospasm) |
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what is the treatment of choice for acute mesenteric ischemia secondary to venous thrombosis?
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heparin
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what treatment should you avoid in acute mesenteric ischemia?
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vasopressors
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what are (2) signs associated with chronic mesenteric ischemia?
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postprandial ("dull") pain
weight loss |
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how do you confirm suspected diagnosis of chronic mesenteric ischemia?
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mesenteric arteriography
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what is the definitive treatment for chronic mesenteric ischemia?
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surgical revascularization
(90% effective) |
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what is Ogilvie's syndrome?
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when there are signs, symptoms and radiographic evidence of large bowel obstruction but there is no mechanical obstruction
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colonic distention leading to a diameter greater than __ cm is at risk of impending rupture
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10 cm
(decompress immediately) |
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what are the mc antibiotics associated with pseudomembranous colitis?
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clindamycin
ampicillin cephalosporins (all antibiotics have the potential) |
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what are the complications of severe pseudomembranous colitis?
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toxic megacolon
colonic perforation anasarca (electrolyte distrubances) |
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what are the (2) ways to diagnose pseudomembranous colitis?
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stool C.difficile toxin (takes 24 hrs)
flexible sigmoidoscopy |
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how do you treat pseudomembranous colitis?
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metronidazole is drug of choice
oral vancomycin is second line (cholestyramine as adjuvant for diarrhea) |
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what is cholestyramine?
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a bile acid sequestrant
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where are the (2) mc site of colonic volvulus?
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sigmoid (75%)
cecum (25%) |
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how do you make the diagnosis of a sigmoid volvulus?
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abdominal films - "omega loop sign"
barium enema - "bird's beak" sigmoidoscopy - prefered diagnostic/therapeutic test |
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how do you make the diagnosis of a cecal volvulus?
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abdominal film - "coffee bean sign" in RLQ
barium enema - "bird's beak" |
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what is the treatment of cecal volvulus?
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emergent surgery
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