Sugery Exam II Part 2

True

False

Deep crampy pain in hypogastrium

Vomiting indicating long standing obstruction

Pain anterior to sigmoid obstruction

Loud borborygmus

Paralytic ileus' usually presents with cramping

Ogilvie's syndrome is caused by adhesion

Cancer is common in elderly patients without Hx of adhesions

First step in treatment is removal of obstruction

Ulcerative Colitis is a risk factor

Gall stone increases risk in men

Symptomatic during first 5 years

All of the above

Surgical resection except after metastases

Surgical resection of colon only

Palpation of tumors to determine malignancy

Surgical resection of colon and lymphnodes

Palliative procedure: removal of colon

Treatment of choice: radiation therapy

Treatment of choice: low anterior resection

Palliative procedures: abdominperitoneal resection

True

False

Constipation relieved by passing flatus

Stranding of pericolic fat on CT

Not likely to have blood in the stool

Generalized abdominal pain

All of the above

True

False

Sigmoid volvuli include small bowel obstruction

Volvuli may cause vascular impairment

Cecal volvulus rises out of the pelvis on plain film

Sigmoid pain is colicky and begins in right abdomen

Resection and anastamosis

Colonoscopy or rigid sigmoidoscope

Cecal decompression

All of the above

A & C

True

False

Cecal Volvulus

Ulcerative Colitis

Sigmoid Volvulus

Cancer of the Colon

Ankylosing spondylitis

Pyoderma gangrenosum

Pericarditis

All of the above

Moderate cases need IV drugs

First attack has high risk of perforation

Megacolon should be treated with resection

All patients with UC can be treated as outpatients

Abdominal pain until abdominal contents discharged

Episodic diarrhea and pain with lassitude

Vague abdominal disconfored followed by nausea

1/3 are unsuspected before surgery

True

False

Perforations more likely in pregnant women

Delayed diagnosis may lead to peritonitis

Most easily diagnoses in women 20-40

May have periappendiceal inflammation

Mucoceles are usually non malignant

True

False

Referred

Somatic

Visceral

Inferred

Is midline when pure

Obstruction is a common cause

Is crampy, colicky and intermittent

All of the above

A & C

True

False

Has aseptic and bacterial causes

Ischemic bowel presents with minor pain

Vascular causes are often catastrophic

Obstructions cause nausea then vomiting

Dysuria

Polyphagia

Chest pain

Abnormal vitals

Appendicitis

Ishemic bowel

Intususseption

Internal hemorrhage