Progress 16 NME (247-258)

mbch4kz2's version from 2016-05-17 16:02


Question Answer
What is paralytic ileus?Disorde of neuromuscular transmission within the myenteric plexus of the intestinal wall. Usually occurs after abdominal surgery and bowel handling. May also be related to intra-abdominal infection, metabolic disorders or a reflex response to retroperitoneal injury
What are the two main sources of blood supply to the bowel?Superior and inferior mesenteric arteries
What is Hersprung's disease?Lack of ganglia in the myenteric plexus of the colon (responsible for peristalsis). Sections of the colon do not have any plexuses - constipation in young children
What are the pathological features of Crohn's disease?Transmural inflammation, serpiginous (wavy margin) ulceration, cobblestone mucosa, skip lesions, fistula (can fistulate externally to other parts of the bowel or to stomach)
What extra-intestinal features may be seen in Crohn's disease?Apthous ulcers, erythema nodosum (red nodules on both shins), pyoderma grangrenosum (ulcers that lead to necrosis- usually on legs), ankylosing spondylitis (form of spinal arthritis), gall stones, episcleritis
What is the acute treatment of Crohn's disease?Stop smoking and IV hydrocortisone
What medications would you use for maintenance of Crohn's disease?1. 5-ASA (Mesalazine- reduce inflammation of bowel) 2. Immunosuppresion- Methotrexate/Azathioprine, monoclonal Ab against TNF-a (Infliximab, Adalimumab)
What is the treatment for mild UC?1. Topical 5-ASA or steroid 2. Oral 5-ASA (if extends beyond left side of colon)
What is the treatment of moderate UC?Oral steroids and topical 5-ASA (eg. sulfasalazine) and Azathioprine (for maintenance)
How would you define moderate UC?>4 bloody stools, low grade temperature and raised inflammatory markers
What is diverticular disease?Protrusion of colonic mucosa through circular muscle at points where arterial branches penetrate. Obsturciton of diversticular osmium causes abscess formation and inflammation.
What are the complications of diverticular disease?Bleeding, diverticulitis, perforation, fistulae, stricture formation

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