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A 60 y/o B complains of progressive weakness. He reports that his stools are very dark. PE; demonstrates fullness in the RLQ. Lab studies show iron def anemia, with a Hgb of 7.4 g/dL. Stool specimens are (+) for occult blood. Colonoscopy discloses an ulcerating lesion of the cecum. 96hrs after surgery. A diagnosis of failure of passage of enteric contents through small bowel and colon that is not mechanically obstructed was made, and IM of neostigmine was given. The activation of which of the following pairs of Rs most likely mediated the therapeutic effect of the drug in the pat disorder?
a)Nm & M2
b)Nn & M3
c) β2 & M3
d)β2 & Nn
e)Nn & α1
f)Nm & α1
__I dont care about yr exp few hr later about Q. I just care ur ability to ans 72sec from time it post __
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First here in with you @cardio…
Olgivie's syndrome rt?
All I know by experience is that after neostigmine adm, you need to watch out for bradycardia…
don't know the answer… feeling dumb! : (
F?
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I mean first time doing your questions…
Thank you for your fantastic help in calling our attention to some areas!!
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Hello @relative can u tell me whats medical term "failure of passage of enteric contents through small bowel and colon that is not mechanically obstructed"?
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Acute colonic pseudo-obstruction (ACPO), rt?
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@relative, go head & ans the following q;
An 80 y/o M with Alzheimer disease who lives in a nursing home undergoes surgery for a fractured femoral neck. On the 5th postoperative day, it is noted that his abdomen is grossly distended and tense, but not tender. He has occasional bowel sounds. The rectal vault is empty on digital examination, and there is no evidence of occult blood. X-ray films show a few distended loops of small bowel and a very distended colon. The cecum measures 9 cm in diameter, and the gas pattern of distention extends throughout the entire large bowel, including the sigmoid and rectum. No stool is seen in the films. Other than the abdominal distention, and the ravages of his mental disease, he does not appear to be ill. Vital signs are normal for his age.
Dx?
a)Mechanical intestinal obstruction
b)Ogilvie syndrome
c)Fecal impaction
d)Daralytic ileus
e)Volvulus of the sigmoid colon
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Rt @relative
Adynamic ileus ( synonymously w the term paralytic ileus & NONobstructive ileus) more specific term POSTop ilus RECENT abdominal surgery as our pat ( true the condition sepsis, generalized peritonitis, blunt abdominal, tumor, electrolyte imbalance…). Typically manifest on X-ray dilated small bowel & colon with air fluid levels bowel in “absence” MECHANICAL obstruction. In clonic ileus ACPO/Ogilvie’s dilation is caused by interruption of sympathetic innervation w unopposed parasympathetica innervation of colon.
For both qs *B* correct. Nn & M3
