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71 Cards in this Set

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This is a chronic inflammation of the colon mucosa
Ulcerative colitis

Affects ONLY the Colon
T/F Crohn’s disease affects all layers of the bowel
True; it is transmural
How do you Dx UC?
Diagnosis is made by a constellation of symptoms with proctosigmoidoscopic examination
What are some Symptoms of UC?
bloody diarrhea
tenesmus
fever
fatigue
weight loss
may develop TOXIC MEGACOLON
More common in jewish population
UC
Surgery is curative in this type of IBS
UC
what study do you NOT do if patient is toxic and suspect UC?
Do not do Barium Enema if patient toxic
What drug is used to treat UC?
Azulasalazine (Azulfadine)
What is another name for Crohn's DZ?
Also called “Regional Enteritis” or “Granulomatous Colitis”.
skip lesions with transmural involvement
Crohn's DZ
Part of the GI tract mostly affected by Crohn's DZ
Most Commonly affects the terminal ileum but all other areas of the bowel may be involved
Is surgery curative with Crohn's?
No, it reocurres after surgery
Affects mostly young people
Croh's DZ
An inflammation of the fat cells under the skin (panniculitis). It causes tender, red nodules that are usually seen on both shins
Erythema nodosum (red nodules)
Name some complications of Crohn's DZ
Vitamin Deficiency
Poor absorption of fat soluble vitamins
Low protein cause low calcium

Diarrhea due to bile acid malabsorption

Kidney stones

Gallstones
How do you Tx Crohn's?
Steroids
Azulfidine
Metronidazole
Immunosuppresants
T/F Rectal bleeding is common in Crohn's
False, it is rare

Common in UC
T/F Development of Cancer is common in Crohn's
False, it is rare

common in UC
Granulomas and fistulas are typical of this IBS DZ
Crohn's Dz
Crypt abscesses, pseudopolyps and toxic megacolon are typical of this DZ
UC
Lead-pipe” s haustrations
“String sign"
UC
an inflammatory disease of the bile duct, which leads to cholestasis; often assoc. with UC
Sclerosing cholangitis
absence of colonic nerve plexus
Hirschsprung’s dz
contraindication for barium enema examination and colonoscopy
toxic megacolon
Diverticulitis
PAIN OUT OF PROPORTION TO THE EXAM
ischemic colitis
ischemic colitis mostly affects this part of the colon
the splenic flexure or sigmoid
Barium Xray demonstrates a “Thumb Print” or pseudotumor pattern
ischemic colitis
Alternating diarrhea & constipation; pain relieved by defecation
Irritable bowel syndrome
how do you Dx IBS?
Clinically; labs will be normal
T/F Diverticulum can occur throughout the entire intestinal tract
TRUE
What is diverticulosis?
presence of diverticula (out pouchings in the intestinal tract)
what is the test of choice for diverticulosis?
barium enema
colonoscopy
test to be avoided with diverticulitis?
No Sigmoidoscopy or Barium enema
the most common congenital anomaly of the GI tract
Meckel Diverticulum
Rule of 2’s of Meckel's diverticulum
2% of the population
2:1 Male:Female
(within) 2 feet from ileocecal valve
2 inches long
2 things confused with (ulcer & appendicitis)
2 types of ectopic tissue (gastric & pancreatic)
2 complications (hemorrhage & perforation)
Most of these are diagnosed during surgery or autopsy because they're difficult to Dx
Meckel's diverticulum
what is the most common surgical emergency
appendicitis; MCC is fecalith
what is Rovsing sign?
pain in RLQ with palpation in LLQ
what is C-Reactive Protein?
CRP is an acute-phase reactant synthesized by the liver in response to bacterial infection
how do you Dx appendicitis?
Clinically

Ultrasound-children
CT scan- Adults
a condition of dilated and fragile blood vessels in the colon that results in intermittent loss of blood from the gastrointestinal tract
Angiodysplasia
vascular lesions most common in the cecum & right colon
Angiodysplasia
an autosomal dominant disease characterized by GI polyps, multiple osteomas, and skin and soft tissue tumors
Gardner's syndrome
Mucocutaneous pigmentation of the perioral region; increased risk of GI cancer
Peutz-Jeghers Syndrome
MC cancers in women
Lung
Breast
Colon
MC cancers in men
Lung
Prostate
Colon
comprises 95% of malignancies in large bowel
Adenocarcinoma
Most common symptom in colon CA?
rectal bleeding or change in bowel habits
T/F CEA is a very poor test for screening
TRUE; only use as a follow up
what screening test for colon CA should be started at age 50?
FOBT-every year
FIT-fecal immunochemical/yr
flexible sigmoidoscopy- 5yrs
double-contrast barium enema every 5 years
colonoscopy every 10 years
Barium enema shows an apple core lesion on exam
Colon CA
best diagnostic test for Colon CA
Colonoscopy
what is Dukes Classification for colon CA
A. mucous membrane of bowel only
B. Muscle
C1. Few nodes
C2. Many nodes
D. distant metastasis
this type of hernia is usually due to a weakness of the lateral wall of the fascia
Direct: (acquired)
what is the second MCC of small bowel obstruction
Hernias
Most likely cause of a palpable GB (Courvoisier’s sign)
adenocarcinoma of ampulla (pancreatic ductal CA)
imaging test for pts with suspected colonic obstruction
colonoscopy or barium enema
Classic triad:
colicky abdominal pain, vomiting, and red currant jelly stools
Intassusception

Tx: Contrast enema can reduce
what causes irritable bowel syndrome
Unknown, but 70% of Pts have psych problems
screening test for Colon CA
DRE
barium enema
sigmoidoscopy/Colonoscopy w/ biopsy
what causes hemorrhoids?
Caused by straining, heavy lifting & occaisionally by intra-abdominal pressure
dysphagia of neuromuscular disorder
Oral phase
dysphagia due to spasms or carcinoma
pharyngeal phase
dysphagia due narrowing by esophagitis & diverticulum.
esophageal phase
how do you treat achalazia?
balloon dilation
botulism toxin
myotomy
episodic dysphagia with chest pain provoked by hot or cold liquids?

How do you treat?
Esophageal spasms; treat with nitrates and CCBs
what percentage of GERD pts have hiatal hernias?
80%
best test for identifying esophageal varices
barium swallow and endoscopy
What type of Sprue is this?

The villi are flattened, making absorption difficult

An overgrowth of coliform bacteria within the jejunum have been demonstrated
Tropical sprue
Gluten is responsible for this type of sprue; it is a protein found in wheat, rye, oats, & barley
Celiac Sprue
biopsy shows Gm + rods (Tropheryma whippelii) and is treated with penicillin, tetracycline
Whipples disease