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71 Cards in this Set
- Front
- Back
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This is a chronic inflammation of the colon mucosa
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Ulcerative colitis
Affects ONLY the Colon |
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T/F Crohn’s disease affects all layers of the bowel
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True; it is transmural
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How do you Dx UC?
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Diagnosis is made by a constellation of symptoms with proctosigmoidoscopic examination
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What are some Symptoms of UC?
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bloody diarrhea
tenesmus fever fatigue weight loss may develop TOXIC MEGACOLON |
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More common in jewish population
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UC
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Surgery is curative in this type of IBS
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UC
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what study do you NOT do if patient is toxic and suspect UC?
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Do not do Barium Enema if patient toxic
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What drug is used to treat UC?
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Azulasalazine (Azulfadine)
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What is another name for Crohn's DZ?
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Also called “Regional Enteritis” or “Granulomatous Colitis”.
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skip lesions with transmural involvement
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Crohn's DZ
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Part of the GI tract mostly affected by Crohn's DZ
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Most Commonly affects the terminal ileum but all other areas of the bowel may be involved
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Is surgery curative with Crohn's?
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No, it reocurres after surgery
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Affects mostly young people
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Croh's DZ
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An inflammation of the fat cells under the skin (panniculitis). It causes tender, red nodules that are usually seen on both shins
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Erythema nodosum (red nodules)
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Name some complications of Crohn's DZ
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Vitamin Deficiency
Poor absorption of fat soluble vitamins Low protein cause low calcium Diarrhea due to bile acid malabsorption Kidney stones Gallstones |
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How do you Tx Crohn's?
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Steroids
Azulfidine Metronidazole Immunosuppresants |
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T/F Rectal bleeding is common in Crohn's
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False, it is rare
Common in UC |
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T/F Development of Cancer is common in Crohn's
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False, it is rare
common in UC |
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Granulomas and fistulas are typical of this IBS DZ
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Crohn's Dz
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Crypt abscesses, pseudopolyps and toxic megacolon are typical of this DZ
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UC
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Lead-pipe” s haustrations
“String sign" |
UC
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an inflammatory disease of the bile duct, which leads to cholestasis; often assoc. with UC
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Sclerosing cholangitis
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absence of colonic nerve plexus
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Hirschsprung’s dz
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contraindication for barium enema examination and colonoscopy
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toxic megacolon
Diverticulitis |
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PAIN OUT OF PROPORTION TO THE EXAM
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ischemic colitis
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ischemic colitis mostly affects this part of the colon
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the splenic flexure or sigmoid
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Barium Xray demonstrates a “Thumb Print” or pseudotumor pattern
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ischemic colitis
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Alternating diarrhea & constipation; pain relieved by defecation
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Irritable bowel syndrome
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how do you Dx IBS?
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Clinically; labs will be normal
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T/F Diverticulum can occur throughout the entire intestinal tract
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TRUE
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What is diverticulosis?
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presence of diverticula (out pouchings in the intestinal tract)
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what is the test of choice for diverticulosis?
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barium enema
colonoscopy |
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test to be avoided with diverticulitis?
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No Sigmoidoscopy or Barium enema
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the most common congenital anomaly of the GI tract
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Meckel Diverticulum
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Rule of 2’s of Meckel's diverticulum
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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) |
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Most of these are diagnosed during surgery or autopsy because they're difficult to Dx
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Meckel's diverticulum
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what is the most common surgical emergency
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appendicitis; MCC is fecalith
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what is Rovsing sign?
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pain in RLQ with palpation in LLQ
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what is C-Reactive Protein?
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CRP is an acute-phase reactant synthesized by the liver in response to bacterial infection
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how do you Dx appendicitis?
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Clinically
Ultrasound-children CT scan- Adults |
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a condition of dilated and fragile blood vessels in the colon that results in intermittent loss of blood from the gastrointestinal tract
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Angiodysplasia
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vascular lesions most common in the cecum & right colon
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Angiodysplasia
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an autosomal dominant disease characterized by GI polyps, multiple osteomas, and skin and soft tissue tumors
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Gardner's syndrome
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Mucocutaneous pigmentation of the perioral region; increased risk of GI cancer
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Peutz-Jeghers Syndrome
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MC cancers in women
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Lung
Breast Colon |
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MC cancers in men
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Lung
Prostate Colon |
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comprises 95% of malignancies in large bowel
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Adenocarcinoma
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Most common symptom in colon CA?
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rectal bleeding or change in bowel habits
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T/F CEA is a very poor test for screening
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TRUE; only use as a follow up
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what screening test for colon CA should be started at age 50?
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FOBT-every year
FIT-fecal immunochemical/yr flexible sigmoidoscopy- 5yrs double-contrast barium enema every 5 years colonoscopy every 10 years |
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Barium enema shows an apple core lesion on exam
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Colon CA
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best diagnostic test for Colon CA
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Colonoscopy
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what is Dukes Classification for colon CA
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A. mucous membrane of bowel only
B. Muscle C1. Few nodes C2. Many nodes D. distant metastasis |
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this type of hernia is usually due to a weakness of the lateral wall of the fascia
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Direct: (acquired)
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what is the second MCC of small bowel obstruction
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Hernias
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Most likely cause of a palpable GB (Courvoisier’s sign)
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adenocarcinoma of ampulla (pancreatic ductal CA)
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imaging test for pts with suspected colonic obstruction
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colonoscopy or barium enema
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Classic triad:
colicky abdominal pain, vomiting, and red currant jelly stools |
Intassusception
Tx: Contrast enema can reduce |
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what causes irritable bowel syndrome
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Unknown, but 70% of Pts have psych problems
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screening test for Colon CA
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DRE
barium enema sigmoidoscopy/Colonoscopy w/ biopsy |
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what causes hemorrhoids?
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Caused by straining, heavy lifting & occaisionally by intra-abdominal pressure
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dysphagia of neuromuscular disorder
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Oral phase
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dysphagia due to spasms or carcinoma
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pharyngeal phase
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dysphagia due narrowing by esophagitis & diverticulum.
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esophageal phase
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how do you treat achalazia?
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balloon dilation
botulism toxin myotomy |
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episodic dysphagia with chest pain provoked by hot or cold liquids?
How do you treat? |
Esophageal spasms; treat with nitrates and CCBs
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what percentage of GERD pts have hiatal hernias?
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80%
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best test for identifying esophageal varices
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barium swallow and endoscopy
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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
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Gluten is responsible for this type of sprue; it is a protein found in wheat, rye, oats, & barley
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Celiac Sprue
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biopsy shows Gm + rods (Tropheryma whippelii) and is treated with penicillin, tetracycline
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Whipples disease
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