Gi Continued 2

Front 1

Describe the approach to treatment for mild viral or bacterial diarrhea

Back 1

Hydration, Absorbant preparations Bismuth (Pepto), Inhibition of motility, Opiates such as diphenoxylate and Loperamide (Imodium) Antibiotics

Front 2

Describe the approach to prevention and treatment of traveler's diarrhea

Back 2

Prevention: careful eating / drinks is most important prevention. local water should be avoided, includes foregoing fresh vegetables, which have been washed in water, and ice cubes. Chemoprophylaxis: majority caused by entertoxigenic E. coli, TMS (one double strength daily) and cipro (500 mg bid x 3 days) Tx: Same as other diarrhea treatments

Front 3

Describe the typical syndromes of infectious diarrhea due to the parasites Giardia lamblia

Back 3

acute, intermittent, or chronic Diarrhea,accompanied by dull cramping px above umbilicus, anorexia, nausea, bloating, and flatulence. A less common important sx is steatorrhea and progressive weight loss.

Front 4

Describe the typical syndromes of infectious diarrhea due to the parasites Entamoeba histolytica

Back 4

diarrhea Bouts, abd px, and weight loss. diarrhea contains blood and mucus, and tender hepatomegaly and px over the cecum and ascending colon may be present. Occasionally a mass lesion called an ameboma may develop in large bowel

Front 5

Discuss the findings on the history and physical exam that would make you include pseudomembranous colitis (Clostridia difficile infection) in your differentia

Back 5

Hx Of resent broad-spectrum antibiotics treatment. Especially seen after abdominal surgery and tx. Abrupt bloody diarrhea and fever without vomit.

Front 6

Describe the clinical syndromes and causative pathogens of acute proctitis and gastroenteritis that can be seen in homosexual men

Back 6

Proctitis: Pathagens - Neisseria Gonorrhoeae, Anal syphilis, Chalymdia Trachomatis, HSV-2, (HPV)

Front 7

Identify diarrhea, bleeding, and abdominal pain as the major clinical manifestations of inflammatory bowel disease

Back 7

idiopathic, chronic, or recurrent intestinal inflammation. ulcerative colitis inflammation is confined to mucosa and submucoas of large intestine. crohn’s inflammation can affect any part of intestinal tract and all layers of intestinal wall. cardinal sx's are bloody diarrhea, and abd px

Front 8

Describe typical features of ulcerative colitis

Back 8

bloody diarrhea, and abd px; sever cases: fever, anorexia, and weight loss. cramping lower abd px, abd tenderness, fever, and rectal symptoms. UC always involves lower rectum; colonic mucosal inflammation extends in contiguous manner to varying degree

Front 9

Describe typical features of Crohn's disease (a.k.a.: regional enteritis)

Back 9

chronic or recurrent transmural inflammation involving any part of digestive tract. abd px, and diarrhea. Intestinal fistula formation, bowel obstruction are common complications.

Front 10

What are the 2 major diagnostic tests for ulcerative colitis;

Back 10

sigmoidoscopy (or colonoscopy) and barium enema. recognize the characteristic changes in the mucosa which are seen on sigmoidoscopy

Front 11

List or recognize several local and systemic complications that may be associated with ulcerative colitis, especially increased risk of colon cancer and arthritis

Back 11

Colitis >10 years, the risk of developing colon cancer increased approx 0.5% to 1% per year

Front 12

Briefly describe the role of each of the following in ulcerative colitis:
corticosteroids

Back 12

used for their systemic anti-inflammatory effects. They have utility in short-term treatment of moderate to sever disease

Front 13

Briefly describe the role of each of the following in ulcerative colitis:
sulfasalazine

Back 13

consists of 5 aminosalysilicacid. It is largely unabsorbed in the small intestine. In the colon it has anti-inflammatory effects. It is used in the active treatment of ulcerative coloitis and Crohn’s disease and during disease inactivity in order to maintain remission

Front 14

Describe the typical presentation of a patient with ischemic colitis

Back 14

interruption in supply of blood to bowel is most common in those >50 yrs old or with inflammatory bowel disease. usually presents with L sided abd px accompanied by loose stools. surgical intervention. Occur spontaneously due to transient nonocclusive ischemia