Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
17 Cards in this Set
- Front
- Back
|
what are the symptomatic differences between proximal and distal small bowel obstruction (SBO)?
|
proximal:
- incr vomiting - severe pain - minimal abdominal distention distal: - less vomiting - significant abdominal distention (easily seen on abdominal films) |
|
|
what is the mcc of small bowel obstruction?
|
adhesions
(2nd mc incarcerated hernia) |
|
|
what is the mcc of large bowel obstruction?
|
colon cancer
|
|
|
what diagnostic test is used to determine the site of intestinal obstruction?
|
barium enema
|
|
|
what electrolyte disorder causes paralytic ileus?
|
hypokalemia
|
|
|
what does abdominal plain film show in a pt w/ paralytic ileus?
|
uniform distribution of gas in the small bowel, colon and rectum
|
|
|
describe the epidemiology of inflammatory bowel disease (IBD)
|
caucasian
jewish 15-35 yo |
|
|
describe the characteristics of Crohn's disease
|
terminal ileum is hallmark
skip lesions fistulae luminal strictures noncaseating granulomas* transmural thickening (luminal narrrowing) mesenteric "fat creeping" |
|
|
what are the extraintestinal manifestations of Crohn's disease?
|
uveitis
arthritis ankylosing spondylitis erythema nodosum pyoderma gangrenosum apthous oral ulcers cholelithiasis nephrolithiasis |
|
|
what elements are malabsorbed in Crohn's disease?
|
vitamin B12 and bile acids
(both occur at terminal ileum) |
|
|
why does cholelithiasis occur in Crohn's disease?
|
secondary to decreased bile acid absorption
|
|
|
why does nephrolithiasis occur in Crohn's disease?
|
secondary to incr colonic absorption of dietary oxalate -> calcium oxalate kidney stones
|
|
|
what are the medical treatment options for Crohn's disease?
|
sulfasalazine 5-ASA (if colon involved)
metronidazole (if 5-ASA non-effective) systemic corticosteroids immunosuppressants bile acid sequestrants |
|
|
how do bile acid sequestrants help in Crohn's disease?
|
in pts with terminal ileum resections, they make the bile acids insoluble and osmotically inactive -> decr diarrhea
|
|
|
what are some complications of UC?
|
colon cancer (UC > Crohn's)
sclerosing cholangitis cholangiocarcinoma toxic megacolon (mcc of death in UC) |
|
|
describe medical treatment for UC
|
systemic corticosteroids (acute exacerbations)
sulfasalazine (mainstay) immunosuppressive agents |
|
|
what is the MOA of sulfasalazine?
|
blocks prostaglandin release -> decr inflamm
- metabolized by bacteria in the colon to 5-ASA (mesalamine) and sulfapyridine - 5-ASA is the effective moety - sulfapyradine causes SE of crystalization in the bladder/urethra |
