012215 miscellaneous disorders Flashcards Preview

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Flashcards in 012215 miscellaneous disorders Deck (17):
1

IBS

chronic and replasing abd pain, bloating, changes in bowel habits including diarrhea and constipation

pathogenesis is poorly understood (could be visceral hypersensitivity, abnormal GI motility, or post infectious IBS, etc)

2

diverticular dis

actually PSEUDOdiverticular outpouchings of colonic mucosa and submucosa

3

epidemiology of diverticular dis

rare in young
prevalence approaches 50% in Western adult populations beyond age of 60

4

mechanism of diverticular dis

develops under conditions of elevated intraluminal pressure in sigmoid colon

exacerbated by diets low in fiber, which reduce stool bulk

5

location that's most common for diverticular disease

sigmoid colon, but all regions of colon may be affected

6

what causes diverticulitis?

obstruction of diverticula, which leads to inflam changes

7

complications of diverticular dis?

can lead to perforation
perforation can lead to pericolonic abscesses, development of sinus tracts, and peritonitis

8

symptoms of diverticular dis

most remain asymptomatic throughout lives

20% develop complaints-intermittent cramping, continuous lower abd discomfort, CONSTIPATION, diarrhea

9

pathogenesis of acute appendicitis

in 50-80% of cases, there is luminal obstruction-usually a stonelike mass of stool or fecalith. ischemic injury and stasis of luminal contents, which favor bacterial proliferation, trigger inflam responses.

10

symptoms of acute appendicitis

periumbilical pain early that moves to RLQ
nausea, vomiting, low grade fever, mildly elevated WBC

11

McBurney's sign

sign of acute appendicitis
deep tenderness noted at 2/3 of the idstance from ubilicus to the R anterior superior iliac spine (McBurney's point)

12

ischemic colitis

ranges from mucosal infarction to transmural infarction

13

causes of ischemic colitis

mucosal infarction: hypotension, arterial spasm

transmural infarction: arterial occlusion (thrombosis or embolis)

14

watershed zones for ischemic colitis

splenic flexure
sigmoid colon and rectum

15

what other areas can be subject to ischemic colitis

R colon

16

ischemic colitis-what can you see?

hemorrhagic mucosa
ulcers

17

acute transmural infarction of ischemic colitis manifests usually with what symptoms

sudden, severe abd pain and tenderness
sometimes accompanied by nausea, vomiting, bloody diarrhea, or grossly melanotic stool