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GI - 2 > Lower GIB > Flashcards

Lower GIB Flashcards

1
Q

Lower GI bleed involves a source where?

A

Distal to Ligament of Treitz

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2
Q

Most common sign of a LGIB?

A

Hematochezia = bright red blood in stool

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3
Q

Differential diagnoses of LGIB depend on what 2 things?

A

Age of patient

Severity of bleeding

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4
Q

What things can stimulate Hematochezia?

A

NSAIDs, Anticoagulants, liquid medication with red dye

Beets, Red Kool-aid

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5
Q

Co-morbid conditions?

A

IBD

Liver/renal/diverticular disease

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6
Q

10% of hematochezia conditions are due to what type of bleed?

A

UPPER GI bleed

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7
Q

90% of hematochezia conditions are due to what type of bleed?

A

Lower GI bleed

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8
Q

4 common differential diagnoses for a LGIB?

A

Diverticulosis
IBD
Ischemic Colitis
Intussusception

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9
Q

4 common differential diagnoses for a LGIB?

A

Diverticulosis
IBD
Ischemic Colitis
Intussusception

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10
Q

Diverticulosis

A

Sac-like protrusions of mucosa through the muscularis due to increased intraluminal pressure

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11
Q

Most common location for Diverticulosis?

A

Sigmoid colon

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12
Q

Symptoms of Diverticulosis?

A

PAINLESS, large-volume hematochezia in older patients

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13
Q

Many patients with Diverticulosis describe have ____ history with colonoscopy

A

Normal

– usually asymptomatic

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14
Q

Diagnostic test to do for Diverticulosis once the bleeding stops?

A

Colonoscopy

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15
Q

Diverticulitis vs. Diverticulosis?

A 
Diverticulitis = NO hemorrhage
Diverticulosis = Large volume Hematochezia (painless)
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16
Q

Painless hematochezia in elderly patients with an asymptomatic history could be?

A

Diverticulosis

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17
Q

2 types of IBD?

A

Crohn Disease

Ulcerative Colitis

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18
Q

Crohn Disease - correlation with smoking?

A

Usually onset of Crohn’s correlates with new onset of cigarette smoking

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19
Q

Symptoms of Crohn Disease?

A

Fever, RLQ pain (mimics appendicitis), diarrhea

20
Q

Why does Crohn Disease present with RLQ pain?

A

Ileum is most commonly affected (ileitis)

21
Q

Abscesses, strictures, fistulas are all common with?

A

Crohn Disease

22
Q

For Crohn Disease, serum ___ will be (+)

A

ASCA

23
Q

What sign will be (+) with enema for Crohn Disease?

A

String sign - due to narrowing of lumen

24
Q

Possible complications with Crohn Disease?

A

Colon cancer
Gall/kidney stones
Bile salt malabsorption - secretory diarrhea

25
Q

Is surgery suggested for Crohn Disease?

A

ONLY if absolutely necessary for complications

– can make Crohn Disease worse!

26
Q

Is perinanal disease common with Crohn Disease?

A

Yes

27
Q

Ulcerative Colitis - correlation with smoking?

A

Can correlate with recent cessation of smoking

- smoking is protective against developing it

28
Q

Symptoms of Ulcerative Colitis?

A

Bloody diarrhea, fecal urgency and cramps relieved by defecation
- LLQ pain

29
Q

Bloody diarrhea with cramps that are relieved by defecation can suggest?

A

Ulcerative Colitis

30
Q

For Ulcerative Colitis, serum ___ will be (+)

A

ANCA

31
Q

ANCA (+)

A

Ulcerative Colitis

32
Q

ASCA (+)

A

Crohn Disease

33
Q

What sign will be positive with Ulcerative Colitis?

A

“lead pipe colon” = loss of haustra

34
Q

Possible complications of Ulcerative Colitis?

A

Colon cancer

Toxic megacolon, sclerosing cholangitis

35
Q

Is surgery suggested for Ulcerative Colitis?

A

Yes - not first line of treatment though

36
Q

2 common extra-intestinal manifestations of Ulcerative Colitis?

A

Pyoderma gangrenosum

Ankylosing spondylitis

37
Q

Pyoderma gangrenosum and ankylosing spondylitis can be seen with?

A

Ulcerative Colitis

38
Q

Common PMH item with Ischemic Colitis?

A

Atherosclerosis

39
Q

Symptoms of Ischemic Colitis?

A

Cramping lower abdominal pain and passage of bloody stool

40
Q

What does the X-ray show with Ischemic Colitis and why?

A

Thumb-printing

- hemorrhage causes colonic wall thickening

41
Q

What does a Sigmoidoscopy show with Ischemic Colitis?

A

Friability and submucosal hemorrhage

- risk of perforation due to free air under diaphragm

42
Q

Telescoping bowel

A

Intussusception

43
Q

What will be seen on imaging with Intussusception?

A

Bull’s eye

44
Q

Symptoms of Intussusception?

A

Common in kids
= Colicky abdominal pain
- - jelly like stool?

45
Q

Symptoms of Intussusception?

A

Common in kids
= Colicky abdominal pain
- - jelly like stool?

GI - 2 (61 decks)

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