Lower GI Flashcards

1
Q

What increases the secretions and motility of the GI?

A

Food
Nervous system –> CNS vs PNS
Activity –> light activity stimulates, rapid stops, sedentary slows
Disease –>inflammation, disease can increase or decrease

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2
Q

What decreases secretions and motility?

A

diet (fibre)
Age
Stretching of colon –> peristalsis

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3
Q

What kind of instestinal infarction needs to occur to impact the GI?

A

A large clot of a major artery; GI has many redundancies so when one issue arises there are other ways around the problem

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4
Q

What kind of altered motility is Diarrhea? Describe what occurs. What can cause it? How is it Treated?

A

Excessive motility, Loss of fluids has a potential for dehydration
Commonly caused by infectious or toxic agents leading to epithelial disruption
Can be caused by drugs, chemo, foods, and more
Treated with: rehydration, bulkng agents,
anti-motility drugs (loperamide) –> not alwyas used, if from sickness or infection might be left to ride it out unless it is direct cause of dehydration

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5
Q

What kind of altered motility is Constipation? Describe what occurs. What can cause it? How is it Treated?

A

Inadequate/ reduced motility. Stool becomes harder and more difficult to pass
Impactions and discomfort, Enteric nervous system disruption
Treated: motility agents (sennosides, bisacodyl, PEG), fluids, bulking agents (fibre), stool softeners (docusate)

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6
Q

Who is at risk for Diarrhea?

A

Travelers, children in daycare, elderly in nursing homes, food workers, hospitalized pts

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7
Q

What are the main differences between Non-inflammatory and Inflammatory diarrhea?

A

Non-inflammatory is less sevre but can cause dehydration
Inflammatory has presence of blood and fecal leukocytes; more severe illness

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8
Q

What main organisms can cause diarrhea?

A

Camphylobacter jejuni, Salmonella, Shigella, E. coli

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9
Q

When do you refer diarrhea to a physician?

A

blood
>7 days
travel-associated
Immunocompromised
fever, severly ill, debilitated
extremes in age young/old
complex patient

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10
Q

What is the self management for diarrhea?

A

Hydration
Rest
hygiene
healthy diet
Loperamide to reduce duration of symptomms
Simethicone for gas and cramping

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11
Q

Are neoplasms of the small intestine common?

A

No

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12
Q

What are the 3 types of hernia obstructions?

A

Bulging through
telesxcoping
Twisting

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13
Q

What kind of tumor accounts for 90% of all tumors in intestinal neoplasms?

A

Epithelial tumors (adenomas and carcinomas)

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14
Q

What are some common signs of a small bowel neoplasm?

A

nausea, affected apetite, changes in bowel habits, diffuculty or pain on eating, wt loss

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15
Q

What causes IBD?

A

Combination of genetics, environment, and immune response

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16
Q

What can happen to nearby hollow organs in intestinal diseases?

A

Can be affected; disease can chew through and affect those organs to such as the bladder

17
Q

When is IBD typically daignosed?

A

In adolescence or early adulthood

18
Q

What percent of people are diagnosed at >65 years of age?

A

15%

19
Q

What are some additional risk factors for IBD?

A

smoking, family history, fatty diet, hormonal medications, stress, urban residence, environmental pollution

20
Q

What other extraintestinal symptoms can occur in IBD?

A

arthritis, some eye conditions, fever, aphthous ulcers

21
Q

Symptoms of IBD?

A

Abdoinal pain
mouth and stomach ulcers
diarrhea
rectal bleeding
loss of apetite
wt loss
fever
fatigue
change or loss of menstrual cycle

22
Q

What are some long term complications with IBD?

A

malnutrition/ malabsorbtion
anemia
perforated bowel
fistua
strictures
abcesses
eye sorness/ redness
swelling/ joint pain
osteoporosis
increased risk of colon cancer

23
Q

What is the etiology of Crohns disease?

A

Unknown; infectious and immunolgic mechanisms have been proposed

24
Q

How does a smal intestine look in Crohns dsiease?

A

Mucosa surface irregular, hypereia, focal uceration
Skip lessions; segements of normal and irregular

25
Q

How does ulcerative colitis present itself?

A

gradual onset of symptoms
18-35 years old
restricted to the colon
diarrhea, pain, redness, swelling, loss of function

26
Q

What are the treatment aims for ulcerative colitis?

A

Reduce inflammation
Reduce Pain
Prevent further inflammation

27
Q

What are risk factors for ulcerative colitis?

A

genetics, environmental factors, dysregulated immune response in GI tracdt, antibiotic and NSAID use

28
Q

What are some symptoms of ulcerative colitis?

A

Ulcers or sores in colon
Periods of active inflammation and remission
small harder stools
flare ups ranging in severity

29
Q

What is the natural disease progression of ulcerative colitis?

A

immune system not able to turn off
chronic inflammation until ulcers are removed or treated
last 6 inches of colon always involved and can move up over time

30
Q

What are some non GI tract symptoms of Ulcerative colitis?

A

fatigue, fever, low energy, joint pain, liver inflammation, osteoporosis, skin problems, eye problems

31
Q

WHich of the listed features are not similar in Crohns and Ulcerative Colitis?
familial
peak age
immune distrubance
extraintestinal complication
treatment
distribution
transmural
granuloma
fistula
megacolon
cancer

A

familial- same
peak age - same (15-25)
immune distrubance - same
extraintestinal complication - same
treatment- same
distribution - different (C: segmental including ileum, UC: diffuse, colon only)
transmural - different; (C:++ UC: -)
granuloma- different (C: + UC: -)
fistula - different (C: + UC: -)
megacolon - different (C: - UC: +)
cancer - both yes, but more so in UC

32
Q

What is the ladder of Therapy for IBD?

A

Controling inflammation moving up ladder when ineffective
Aminosallicyliates - anti-inflam
Corticosteroids - anti-inflam; SE not great for long term use
Immunomodulators - suppress immune system; increased risk of infection though
Antibiotics - Used to prevent and control infection in UC and CD
Biologics - block protein called tumor necrosis factor (only in moderate-severe cases)

33
Q

Which biologics are used for UC?

A

Infliximab, Adalimumab, Golimumab, Vedolizumab,
Etrolizumab(only UC only drug)*

34
Q

WHich biologics are used for Crohns?

A

Infliximab, Adalimumab, Golimumab, Vedolizumab
Crohns only: Certolizumab,Natalizumab, Ustekinumab

35
Q

What is used to measure inflammation decrease in fecal matter?

A

Fecal calprotectin