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GIT > 6 Feb 24 > Flashcards

6 Feb 24 Flashcards

1
Q

Minimal Bright Red Blood per rectum
Def

A

Few drops of blood in toilet bowl after defecation
Causes hemorrhoids or anal fissures

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2
Q

BRBPR factors that suggest colonoscopy

A

Age >45
Large amount of blood mixed in stool
Systemic SS (fever,wt loss)
Changes in bowel habits /stool caliber

Workup : colonoscopy

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3
Q

BRBPR in younger pt workup

A

Dx : anoscopy before colonoscopy

If bening finding eg hemorrhoid
Inc fibre intake
Topical analgesics
Interval followup

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4
Q

Pt with down syndrome and constipation

A

Assess for sec endorine causes of constipation
Hypothyroidism
DM
Hypercalcemia

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5
Q

IBD ulcerative colitis Areas involved

A

Rectum always and colon
Continuous lesions

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6
Q

Colonoscopy findings of UC

A

Mucosal and submucosal inflammation
Pseudopolyps
Microscopy shows no granulomas.

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7
Q

Complication of UC

A

Toxic megacolon

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8
Q

CF of UC

A

Age 14-40
Abd pain
Bloody diarrhea
Tenesmus
Fecal incontinence
Fever
Weight loss

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9
Q

Most common extraintestinal CF of IBD

A

Inflammatory arthritis
(When treated with NSAIDS further worsens IBD)

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10
Q

Crohn Dx area involved

A

Mouth (ulcers ) to anus (mostly ileum and colon)

Perianal Dx with rectal sparing
Skip lesions

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11
Q

Crohn dx microscopy

A

Non caseating granulomas

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12
Q

Crohn Dx Gross finding on colonoscopy

A

Transmural inf
Linear mucosal ulcers
Skip lesions
Cobblestoning , creeping fat

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13
Q

Crohn dx complications

A

Fistulae
Abscesses
Strictures (bowel obstruction)

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14
Q

CF of crohns

A

Age 15-40
Abd pain (often RLQ)

Watery diarrhea (bloody if colitis )

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15
Q

Ttt of CD

A

Corticosteroids
Biologic agents (infliximab)

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16
Q

Microscopic Colitis CF

A

🧿Watery nonbloody diarrhea
Secretory diarrhea that happens during fasting and at night
🧿Fecal urgency
🧿Fecal incontinence
🧿Abd pain fatigue weight loss
arthralgias

17
Q

Microscopic colitis Triggers

A

Smoking
Medicines (NSAIDS , PPIs , SSRIs)

18
Q

Dx of MC

A

Colonoscopic biopsy with lymphocytic infiltration of lamina propria

🔪 collagenous: thick subepithelial collagen band
🔪 lymphocytic : high levels of intraepithelial lymphocytes

Normal CRP, Hb , negative fecal occult blood

19
Q

Ttt of Microscopic Colitis

A

Remove triggers eg smoking
Antidiarrheal medicines and budesonide

20
Q

MC Risk factors

A

NSAIDS PPIs SSRIs
Smoking
Autoimmune dx
Women >60 are disproportionately affected

21
Q

IBS definition

A

Abd pain >_1days /week X >-3months and >-2 of the following

Link with defecation
Change in stool freq
Change in stool form
Lack of alarm features

22
Q

Chronic mesenteric ischemia Etiology

A

Atherosclerosis (smoking , dyslipidemia)

23
Q

Chronic mesenteric ischemia CF and dx

A

Crampy , PP epigastric pain
Food aversion and weight loss
Early satiety , diarrrhea
Occurs within first hours of eating
Slowly resolves over next 2hrs

Dx:

Signs of malnutrition , abd bruit
CT angio(preferred) ,
doppler USG

24
Q

Ttt of CMI

A

Risk reduction( smoking cessation)

Endovascular or open surgical revascularization

25
Q

Mechanism if pain in Chronic meaenteric ischemia

A

Shunting if blood away from small intestines to meet inc demand of stomach
In atherosclerosis the celiac and SMA may b narrowed and unable to dilate appropriately to maintain blood flow to intestines.

26
Q

RF of giardiasis

A

Contaminated food or water
Fecal incontinence and crowding (day care, nursing home)
Immunodef ( CVID, IgA def , CF , HIV)

27
Q

Patho of giardia

A

Villous blunting , disruption of epithelial tight junctions , loss of brush border enzymes ➡️ُmalabsorption

28
Q

CF of giardia

A

Subacute <4w Or chronic (months)
Loose oily non bloody stools
Bloating flatulence
Weight loss
Dec linear velocity (children),
Vitamin Def

29
Q

Dx of giardia

A

Stool antigen or PCR testing (more Sensitive)
Stool microscopy

30
Q

Ttt of giardia

A

First line : Tinidazole , nitazoxanide

Alternate : metronidazole (children)

Pregnancy(first trimester) : paromomycin

Refractory/recurrent: Evaluation if immunidef dx

31
Q

Chronic diarrhea types

A

Functional ; IBS

Organic :

   IBD
   Infection 
   Malabsorption
32
Q

Chronic diarrhea due to organic causes
Suspicion if :

A

Age >50
Nocturnal SS
Weight loss Fever
Rectal bleed
Elevated inf markers
FH if colon cancer/IBD

GIT (20 decks)

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