012215 miscellaneous disorders

Question 1

IBS

Answer 1

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)

Question 2

diverticular dis

Answer 2

actually PSEUDOdiverticular outpouchings of colonic mucosa and submucosa

Question 3

epidemiology of diverticular dis

Answer 3

rare in young

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

Question 4

mechanism of diverticular dis

Answer 4

develops under conditions of elevated intraluminal pressure in sigmoid colon

exacerbated by diets low in fiber, which reduce stool bulk

Question 5

location that’s most common for diverticular disease

Answer 5

sigmoid colon, but all regions of colon may be affected

Question 6

what causes diverticulitis?

Answer 6

obstruction of diverticula, which leads to inflam changes

Question 7

complications of diverticular dis?

Answer 7

can lead to perforation

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

Question 8

symptoms of diverticular dis

Answer 8

most remain asymptomatic throughout lives

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

Question 9

pathogenesis of acute appendicitis

Answer 9

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.

Question 10

symptoms of acute appendicitis

Answer 10

periumbilical pain early that moves to RLQ

nausea, vomiting, low grade fever, mildly elevated WBC

Question 11

McBurney’s sign

Answer 11

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)

Question 12

ischemic colitis

Answer 12

ranges from mucosal infarction to transmural infarction

Question 13

causes of ischemic colitis

Answer 13

mucosal infarction: hypotension, arterial spasm

transmural infarction: arterial occlusion (thrombosis or embolis)

Question 14

watershed zones for ischemic colitis

Answer 14

splenic flexure

sigmoid colon and rectum

Question 15

what other areas can be subject to ischemic colitis

Answer 15

R colon

Question 16

ischemic colitis-what can you see?

Answer 16

hemorrhagic mucosa

ulcers

Question 17

acute transmural infarction of ischemic colitis manifests usually with what symptoms

Answer 17

sudden, severe abd pain and tenderness

sometimes accompanied by nausea, vomiting, bloody diarrhea, or grossly melanotic stool