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SP: GI and Nutrition Pearls (10%) > Diseases of the Small Intestine and Colon > Flashcards

Diseases of the Small Intestine and Colon Flashcards

1
Q

What is the most common location for a large bowel obstruction?

A

Sigmoid colon

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2
Q

What would be the expected findings on KUB in a patient with a mechanical obstruction?

A

Dilated loops of bowel with air fluid levels and little or no gas in the colon

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3
Q

What is the most common cause of mechanical obstruction in a patient with history of abdominal surgery?

A

adhesions

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4
Q

A patient undergoes a barium study of the colon and an “Apple core” lesion is found. What do you suspect?

A

colon cancer

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5
Q

What is the most common type of colon cancer?

A

adenocarcinoma

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6
Q

A 17 year old presents with abdominal pain, bloating, flatulence, and diarrhea after ingesting dairy. What is the test used to make the diagnosis?

A

Lactase breath hydrogen test

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7
Q

what lab antibodies would likely be positive in a patient with Celiac sprue?

A

+anti-tissue transglutaminase
+antigliadin
+anti endomysial antibodies

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8
Q

Celiac sprue is an abnormal immune response to what food product?

A

gluten

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9
Q

What finding on abdominal X-ray is suggestive of acute mesenteric ischemia?

A

Thumb-printing of small bowel or right colon due to submucosal bleeding (Thumb printing may also be seen with toxic megacolon)

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10
Q

What is the gold standard for diagnosis of mesenteric ischemia?

A

angiography

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11
Q

A diabetic presents with abdominal pain that begins one hour after eating and resolves a few hours later. What is your suspected diagnosis?

A

Chronic mesenteric ischemia

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12
Q

A 55 year old male presents with acute abdominal pain. He is in atrial fibrillation and has a relatively benign exam. What is your diagnosis?

A

mesenteric ischemia

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13
Q

What antibodies will be found positive in Crohn’s disease?

A

+ anti-saccharomyces cerevisiae antibodies (ASCA)

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14
Q

What antibodies will be found positive with ulcerative colitis?

A

+ anti-neutrophil cytoplasmic antibodies (pANCA)

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15
Q

Patient presents with alternating diarrhea and then constipation. A complete workup and physical exam are normal. What do you suspect?

A

Irritable bowel syndrome

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16
Q

What are the three major complications of ulcerative colitis?

A

Toxic megacolon
Primary Sclerosing Cholangitis
Colorectal cancer

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17
Q

Crohn’s disease affects what part of the GI tract?

A

Mouth to anus

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18
Q

Which type of diverticular problem generally is painless bleeding?

A

diverticulosis

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19
Q

A patient having less than two bowel movements per week is defined as having what?

A

constipation

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20
Q

Which type of laxative is first in the line of treatment after lifestyle changes and adequate fiber?

A

Osmotic Laxatives - These laxatives include milk of magnesia, magnesium citrate, sorbitol, polyethylene glycol, and lactulose

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21
Q

What is the test of choice to diagnose appendicitis in an adult?

A

CT

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22
Q

What is the test of choice to diagnose appendicitis in a child?

A

ultrasound

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23
Q

What is Iliopsoas sign?

A

RLQ pain with R hip extension

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24
Q

What is Obturator sign?

A

RLQ pain upon flexion and internal rotation of RLE

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25
Q

What is Rovsing’s sign?

A

RLQ pain upon palpation of LLQ

26
Q

What is McBurney’s sign?

A

Pain upon palpation of the RLQ

27
Q

What tumor marker is elevated in pancreatic cancer?

A

CA 19-9

28
Q

What is the most common cause of painless rectal bleeding in pediatric population?

A

polyps

29
Q

What are the three borders of Hesselbach’s triangle?

A

Medial border: rectus abdominus
Superior border: inferior epigastric artery
Lateral border: inguinal ligament

30
Q

What is intestinal pseudo-obstruction without evidence of mechanical cause called?

A

Ogilvie Syndrome

31
Q

List the 6 “rule of 2” characteristics of Meckel’s diverticulum.

A

2% of population - 2 feet proximal to ileocecal valve - 2 inches long - 2 years old - 2:1 M:F ratio - 2 tissues: gastric & pancreatic

32
Q

Which disorder commonly has cobblestoning or skip lesions on imaging?

A

Crohn’s

33
Q

What test is used to diagnose lactase deficiency?

A

Lactose breath hydrogen test

34
Q

What disorder is colon dilation air fluid levels and thumbprinting sign on imaging suggestive of?

A

Toxic megacolon (Thumbprinting may also occur with mesenteric ischemia)

35
Q

What is the Dx? Acute abdominal pain. KUB shows dilated loops of bowel with air fluid levels.

A

small bowel obstruction

36
Q

At what age should routine colonoscopy screening begin for men and women?

A

age 50

37
Q

Most common type of colon cancer?

A

adenocarcinoma

38
Q

What is the DX? 65-year-old male 3 months of recent weight loss poor appetite new constipation and anemia.

A

think colon cancer

39
Q

Celiac sprue intestinal biopsy findings?

A

villous atrophy

40
Q

Good test for malabsorption?

A

Fecal fat testing

41
Q

Intestinal angina?

A

chronic mesenteric ischemia

42
Q

What is the Dx? 60-year-old male smoker complains of recurrent dull abdominal cramps/pain within 1 hour of eating meals.

A

chronic mesenteric ischemia

43
Q

What is severe abdominal pain out of proportion to physical exam findings suggestive of?

A

acute mesenteric ischemia

44
Q

Acute thrombosis or embolism of the celiac or mesenteric arteries?

A

acute mesenteric ischemia

45
Q

Name the criteria used to diagnose Irritable bowel syndrome.

A 
Rome criteria: 
Pain relieved with defecation
Change in frequency and form
Altered stool passage
Passage of mucus
46
Q

Irritable bowel disease that may affect the entire GI tract from mouth to anus?

A

Crohn’s

47
Q

What are the extraintestinal manifestations that can be seen in ulcerative colitis patients?

A 
Pyoderma gangrenosum
Arthritis
Ankylosing spondylitis
Erythema nodosum
Uveitis
48
Q

Inflammatory bowel disease that only affects the large intestines?

A

Ulcerative colitis

49
Q

Inflammatory bowel disease that often presents with bloody diarrhea?

A

Ulcerative colitis

50
Q

What is the Dx? Newborn with double bubble sign on abdominal X-ray.

A

duodenal atresia

51
Q

List 3 antibiotic regimens which can be used for diverticulitis?

A

Quinolone with metronidazole
Amoxicillin-clavulanate
Trimethoprim-sulfamethoxazole

52
Q

Treatment for acute diverticulitis?

A

Initial: NPO/IV fluids antibiotics - May require surgery if perforation or abscess

53
Q

+anti-tissue transglutaminase +anti gliadin and +anti endomysial antibodies are suggestive of what disorder?

A

Celiac sprue

54
Q

What cardiac disorders are acute mesenteric ischemia associated with?

A

AFib, CHF, MI

55
Q

Sign seen with appendicitis with pain over the right lower quadrant one-third of the distance from the ASIS to the umbilicus?

A

McBurney’s

56
Q

Medications to treat gastroparesis?

A

Metoclopramide

IV erythromycin

57
Q

A sausage shaped mass and currant jelly stool are consistent with what diagnosis?

A

intussusception

58
Q

A newborn with bilious vomiting and a non-distended abdomen is found to have a double bubble sign on KUB. What is your diagnosis?

A

duodenal atresia

59
Q

What exam finding would be possibly seen on radiologic work up for child with pyloric stenosis?

A

US for identification shows a Double-track - Follow up barium studies show String sign and Shoulder sign

60
Q

Use of what antibiotic is associated with increased risk of pyloric stenosis?

A

Clarithromycin (Note: erythromycin is also associated)

61
Q

A baby presents with vomiting and abdominal exam reveals an olive like mass in the RUQ. What do you suspect?

A

pyloric stenosis

62
Q

Both mesenteric ischemia and toxic megacolon may have a thumb printing sign on imaging. What differentiates the two on physical exam?

A

Mesenteric ischemia has a soft abdomen - Toxic megacolon as rigid abdomen

SP: GI and Nutrition Pearls (10%) (7 decks)

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