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Flashcards in Diseases of the Colon Deck (9)
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1
Q

What are the similarities between Crohn’s disease and ulcerative colitis?

A
  • IBD: chronic, dysregulated inflammation of small/large intestine
  • chronic diarrhea
  • Weight loss
  • Fatigue
2
Q

What are the differences between Crohn’s disease and ulcerative colitis?

A

UC

  • Lower abd pain
  • Hematochezia
  • Mucus in stool
  • Tenesmus
  • Localized to colon
  • No fistulae, abscesses, or strictures
  • Diffuse distribution
  • Mucosal/submucosal inflammation
  • superficial/confluent ulcers
  • mild to no fibrosis
  • no granulomas
  • malignant potential

Crohn’s

  • Mid or lower abd pain
  • N/V
  • Steatorrhea
  • Fistula symptoms
  • “Tongue to bum” - entire GI tract
  • Strictures are common
  • “Skip lesions” distribution
  • Transmural inflammation
  • Deep, linear ulcers
  • Marked fibrosis
  • ~20% have granulomas
  • Obstruction and malabsorption
  • Can recur after colectomy
3
Q

What are the complications of diverticular disease and their presentation?

A

Complications:

  • Hemorrhage
  • Acute diverticulitis

Presentation:

  • 80% are asymptomatic
  • > 50% are elderly
  • Hemorrhage: painless hematochezia often heavy and stops w/in 2-3 days
  • Diverticulitis: lower abd pain, nausea, fever
4
Q

What are the causes of lower GI bleed?

A
  • Diverticulosis
  • Arteriovenous malformations
  • Colitis (IBD usually)
  • Neoplasia
  • Post-polypectomy or biopsy

Misc

  • Internal hemorrhoids
  • Solitary rectal ulcer
  • Anal fissure
  • Dieulafoy’s lesions
5
Q

What is the presentation of lower GI bleeding?

A

Presentation varies based on cause. Determining the stuff below helps you figure out the cause

  • Chronic vs acute vs no pain
  • Diarrhea?
  • Wt loss?
  • NSAIDs?
  • H/o radiation?
  • Heavy vs light bleeding
  • Travel history?
  • Dysentery?
  • Antibiotic use?
  • Recent surgery

You get the idea. Go look at his “historical clues” slide — he said test questions would be based on it

6
Q

What are the causes of colonic obstruction?

A
  • Malignancy
  • Benign (adhesions, strictures, volvulus)
  • Foreign body
7
Q

What is the presentation of colonic obstruction?

A
  • N/V
  • Abd distension
  • Constipation
  • Obstipation
8
Q

What are the causes of colitis?

A

Microscopic

Ischemic

  • Vasculitis
  • Substance abuse (cocaine, meth)
  • Rx
  • Mesenteric thrombosis
  • Rare: marathon running, extreme dehydration

Infectious

Radiation

9
Q

How can you differentiate colitis from diverticulitis?

A

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