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Clin Med 3 GI > Diverticulitis/CRC > Flashcards

Diverticulitis/CRC Flashcards

(45 cards)

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0
Q

site of most diverticulosis

A

sigmoid colon

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1
Q

tx diverticulosis

A

high fiber diet (25-40 g/day)

adequate fluids

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2
Q

complication of macroperf in diverticulitis

A

free air, peritonitis

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3
Q

complications of diverticulitis (4)

A

abscess- walled off perforation
fistula- to the bladder or vagina
obstruction- due to inflammation
perforation

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4
Q

progressive, steady/aching LLQ pain, fever, tachycardia (from pain)
N/V, constipation, diarrhea, urinary sx

A

complicated diverticulitis

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5
Q

rigid abd with guarding, rebound tenderness, & absent bowel sounds

A

peritonitis

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6
Q

lab findings for diverticulitis? (3)

A

CBC- leukocytosis w/ left shift
stool for fecal occult
DRE for rectal mass

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7
Q

test of choice for diverticulitis dx?

A

CT scan

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8
Q

CT findings for diverticulitis (4)

A

fat stranding
bowel wall thickening
diverticulosis
the 4 complications (abscess, fistula, obst., perf)

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9
Q

flex sig/colonoscopy/BE use in diverticulitis?

A

contraindicated in acute diverticulitis due to perf. risk

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10
Q

tx uncomplicated diverticulitis (4)

A

metronidazole 500 mg PO TID
Cipro 500 mg PO BID 10-14 days both
clear liquid diet 2-3 days
colonoscopy 4-6 wks after episode

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11
Q

indications for hospitalization with diverticulitis (4)

A

toxic appearance
inability for PO
comorbidities (elderly, immunocomp.)
complication

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12
Q

inpt tx diverticulitis (4)

A

NPO (1-2 days)
IV fluids
Demerol
IV abx w/ G- and anaerobic coverage

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13
Q

indications for inpt emergent surgery for diverticulitis

A

peritonitis

failure to improve w/in 3-4 days

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14
Q

most common cause of acute lower GI bleed in the U.S.

A

diverticular bleeding

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15
Q

sx of diverticular bleeding (3)

A

painless bleeding
occult blood
hematochezia

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16
Q

pathology & common site of diverticular bleeding

A

artery is draped over length of diverticulum which is easily exposed to injury

usually Right side

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17
Q

diagnostics for diverticular bleeding (2)

A

1st: EGD/NG to r/o UGI source
2nd: Flex Sig or Colonoscopy
locate the source of the bleeding

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18
Q

non-neoplastic, benign colon polyps

19
Q

non-neoplastic, inflammatory colon polyps

20
Q

neoplastic colon polyps

21
Q

most common adenoma

Study These Flashcards
A

tubular adenoma

22
Q

highest cancer risk adenoma

Study These Flashcards
A

villous adenoma

23
Q

high risk adenoma characteristics (3)

Study These Flashcards
A

> 10 mm
high grade dysplasia on pathology
villous component

24
follow up for 1-2 small adenomas?
5 years
25
indications for follow up on adenomas w/in 3 years?
10+ adenomas
26
f/u for large adenoma or one that had to be removed in pieces
6 mo
27
common site of CRC
left side
28
risk factors for CRC (many)
personal or FH adenoma, colon CA, FAP/HNPCC Age > 50 IBD (colitis longer than 8-10 years) obesity, excess EtOH, smoking, Type II DM, AA
29
asymptomatic; or: abd pain, change in bowel habits, hematochezia or fecal occult, weakness/fatigue, anorexia, wt. loss, iron deficiency anemia
colorectal cancer
30
PE: physical wasting, wt. loss, signs of volume loss, pallor, LAD, abd distension, ascites, mass, organomegaly, + fecal occult, rectal mass
colorectal cancer
31
classic imaging finding of CRC
apple core lesion
32
lab findings for CRC (4)
microcytic anemia elevated alk phos apple core lesion on CT carcinoembryogenic antigen (CEA) for monitoring reoccurrence
33
stage A CRC on Dukes-Astler-Coller
negative nodes, confined to mucosa
34
Stage C1 of Dukes-Astler-Coller
positive nodes, extension through the muscularis propria
35
CRC screening (3)
Colonscopy- best choice Combo Flex Sig & BE- if you have to Fecal immunochemical test- preferred CRC detection test
36
when to begin CRC screening?
50 y/o, w/o risk factors
37
familial adenomatous polyps (FAP) etiology
autosomal dominant, APC mutation
38
indications for prophylactic colectomy in FAP (2)
> 1 cm | villous pathology
39
extracolonic manifestations of FAP (4)
osteomas dental abn adrenal masses epidermoid cysts & fibromas
40
early onset right-sided CRC (40-45 y/o)
HNPCC
41
HNPCC colon CA common site
proximal right sided
42
HNPCC associated CA (many)
ovary, gastric, small bowel, hepatobiliary, pancreas, renal pelvis, ureter
43
HNPCC diagnostic criteria
3-2-1 CRC or other assoc. CA in 3 relatives occurrence in 2 successive generations Diag. by age 50 in at least 1 pt in hx
44
HNPCC screening
annual colonscopy at 20-25 or 10 years prior to earliest age of onset in FH

Clin Med 3 GI (4 decks)

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