Diverticulitis I Flashcards Preview

F3 E3 Shea > Diverticulitis I > Flashcards

Flashcards in Diverticulitis I Deck (30)
Loading flashcards...
1
Q

the prevalence of diverticulosis increase with what factor?

A

age

2
Q

what area of the colon is predominately involved in diverticulosis?

A

sigmoid colon

3
Q

patients with diverticulosis usually present

A

asymptomatically in 70 to 80 percent , exam may be completely normal and the condition is discovered incidentally on colonoscopy or other imaging

4
Q

complication of diverticulosis

A

diverticulitis (inflammation) and bleeding

5
Q

if they are symptomatic diverticulosis is associated with what symptoms?

A

occasional abdominal cramping, constipation, diarrhea, bloating

6
Q

what labs and or imaging should be ordered in patients with diverticulosis?

A

no labs or images are needed, move onto treatment

7
Q

diverticulosis treatment

A

high fiber diet and adequate hydration

8
Q

seed and nut association with diverticulosis

A

avoidance of seeds/nuts is not recommended

9
Q

which type of diverticulitis is most common

A

uncomplicated

10
Q

describe the symptoms of a patient with acute diverticulitis

A

a progressive and steady achy pain in the left upper quadrant with fever and/or chills. The patient may also have nausea, vomiting, change in bowel habits, or irritative urinary symptoms

11
Q

what types of irritative urinary symptoms may be present in acute diverticulitis?

A

pneumaturia (passing gas through urine, bubbles in urine)

fecaluria (feces through urine, if colovesical fistula present)

12
Q

describe the signs of a patient with acute diverticulitis

A

low grade fever with LLQ tenderness and possible mass possible peritoneal signs

13
Q

bowel signs with acute diverticulitis

A

normal or abnormal

14
Q

CBC in acute diverticulitis

A

mild to moderate leukocytosis that may be absent in elderly (less likely to mount immune response)

15
Q

test of choice for acute diverticulitis, what are we looking for?

A

A/P CT scan with contrast

looking for bowel thickening and fat stranding and presence of colonic diverticula

16
Q

which test are contraindicated due to risk of perforation in acute diverticulitis

A

Sigmoidoscopy/Colonoscopy and Barium Enema

17
Q

acute diverticulitis treatment uncomplicated

A

send home with oral antibiotics
begin CL/LR diet
F/U w/in 2 days

repeated imaging not needed if showing clinical improvement

18
Q

acute diverticulitis treatment complicated

A

Admit
NPO, IV fluids
IV antibiotics (Transitioned to PO abx to complete a total 10-14 day course)
GI consult, surgery

repeated imaging not needed if showing clinical improvement

19
Q

acute diverticulitis treatment uncomplicated antibiotic choice

A

Gram negative/anaerobic coverage x 10 days

ex Metronidazole 500 mg PO TID + Ciprofloxacin 500 mg PO BID

20
Q

when is surgical repair indicated for acute diverticulitis?

A

peroration with peritonitis
condition deteriorates/ fails to improve within 72 hours of treatment
complicated

21
Q

after the acute episode of diverticulitis resolves what type of diet is recommended to patients

A

a high fiber diet

22
Q

6 to 8 weeks after an acute episode of diverticulitis what should be performed in patients

A

a colonoscopy in appropriate candidates to evaluate extent of the disease and to exclude a concomitant colon cancer or IBD

23
Q

which type of bleeding does diverticular bleeding cause?

A

overt lower GI bleeding that usually resolves spontaneously

24
Q

main symptom of diverticular bleeding

A

Painless hematochezia

25
Q

BMP lab finding in those with diverticular bleeding

A

BUN should NOT be elevated in patients with colonic diverticular bleeding

26
Q

how do we locate the source of bleeding in patients with diverticular bleeding?

A

Scope: Flex Sig/Colonoscopy or possible tagged red blood cell scan or angiography

27
Q

how is diverticular bleeding managed?

A

measures taken to maintain blood volume (transfuse as needed)
treatment of the bleeding site though endoscopic therapy, angiographic therapy, or possible surgical intervention

28
Q

Sac-like protrusions of the colonic wall is referred to as

A

Diverticulum (single) or diverticula (multiple)

29
Q

Diverticulosis is described as what?

A

just the presence of diverticula

30
Q

Diverticulitis is described as what?

A

the presence AND the inflammation of a diverticulum