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GI FInal Flashcards

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1
Q

IBD is most common among what race, specifically what descent?

A

most common among caucasians, specifically jewish descent

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2
Q

Crohn’s Disease typically takes place where? describe location

A

occurs anywhere but rectum is often spared, and has skip lesions

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3
Q

Ulcerative Colitis takes place where? describe location

A

UC takes place in sigmoid colon, starts at the rectum, and is continous

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4
Q

What part of the intestine does crohn’s ileitis typically effect?

A

terminal ileum 85%

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5
Q

crohn’s ileocolitis typically occurs where?

A

small and large intestine 40-55% of time

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6
Q

Name the condition: “cobblestone appearance”

A

Crohn’s disease

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7
Q

What is the term used when Crohns disease affects the entire depth of the bowel wall

A

transmural

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8
Q

T/F Granulomas can be seen on a crohns disease biopsy of tissue

A

T

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9
Q

Common symptoms of Crohns disease 3

A

Constant abdominal pain, weight loss, diarrhea

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10
Q

PE signs of crohns

A

+/- low grade fever, RLQ abdominal tnederness, possible abdominal mass, perineal abnormailites

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11
Q

Steps of progressive bowel obstruction of crohns

A
  1. inflammation causes thick tissues. 2. fistula heal and leave fibrosis 3. can lead to strictures
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12
Q

Abnormal lab results of crohns

A

CBC, ESR, CRP, nutritional deficiences

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13
Q

A vertebral fracture is a complication to what GI condition? why?

A

Crohns, d/t vitramin d deficiency, inc. glucocorticoid intake, and hypocalcemia

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14
Q

procedure of choice for diagnosing crohns?

A

colonoscopy, better than tissue biopsy

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15
Q

T/F for the majority of the time crohns and UC are not distinguishable from each other

A

False, 85% they are distinguishable

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16
Q

4 possible treatment for crohns

A

antiinflammatories, antibiotics, nutritional support, and surgery

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17
Q

Which is more common: crohns or UC?

A

UC

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18
Q

UC superficial or deep inflammation?

A

superficial mucosal infalmamation

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19
Q

Symptoms of UC 5

A

abrupt onset, bloody diarrhea, lower abdominal pain, rectal bleding, tenesmus

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20
Q

Tenesmus def

A

urgency to have bowel movement with incomplete feeling of evacuation

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21
Q

How is UC abodminal pain relieved?

A

relieved by having a bowel movement

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22
Q

UC tends to have abdominal masses, whereas crohns does not. T/F

A

F. Crohns=possible Abdominal masses; UC= NO abdominal masses

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23
Q

Mild UC = bleeding? fever? number of bowel movements?

A

rectal bleeding, no fever, less than 4 BM

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24
Q

Moderate UC= bleeding? BM?

A

moderate bleeding, 4-6 BM

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25
Severe UC=Bleedings? Fever?
Severe bleeding and FEVER, with some hemorrhage, perforatin, gangrene
26
complications to UC
toxic megacolon, colon cancer
27
complications to both UC and Crohns
colon cancer
28
T/FTreating bowel disease will most likely rid pyoderma gangrenosum.
False
29
2 extraintestinal findings of IBD
pyoderma gangrenosum and erythema nodosum
30
Dysentery Def
bloody diarrhea of any cause
31
Bacterial causes of dysentery commonly include
shigella, salmonella, e coli, campylobacter
32
most common cause of travelers diarrhea
E coli
33
most common parasitic cause of dysentery for travelers to india/tropical locations
Entamoeba histolytica
34
Mechanism of transmission of infectious dysentery
consumption of food/water that contains fecal material of pathogens of human/animals
35
Treatment for dysentery
PCP hydration, antibiotics
36
Common treatment contraindication for dysentery is
anti diarrheal meds
37
Possible side effects of antidiarrheal meds in dysentery pts 3
hemolytic uremic syndrome, toxic megacolon, fever
38
most common cause of non bloody acute diarrhea? second most commoN?
infectious agents is 1. medications is 2
39
acute, non bloody diarrhea is usually accompanied by nausea vomiting, called ?
gastroenteritis
40
Nonbloody diarrhea etiology 2. what are they called
working with children=rotavirus | drinking out of a stream=giardia
41
Food poisoning def
ingestion of a toxin produced by bacteria
42
Bacillus cereus is most commonly ingested after eating what
fried rice
43
which of the following can be ingested following eating potato salad?
staph aureus
44
which of the following can be ingested following eating seafood?
vibrio species
45
which of the following can be ingested following eating pourly reheated meals/poultry
clostridium perfringens
46
anti diarrheal meds are safe for
non dysentery diarrhea patients
47
foods that are easily digested when someone has diarrhea
toast, banana, apple sauce,
48
antibiotic induced diarrhea can be cause by 2 things
1. reduced digestive function | 2. allowing the overgrowth of pathogens like Clostridium difficile
49
DEF: hematochezia
fresh blood in the stool
50
patient over 50 Y.O. with painless bleeding, DX
colon cancer till proven otherwise
51
benign painless hematochezia can be caused by
hemorrhoids, colon cancer, eating beets
52
Duodenum is
retro peritoneal
53
3 functions of the small intestine
1 nutrient absorbition and digestion. 2. delivery of undigested waste/waste to large intestine 3. Immune system, GALT, 70% of immune system
54
liver and gall bladder provide BLANKK while pancreas provides BLANKK
liver/GB=bile; pancreas=bi carb and enzymes
55
food that has been properly digested enters absorptive epithelial cells called
enterocytes
56
chyme absorbtion into enterocytes occurs via 2
active transportation and passive diffusion
57
where is the main nutrient absorption location
jejunum
58
where does water and small ions get absorbed?
in between enterocyte cells at tight junctions
59
2 main types of diarrhea
osmotic and secretory
60
osmotic diarrhea= | secretory diarrhea=
O.D=water is drawn in by indigested particles,stops when pT fasts S.D= intestinal crypt cells secrete too much water, DOES NOT STOP WHEN PT FASTS
61
why does a person have smelly poop and farts with lactose sensititvity?
the unabsorbed lactose gets into the colon and the colonic bacteria produces CO2 and H2 gases
62
T/F Prolonged chronic lactose sensitivity with intake of lactose can lead to weight loss and cramping abdominal pain
False, NO weight loss with lactose sensititivty
63
Describe the lactose hydrogen breath test, whats a positive test?
person ingests lactose, 3-8 hrs later hydrogen in breath is measured, inc. hydrogen =lactase deficienty
64
Explain the reaction of GALT when gluten is ingested?
GALT senses that gliadin is an enemy, causing enhanced lymphocyte respoinse and autoantibodies produced. leading to inflammatory cascade, villous atrophy, and decreased asorptive ability,
65
The symptoms of celiacs disease 6
diarrhea, flatus, smelly stools, abdominal distension, fatigue, weight loss
66
dermatologic sign of celiacs disease
dermatitis herpetiformis
67
Diagnostic labs for celiacs diseae 2`
anti-tissue transglutaminase antibody and IGA
68
Diagnositic procedure of choice for DDX celiacs
endoscopic biopsy of distal duodenum showing villous atrophy
69
BLANKK the number two cancer killer in the U.S.
colorectal cancer
70
lifestyle risks of developing colorectal cancer 6
obesity, smoking, drinking, diabetes, low fiber high fat, no exercise
71
describe the sequence of pathophysiology of colorectal cancer
normal mucosa-->adenamouts polyps--> carcinoma
72
polyps def
discrete lesions that protrudes into the intestinal lumen from the mucosa
73
what is the mechanism of cancerous cell change in colorectal cancer? 2
deactivation of tumor supressor genes or mutation in genes leading to oncogene activation
74
most colon cancers are due to BLANKKK mutations, sporadic or inheritied
sporadic
75
Lynch syndrome is AKA and involves what side of the colon?
herditary nonpolyposis colorectal cancer
76
2 types of polyps that can lead to cancer, which is more common?
adenomatous and serratus, adenomatous is more common
77
what size of polyp has the highest increased risk of malignancy?
greater than 2.5 cm
78
sessile or pedunculated shaped polyp has a higher risk of malignancy?
sessile has a higher rate of malignancy
79
two types of colon cancerous lesions that can form,
bulky adenocarcinoma and annular constricting carcinoma( apple core lesion)
80
most common location in colon for colon cancer to occur is the
rectosigmoid colon
81
3 sxs of colon cancer?
asymptomatic till late stage. 1. bleeding 2. weight loss 3. change in frequency of bowel movements
82
colon cancer can produce high levels of BLANKK that can be used s a tumor marker.
carcinoembrionic antigen
83
what test is preferred for fecal occult blood testing?
fecal immunochemical testing is most sensitive and specific
84
sigmoidoscopy should be done every BLANKK years, colonsoscopy should be done every BLANKK years?
sigmoid=5 years; colonsoxcopy = 10 years
85
regular screening shoudl occur in patients that are blankk y.o?
50-75 years old
86
If patient is positive for family hx of colon cnacer, when should screening begin?
at age 40 or 10 eyars before family members diagnosis
87
Describe the Rome III IBS criteria
recurrent abdomjinal pain at least 3 days per month in the last 3 months with 2 or more of: improved w/ defecation, change in frequency, change in stool appearance
88
if present, abdominal tenderness is located where in IBS
LLQ
89
What antibiotic is recommended for IBS?
rifaximin
90
duverticulosis is most common in what area of the colon?
sigmoid colon
91
what is the most common cause of hematochezia in patients that are older than 60 y.o
diverticulosis
92
Lab findins for diverticulitis show BLANKK. A BLANKK imaging can show diverticulitis.
LAB= leukocytosis. CT scan showsdiverticultis
93
What disease can cause chronic constipation? what hormone would you want to evaluate in the blood?
hypothyroidism, TSH
94
leading cause of appendix inflammation is by a
fecalith
95
peritonitis is most commonly caused by
infection
96
Is peritointis pain sensitive?
VERY
97
a secondary cause of perionitis is commonly
a perforation of a hollow viscus

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