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Flashcards in GI FInal Deck (97):
1

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

most common among caucasians, specifically jewish descent

2

Crohn's Disease typically takes place where? describe location

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

3

Ulcerative Colitis takes place where? describe location

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

4

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

terminal ileum 85%

5

crohn's ileocolitis typically occurs where?

small and large intestine 40-55% of time

6

Name the condition: "cobblestone appearance"

Crohn's disease

7

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

transmural

8

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

T

9

Common symptoms of Crohns disease 3

Constant abdominal pain, weight loss, diarrhea

10

PE signs of crohns

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

11

Steps of progressive bowel obstruction of crohns

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

12

Abnormal lab results of crohns

CBC, ESR, CRP, nutritional deficiences

13

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

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

14

procedure of choice for diagnosing crohns?

colonoscopy, better than tissue biopsy

15

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

False, 85% they are distinguishable

16

4 possible treatment for crohns

antiinflammatories, antibiotics, nutritional support, and surgery

17

Which is more common: crohns or UC?

UC

18

UC superficial or deep inflammation?

superficial mucosal infalmamation

19

Symptoms of UC 5

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

20

Tenesmus def

urgency to have bowel movement with incomplete feeling of evacuation

21

How is UC abodminal pain relieved?

relieved by having a bowel movement

22

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

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

23

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

rectal bleeding, no fever, less than 4 BM

24

Moderate UC= bleeding? BM?

moderate bleeding, 4-6 BM

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