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intestinal disorders Flashcards

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1
Q

diverticular disease is?

A

Diverticulosis, also known as “diverticular disease”, is the condition of having diverticula in the colon, which are outpocketings of the colonic mucosa and submucosa through weaknesses of muscle layers in the colon wall. These are more common in the sigmoid colon, which is a common place for increased pressure. This is uncommon before the age of 40, and increases in incidence after that age.

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2
Q

what is another name for the tiny pockets in the lining of the bowel?

A

diverticula

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3
Q

diverticulosis is formed by?

A

increased pressure on weakened spots of the intestinal walls by gas, waste, or liquid

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4
Q

where is diverticulosis most common?

A

95-98% of the time in the sigmoid colon

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5
Q

diverticulosis occurs in _____% over 40 and _____% of people over 60

A

10%

50%

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6
Q

True or False

There are many symptoms to diverticulosis

A

False

there are few

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7
Q

Diverticulosis: it is _______ reversible and complications occur in about _____% of people

A

rarely

20

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8
Q

what is diverticular bleeding?

A

chronic injury to small blood vessels next tot he diverticula

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9
Q

what is diverticulitis?

A

inflammation and infection in one or more diverticula

diverticula become blocked with waste

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10
Q

what are S/S of diverticular bleeding?

A

bright red-colored/wine-colored stools
painless urge to defecate
copious bleeding that stops spontaneously

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11
Q

S/S of diverticulitis?

A

Can occur suddenly and without warning
Alternating diarrhea with constipation
Painful cramps/ tenderness in lower abdomen
Chills or fever over 101°
Recurrent urinary tract infections (colovesicular fistulas)
Severe/ generalized abdominal pain (diffuse peritonitis)
Back or lower extremity pain (perforation)

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12
Q

diverticular disease risk factors are?

A 
Low-fiber diet 
Advanced age 
Obesity 
Pelvic Floor disorder (females)
Male gender= diverticulitis 
High fat intake 
Lack of regular physical activity
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13
Q

true or false

Men have a higher chance of diverticulitis

A

True

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14
Q

how can diverticular disease be prevented?

A

maintain good bowel habits
fiber consumption
exercise regularly

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15
Q

what is the recommended amount of fiber intake according to the American Dietetic Association?

A

20 to 35 grams a day

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16
Q

what are 3 drug therapies for DD?

A

antibiotics for infection
anticholinergics for relieving cramps
analgesic for pain relief

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17
Q

in an emergency with DD, a ______ procedure is performed

A

Hartmans

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18
Q

what is the Hartmans Procedure?

A

In an emergency- detach the sigmoid colon from the rectum, close the rectum, reconnect the sigmoid colon directly to an opening created on the surface of the body
Reversed within 6 months

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19
Q

a colonoscopy with __________ can be used to stop bleeding

A

electrocoagulation

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20
Q

DD primarily affects ?

A

industrialized western societies
males= females
older age

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21
Q

western societies have _____ sided gut pain while eastern societies have _____ sided gut pain

A

left

right

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22
Q

complications occur in about ____-____% of patients with diverticulosis during life

A

10-20%

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23
Q

morbidity for DD is worse in _______ patients

A

younger

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24
Q

Prognosis of DD is ______ with early detection and treatment of complications

A

good

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25
what is Colorectal Cancer (CRC) ?
cancer of colon (large intestine) and/or rectum
26
CRC affects the colon about ____% of the time
70%
27
CRC affects the rectum about ____% of the time
30%
28
if CRC is found early, the 5 year survival is _____%
90
29
if CRC metatsis to lymph nodes, the 5 year survival goes to ____-____%
35-60%
30
if CRC metastasis to liver, the 5 year survival goes to _____%
<10%
31
True or False | When CRC first develops, the symptoms are the worse
False | 1st develops with no symptoms
32
what are S/S of CRC?
Blood in stool Change in bowel habits Stools narrower than usual General stomach discomfort Frequent gas/ pains/indigestion Unexplained weight loss Low Back Pain
33
what are CRC risk factors?
Inflammation of bowel (DD) family history of CRC or colorectal polyps certain hereditary syndromes lifestyle factors
34
Lifestyle factors that increase the chance of CRC include?
``` Lack of regular physical activity Low fruit and vegetable intake Low-fiber and high-fat diet Overweight/obese Alcohol consumption Tobacco use ```
35
what does CRC prevention include?
``` CRC Screening Increasing physical activity Eating fruits & vegetables Limit alcohol consumption Avoid tobacco ```
36
True or False | All men and women aged 50 years or older routinely screened
True
37
what are the 4 screening options for CRC?
Fecal Occult Blood Test (FOBT) Flexible Sigmoidoscopy Double-contrast Barium Enema Colonoscopy
38
what is the fecal occult blood test?
checks for occult blood in stool At home, you place a small amount of your stool from 3 consecutive bowel movements on test cards Return the cards to your doctor's office or a lab Recommended yearly
39
the FOBT is recommended ______?
yearly
40
what is the flexible sigmoidocopy?
Before test, use a strong laxative and/or enema A narrow, flexible, lighted tube inserted in rectum and the lower portion of the colon May remove abnormalities Recommended every five years
41
Flexible Sigmoidoscopy is recommended every ______ years?
5
42
what is the double-contrast barium enema?
enema with a barium solution X-ray of the rectum and colon Barium coats lining of intestines so that polyps/ abnormalities visible on X-ray Recommended every 5years
43
Double-Contrast Barium Enema is recommended every ______ years?
5
44
what is a colonoscopy?
Given a sedative for comfort Narrow, flexible, lighted tube to look at the inside of the rectum and the entire colon May remove abnormalities Recommended every 10 years. Used as a follow-up test if anything unusual is found during other screening tests
45
what test is used a follow up if any other the other test are positive?
colonoscopy
46
the colonoscopy is similar to the______ ______, but the tube is _____ and allows visions of the _____ ____?
flexible sigmoidoscopy longer entire colon
47
CRC treatment includes?
Tumor Removal Resection Colostomy Chemotherapy
48
what is a colostomy?
a surgical operation in which a piece of the colon is diverted to an artificial opening in the abdominal wall so as to bypass a damaged part of the colon.
49
CRC may initially present to a PT as ____ ___ ___
low back pain
50
Hip/thigh pain may be referred from ______ ______
iliopsoas abscess
51
PT need to make sure pts avoid the ___ ____during exercises?
valsalva maneuver
52
what is paralytic Ileus?
is a disruption of the normal propulsive ability (peristalsis) of the gastrointestinal tract functional intestinal obstruction
53
signs and symptoms of Paralytic Ileus include?
Mild to moderate abdominal pain Absent bowel sounds Dehydration Generalized abdominal distention Constipation
54
how is paralytic Ileus diagnosed?
Clinical signs and symptoms Radiography of abdomen Barium enema
55
what is the treatment of paralytic Ileus?
Removal of the cause Restricted oral intake Complete elimination of food and fluids Aspiration of gastric secretions Parenteral nutrition
56
what is Crohn's Disease?
a chronic inflammatory disease of the intestines, esp. the colon and ileum, associated with ulcers and fistulae.
57
Crohn's Disease is more common in ?
the west and Causcasians
58
M:F of Crohn's disease?
1 : 1.2
59
Crohns disease occurs at a mean age of _____, although elderly are also at ______ risk
26 | increased
60
pathology of crohn's disease?
Involved small bowel is thickened and narrowed Colonic fistulae-enteroenteral,enterovaginal, or enterocutaneous Deep mucosal ulcers Skip lesions
61
what are Skip lesions?
A skip lesion is a wound or inflammation that is clearly patchy, "skipping" areas that thereby are unharmed. It is a typical form of intestinal damage in Crohn's disease, but may also be the kind of damage to the renal tubules in acute tubular necrosis
62
clinical features of Crohn's Disease include?
Prolonged diarrhea in 80% Low-grade fever Generalised fatigability abdominal pain
63
Medical management of Crohn's Disease includes?
inducing remission through the use of oral glucocorticosteroids and/or enteral nutrition maintenance through the use of drugs
64
surgical management of Crohn's disease is indicated when?
failure of medical therapy complications such as toxic dilatation, obstruction, perforation, abscesses, fistulas failure to thrive
65
______% of pts with Crohn's disease require an operation at some point
80%
66
pt's with Crohn's disease are ___-___ times more likely to develop bowel cancer, but < ____
6-10 | Ulcerative colitis
67
Ulcerative Colitis (UC) is?
form of inflammatory bowel disease (IBD). Ulcerative colitis is a form of colitis, a disease of the colon (the largest portion of the large intestine), that includes characteristic ulcers, or open sores. The main symptom of active disease is usually constant diarrhea mixed with blood, of gradual onset.
68
True or False | UC is an acute GI disorder?
False | chronic
69
age of onset for UC is?
any age, but 10-40 years are most common
70
UC male to female prevalence?
equal
71
True or False | pt's with UC are at an increased chance of cancer
true
72
True or False | Pts with UC can help prevent cancer risk with bowel resection
true
73
where are the location of lesions in UC?
large intestine; rectum
74
UC: inflammation and ulceration involve the _____/_____ layers
mucosal/submucosal
75
True or False | The symptoms of UC come and go, fairly short periods between flare-ups
False | long periods
76
Clinical manifestations of just UC?
``` 1st symptom – progressive loosening/bloody stools Abdominal pain (relieved by BM) ```
77
Clinical manifestations of just Crohn's Disease?
``` Abdominal pain (not relieved by BM) Abdominal mass Anorexia ```
78
Clinical manifestations that are common in both UC and Crohn's disease?
Diarrhea Weight Loss Skin rashes Joint pain
79
a related serious acute complication of UC and Crohn's disease is?
toxic megacolon
80
diagnosis of UC is done by?
exclusion based on medical Hx & clinical presentation sigmoidoscopy barium enema
81
what are the 4 major drug classes used today to treat UC?
aminosaliclylates steroids Immune modifiers antibiotics
82
True or False | UC can be managed without hospitalization
True
83
UC: there is a ______% mortality rate when complications occur in the first ten years
20%
84
UC: 10 years of chronic attacks can lead to?
colon cancer
85
UC: how can colon cancer be prevented?
removal of the affected section
86
what is IPPA?
ileal pouch-anal anastomosis | primary elective operation for UC pts
87
what are the PT implications for IBD?
Screen for medical disease any time a pt presents with LBP, hip, or SI pain of unknown origin Know what medications a pt is taking Observe for any signs of dehydration

med surg 3 test 3 (9 decks)

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