Large Bowel Disorders Flashcards Preview

Gastroenterology > Large Bowel Disorders > Flashcards

Flashcards in Large Bowel Disorders Deck (50):
1

Acquired by 20% of patients through fecal-oral transmission in a hospital setting

Antibiotic associated colitis (Clostridium difficile infection)

2

Signs and symptoms include: Moderate greenish, foul-smelling watery diarrhea. Mild LLQ tenderness. Stool has mucus but seldom blood. Fever up to 40C (104F)

Antibiotic Associated Colitis (C.diff)

3

Treatment for Antibiotic Associated Colitis (C.diff)

D/C antibiotics. 1st Metronidazole(Flagyl) 500mg TID x 10-14/d. If fails, Vancomycin 125mg PO QID (more expensive). Probiotics

4

If appendicitis is left untreated, how soon does gangrene and perforation develop?

within 36 hrs

5

Most common abdominal surgical emergency

appendicitis

6

Classic h/o of appendicitis

periumbilical pain followed by nausea

7

point just below the middle of a line connecting the umbilicus and the anterosuperior iliac spine.

McBurney's point

8

Pain in the right lower quadrant with palpation of the left lower quadrant

Rovsing sign

9

evaluated by passively flexing the right hip and knee and internally rotating the hip

obturator sign

10

evaluated by placing patient in either the supine or the left lateral decubitus position and extending the right leg at the hip

psoas sign

11

Has become the most important imaging study in patients with ATYPICAL presentations of appendicitis

CT scans

12

condition of having diverticula of the colon. more common in the sigmoid colon. associated w/low fiber, high intake of fat/red meat, obesity, lack of excercise

diverticulosis

13

which are outpocketings of the colonic mucosa and submucosa through weaknesses of muscle layers in the colon wall (Mucosal layer herniates thru muscularis layer)

diverticula

14

H/O includes: chronic constipation, some pts may c/o cramping, bloating, flatulence, and irregular defecation

diverticular disease

15

PE may reveal LLQ tenderness and palpable sigmoid/descending colon

diverticular disease

16

Treatment for diverticular disease

Bulk in diet to get one BM per day at minimum

17

Swelling and inflammation of diverticulum in the intestinal wall

diverticulitis

18

erosion of the diverticular wall by increased intraluminal pressure or inspissated stool within a diverticulum; inflammation and focal necrosis ensue, resulting in perforation

diverticulitis

19

Signs and symptoms include: achy LLQ pain, N/V, low grade fever, palpable mass, distention, stool occult blood, leukocytosis

diverticulitis

20

CI during initial stages of diverticulitis due to risk of perforation

barium enema or colonoscopy

21

test of choice in pts suspected of having acute diverticulitis

CT scan

22

Outpatient treatment for diverticulitis

clear liquid diet, analgesia, Augmentin or Flagyl + Cipro x 7 days

23

Inpatient treatment for diverticulitis (ie the elderly, immunosuppressed, those with significant comorbidities, and those with high fever or significant leukocytosis)

IV fluids, NG tube, IV abx. Surgery- Drainage of abscess, temp or perm colostomy

24

Most common form of congenital abnormality of the small intestine, resulting from an incomplete obliteration of the vitelline duct in 5th week of fetal development

Meckel's Diverticulum

25

Occurs on the antimesenteric border of the ileum, usually 60cm proximal to the ileocecal valve

Meckel's Diverticulum

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2% of the population, 2 feet from the ileocecal valve, and is about 2 inches long, 2% of patients develop a complication over their lifetime, present by age 2

rule of twos for Meckel's Diverticulum

27

3 most common complications for Meckel's Diverticulum

GI bleeding, inflammation of diverticulum, intestinal obstruction

28

Part of the intestines has prolapsed into another section of intestine. Usually occurs at the terminal ileum (ileocecal)

intussusception

29

predominate cause of intestinal obstruction in persons aged 3 months to 6 years

intussusception

30

Signs and symptoms include: colicky/intermittent pain, loose stools w/vomiting, blood or mucus passed through rectum (currant jelly stools)

intussusception

31

Absence of bowel sounds in the RLQ

Dance's sign. Associated w/intussusception

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method of choice to detect intussusception

ultrasound- a bull's eye or coiled spring lesion often observed

33

Treatment for intussusception

barium enema

34

Twisting of the bowel on itself. Sigmoid if most common form. Occurs frequently in middle-aged men and elderly men

volvulus

35

Patients experience abdominal pain, distension, and absolute constipation

volvulus

36

Clinical syndromes caused by impaired intestinal motility and are characterized by symptoms and signs of intestinal obstruction in the absence of a lesion-causing mechanical obstruction

Ileus and intestinal pseudo-obstruction

37

most frequently implicated cause of delayed discharge following abdominal operations

Ileus and intestinal pseudo-obstruction

38

Treatment of ileus

Support patient with bowel rest, fluids and electrolytes. Avoid opiates

39

Neurogenic or muscular impairment of peristalsis. Common after bowel surgery

paralytic ileus

40

Signs and symptoms include: severe colicky pain, absolute constipation, distention, high pitched bowel sounds

mechanical intestinal obstruction

41

Signs and symptoms include: pain, absolute constipation, distention, SILENT abdomen

paralytic intestinal obstruction

42

A cyst at the bottom of the tailbone (coccyx) that can become infected and filled with pus

Pilonidal Cyst

43

Caused by ingrown hairs

Pilonidal Cyst

44

Signs and symptoms include: pain, swelling, redness at bottom of spine, draining pus, fever, leukocytosis

pilonidal cyst

45

Involves incision and draining, removal of pus and hair, and sewing of the edges of the fibrous tract to the wound edges to make a pouch

marsupialization

46

A tear in the anoderm distal to the dentate line, resulting in linear or rocket shaped ulcer. Results from high anal pressure :trauma to the anal canal during defection

anal fissure

47

Symptoms include: Severe, tearing pain during defecation. Throbbing discomfort. Mild hematochezia

anal fissure

48

Subepithelial vascular cushions with connective tissue, smooth muscle fibers, AV communications with the superior rectal artery and rectal veins located proximal to the dentate line

internal hemorrhoids

49

Arise from the inferior hemorrhoidal veins located below the dentate line.

external hemorrhoids

50

Conservative treatment of hemorrhoids

fiber, increased fluids, anusol, tucks pads, sitz baths