Large Intestine & Anorectal

Question 1

Functional disorders of the large intestine are primarily diagnosed based on subjective findings and fulfillment of the __ criteria

Answer 1

Rome

Question 2

_____ is a category of colitis (generic term for inflammation of colon) and is well known for two of it’s subtypes

Answer 2

Inflammatory bowel disease (IBD)

Question 3

What are the two subtypes of inflammatory bowel disease? (IBD)

Answer 3

1. Crohns’ disease

2. Ulcerative colitis

Question 4

What is one of the main secondary disorders associated with disease of the large intestine?

Answer 4

Malabsorption

Question 5

Pain from the large intestine often refers to the ____

Answer 5

Back

Question 6

Is irritable bowel syndrome (IBS) considered pathological or functional?

Answer 6

Functional

Question 7

Another name for Irritable Bowel Syndrome? (IBS)

Answer 7

Spastic colon

Question 8

This is a chronic functional disorder of the large intestine. The cause is unclear. Tends to begin in adolescence/20’s and more in females.

Answer 8

Irritable Bowel syndrome (IBS)

Question 9

In diagnosing IBS it is important to fulfill the Rome Criteria, but also very important to _____

Answer 9

Rule out other DDX’s

Question 10

What is this diagnostic system called?

1. At least 1 day/wk in last 3 months
2. Onset at least 6 months before diagnosis
3. Associated w/2 or more of following:
   - related to defecation
   - assoc. w/change in frequency of stool
   - assoc. w/change in form of stool

Answer 10

Rome Criteria (IV)

Question 11

Generic term for inflammation of the colon

Answer 11

Colitis

Question 12

This type of colitis is autoimmune

Answer 12

Inflammatory Bowel Disease (IBD)

Question 13

This type of colitis is idiopathic

Answer 13

Microscopic

Question 14

The type of colitis related to vascular disease?

Answer 14

Ischemic colitis

Question 15

Crohn’s disease and ulcerative colitis usually begin before age __

Answer 15

30

Question 16

This type of IBD typically affects the distal ileum and right side of the colon. Never the rectum. Microscopic exam would show “skip” lesions

Answer 16

Crohn’s disease

Question 17

Crohn’s disease can lead to perianal conditions in __-__% of cases.

• Abscesses
• Fistulas
• Strictures
• Anal fissures, hemorrhoids

Answer 17

25-33%

Question 18

T/F: Surgery is not uncommon for a person w/Crohn’s disease

Answer 18

True

Question 19

This type of IBD is common on the LEFT side of the colon (can be transverse) and CAN involve the rectum

Answer 19

Ulcerative colitis

Question 20

How does ulcerative colitis differ from Crohn’s disease as far as complications go?

Answer 20

UC DOES NOT cause obstruction, abscess or fistulas. Also surgery is RARE

Question 21

This type of colitis usually affects patient’s >40 yo. Peak incidence is 60s-70s and more common in females. Unknown etiology. It often resolves on it’s own within 3 years

Answer 21

Microscopic colitis

Question 22

What are the two subtypes of microscopic colitis?

Answer 22

Collagenous, lymphocytic

Question 23

Which subtype of IBD is made worse by smoking?

Answer 23

Crohn’s disease

Question 24

Which type of colitis is associated with watery diarrhea?

Answer 24

Microscopic

Question 25

____ will not usually cause rectal bleeding, while ___ will. Subtypes of IBD

Answer 25

Crohn’s, ulcerative

Question 26

In this type of colitis the colon will appear normal in a colonoscopy. You would need a biopsy to diagnose.

Answer 26

Microscopic

Question 27

In this subtype of IBD a colonoscopy would show uniform inflammation

Answer 27

Ulcerative colitis

Question 28

This subtype of IBD can have extra-intestinal manifestations such as uveitis, mouth/skin sores, arthritis/sacroiliitis, increased risk of gallstones, headaches and depression.

Answer 28

Crohn’s disease

Question 29

Risk factors for this type of colitis include smoking and medications (pain relievers, PPI, antidepressants)

Answer 29

Microscopic colitis

Question 30

Mucosal herniations commonly in the distal colon. Attributed to LOW FIBER diet

Answer 30

Diverticulosis

Question 31

Diverticulosis is common after age ___ and most (__% +) never have symptoms!

Answer 31

40, 70%

Question 32

A significant risk factor for diverticulosis?

Answer 32

Constipation

Question 33

LLQ pain especially after a meal and the person gets some relief w/bowel movement.

Answer 33

Diverticulosis

Question 34

A person w/diverticulosis would want to consume a high ___ diet (20-35 grams/day)

Answer 34

Fiber

Question 35

When mucosal outpocketings become infected and inflamed it is called ____

Answer 35

Diverticulitis

Question 36

Fleshy growth in lining of colon or rectum. If untreated can lead to colorectal cancer.

Answer 36

Colorectal polyps

Question 37

70% of colorectal cancer occurs in the ___ and ___

Answer 37

Rectum, sigmoid

Question 38

Colon cancer is more common in ___, while rectal cancer is more common in ____ (gender)

Answer 38

Women, men

Question 39

Two predisposing factors for colorectal cancer?

Answer 39

1. Ulcerative colitis | 2. Low fiber diet

Question 40

Colorectal cancer can be diagnosed through routine exam and screening by ____ testing

Answer 40

Fecal occult blood (FOBT)

Question 41

Testing for colorectal cancer is suggested at age ___

Answer 41

50

Question 42

Painful tear or crack in the lining of the anal canal

Answer 42

Anal fissure

Question 43

Sharp, burning or tearing pain w/or after a bowel movement. Bright red blood can be seen on toilet paper and it reoccurs with next bowel movement

Answer 43

Anal fissure

Question 44

To diagnose an anal fissure you would want to rule out _____ (possible DDX)

Answer 44

Thrombosis hemorrhoid

Question 45

Localized pus in perirectal space which may extend to peritoneum or abdominal organs

Answer 45

Anorectal abscess

Question 46

Tubelike opening that extends from anal canal to perianal skin

Answer 46

Anorectal fistula

Question 47

Inflammation of the rectal tissue

Answer 47

Ano proctitis

Question 48

Itching of perianal skin

Answer 48

Pruritis ani

Question 49

Dilated veins in lower rectum

Answer 49

Hemorrhoids