Large Intestine Disease Flashcards

(31 cards)

1
Q

What are the most common causes of appendicitis in children and adults?

A
  1. lymphoid hyperplasia - child

2. fecalith - adults (impacted feces)

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2
Q

What are the usual symptoms of appendicitis?

A

periumbilical pain –> then localizes to RLQ

-fever, nausea, guarding and rebound tenderness

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3
Q

What is IBD? what do they think is the cause?

A

chronic relapsing inflam of bowel

abnormal immune response to enteric flora

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4
Q

Who is the classic patient with IBD and what are the usual symptoms?

A

young women - west, caucasians, eastern european

-bloody diarrhea, abdominal pain

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5
Q

Where does ulcerative colitis occur?

A

mucosal and submucosal layers

begins in rectum and can extend proximally to cecum

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6
Q

What are the symptoms of ulcerative colitis?

A

LLQ pain, bloody diarrhea, cramping, fever

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7
Q

What are the typical pathognomonic signs of ulcerative colitis?

A

crypt abscesses with neutrophils
pseudopolyps
loss of haustra “ lead pipe “ sign

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8
Q

What are some complications of ulcerative colitis? What is the risk based on?

A

toxic megacolon and carcinoma

- extent of involvement and duration

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9
Q

What are some systemic associations of ulcerative colitis?

A

Primary sclerosing cholangitis – liver disease
pANCA positivity, thromboembolism, DVTs
Arthritis, uveitis, erythema nodosum
Pyoderma gangrenosum – noninfective deep purulent ulcers - serious

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10
Q

Is smoking protective against ulcerative colitis or crohns disease?

A

ulcerative colitis

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11
Q

Where are the lesions found in crohns disease?

A

FULL THICKNESS
anywhwere from mouth to anus
terminal ileum is most common*

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12
Q

Are skip lesions seen in ulcerative colitis or crohn disease?

A

crohn disease

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13
Q

What are the symptoms of crohns disease?

A

RLQ pain
non bloody diarrhea
recurrent fever

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14
Q

What are the typical pathognomonic signs of crohn’s disease?

A
noncaseating granulomas in the submucosa
cobblestone appearance
submucosal fibrosis
strictures - narrow lumen 
"creeping fat"
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15
Q

What are some complications of Crohns disease?

A

malabsorption with nutritional deficiency
calcium oxalate nephrolithiasis
Fistula formation – rupture and connection
Carcinoma – only if colonic disease is present
Liver disease – sclerosing cholangitis
amyloidosis

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16
Q

What are some systemic associations of crohns disease?

A
o	Ankylosing spondylitis 
o	Sacrolitis
o	Migratory polyarthritis
o	Erythema nodosum
o	Uveitis – visual disturbance
17
Q

What is hirshsprungs disease?

A

defective relaxation and peristalsis of rectum and distal sigmoid colon
-segmental absence of ganglion cells - failure to descend from neural crest

18
Q

What is hirsphrungs disease highly associated with?

A

down syndrome

19
Q

What are some clinical features of hirshsprungs disease?

A

o Failure to pass meconium
o Empty rectal vault on DRE
o Massive dilation of bowel proximal to obstruction
o Inc in nonmyelinated cholinergic nerve fibers

20
Q

How would you diagnose hirshsprungs disease?

A

rectal suction biopsy

-look for lack of ganglion cells

21
Q

What is colonic diverticulosis?

A

outpouching of mucosa and submucosa through muscularis propria

22
Q

What is believed to be the cause of colonic diverticulosis?

A

low fiber diet , constipation

23
Q

Where do colonic diverticula typically occur?

A

where vasa recta traverse muscularis propria

-sigmoid colon

24
Q

Although diverticula are usually asymptomatic, what are some possible complications?

A
Alternating Constipation and Diarrhea,
colicky abdominal pain, flatulence 
Rectal bleeding – hematochezia
Diverticulitis – appendicitis like symptoms 
fistula
25
What is angiodysplasia?
acquired malformation of mucosal and submucosal capillary beds
26
Where does angiodysplasia occur?
cecum and right colon due to high wall tension
27
What is the presentation of angiodysplasia?
hematochezia in an older adult
28
What are hemorrhoids?
dilated venous channels of hemorrhoidal plexus
29
Where would atherosclerosis affect the colon?
the SMA - splenic flexure is typically affected
30
How does ischemic colitis present?
postprandial pain | digestion requires inc blood
31
What is IBS?
relapsing abd pain with bloating and flatulence - change in bowel habits - improves with defecation - related to disturbed intestinal motility