Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CPD II > Lower GI 2 > Flashcards

Lower GI 2 Flashcards

(60 cards)

Start Studying
1
Q

Acute intestinal perforation - ssx:

A 
sudden & catastrophic!
severe, generalized abd pain
signs of shock
N/V
anorexia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Acute intestinal perforation - causes:

A 
in SI:
duodenal ulcer
corrosives
strangulation of the bowel
acute appendicitis

in LI:
obstruction
diverticulitis
IBD
toxic megacolon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Acute intestinal perforation - PE:

Work up:

A

quiet - absent bowel sounds
peritoneal signs: rigidity, guarding
w/underlying GI d/o -> looks like “worsening”

abd x-ray or CT -> free air seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Gastroenteritis:

A

inflammation of the lining of the stomach, SI, & LI - most commonly from infx
typically self-limiting; serious in young, elderly, immunocompromised

typical GI inhabited by 500 bacterial species!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Gastroenteritis - ssx:

A 
sudden onset N/V
anorexia
abd cramps
diarrhea
malaise
myalgia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Gastroenteritis - PE:

Work up:

A

distended abd
tenderness
borborygmi

stool testing - hemoccult, WBDc, O&P, culture
rapid enzyme - viral, shiga
CBC, CMP (hypokalemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Viral gastroenteritis - prevalence:

Types:

A

30-40% of infectious diarrhea in the US

Rotavirus
Norovirus
Astrovirus
Enteric adenovirus
In immunosuppressed -> CMV & enterovirus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Rotavirus:
Ssx:

A

MC worldwide
33% of hosp admit/20% death assoc w/GE
highly contagious - fecal-oral
peaks in winter (but yr round)

severe dehydrating diarrhea in kids (3-15 mos)
mild in adults
vomiting
fever >102F
lasts 5-7 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Norovirus:
Ssx:

A

older children & adults
year round
highly contagious
can be endemic -> food, water-borne

acute onset vomiting
abd cramps
diarrhea
fever
HA
lasts 1-2 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Astrovirus:
Ssx:

A

infants, young children
winter months
fecal-oral

six like rotavirus:
dehydrating diarrhea
vomiting
fever
lasts 5-7 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Enteric adenovirus:

Ssx:

A

kids <2 yrs
year round/summer
fecal-oral

diarrhea - 1-2 wks
followed by mild vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Bacterial gastroenteritis - 3 mechanisms:

A

exotoxin - secreted by organism, ingested in food; N/V, diarrhea 12hrs from ingestion, no blood/WBC in stool, abate in 36hrs

enterotoxin - cytotoxins specific for mucus membrane in intestine, secreted in vivo, impaired absorption

mucosal invasion - ingest organism, causes ulceration, bleeding, exudate; stool: WBC, RBC, mb gross blood; watery diarrhea - >1L/d, no fever, HA, myalgia; bloody diarrhea - abd pain, tenesmus, N/V, fever, malaise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Gastroenteritis - exotoxin organisms:

A

Staph aureus - MC
Bacillus cereus
Clostridium perfringens
Clostridium botulinum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Staph aureus GE:

A

most common food poisoning
introduced by food handlers
milk products, meat, potato salad

sudden, abrupt, severe vomiting - 2-6hrs post-ingest
explosive diarrhea
abd cramps
fever rare
lasts 3-6hrs, complete recovery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Bacillus cereus - GE:

A

spore-forming organism found in soil
contaminates food
survives high heat

emesis - 2-6hrs post-ingest
severe vomiting
abd pain
mb diarrhea
no fever/no systemic
diarrhea - 8-16hrs post-ingest
foul smelling
profuse
nausea
abd pain
tenesmus

resolves 12-24hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Clostridium perfringens - GE:

A

spore-forming anaerobe
feces, soil, air, water
synthesized before ingestion, more after
beef, poultry, improper cooking/re-heating

watery diarrhea
foul-smelling
severe, crampy abd pain
8-16hrs post-ingest
resolves 24-36hrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Clostridium botulinum - GE:

A

3 exotoxin types - A, B, E
1/3 of deaths from food-borne dz
improper home canning (A, B)
smoked fish (E)

4-8hr incubation
phase 1 - vague: fatigue, N/V, cramps, diarrhea
phase 2 - visual: diplopia, dec. acuity, ptosis, un-PERRLA
phase 3 - neuro: descending weakness/paralysis, dysphagia, sensorium okay, normal-low temp
65% mortality @2-9days
w/tx <10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Gastroenteritis - enterotoxins:

A

Vibrio cholera
Enterotoxigenic E coli
Clostridium difficile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

V. cholera - GE:

A

endemic in Asia
fecal-contaminated food/water
contaminated saltwater crab/freshwater shrimp
1-3day incubation

sudden, painless, profuse, watery diarrhea
no fever, N/V, blood, abd pain, tenesmus
water loss -> thirst, oliguria, mm cramps, weakness
cold, cyanotic skin
dehydration
hypoTN, tachycardia
recover 7-10days (if rehydrated)
50% fatal in untx severe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Enterotoxigenic E. coli - GE:

A

fecal-oral contaminated food/water
1-3day incubation
tissue invasion or enterotoxin

profuse, watery diarrhea
3-5days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

C. diff - GE:

A

overgrowth of intrinsic organism post-abx
infx via external source (soil, water, pets)
cytotoxin & enterotoxin
pseudomembranous colitis
common nosocomial, iatrogenic

watery diarrhea
cramping abd pain
N/V rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Toxic Megacolon:

A 
d/t C. diff
dilated colon
fever
abd pain
tachycardia

PE: tender abd
absent bowel sounds

work up: elev. WBC
distended bowel on X-ray
colonoscopy contraindicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Gastroenteritis - mucosal invasion:

A 
salmonella
Campylobacter jejuni
Shigella
Enterohemorrhagic E col
Yersinia enterocolitica
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Salmonella - GE:

A 
ingestion of raw egg, chicken, milk
contact w/reptiles
req. large inoculum for infx
direct invasion -> exudative diarrhea
enterotoxin -> secretory diarrhea

watery (or bloody) stool
HA
malaise
N/V
abd pain
6-48hrs post-ingest
mb fever
self-limited to 7days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Campylobacter jejuni - GE:
MC cause of bloody diarrhea in US contaminated pork/beef/lamb/milk/H2O/pets incubation 1-7days ``` 12-24hr prodrome: HA myalgia malaise then severe: abd pain fever watery, then bloody, diarrhea self-limit 7-10days ```
26
Shigella - GE:
MC in children 6mos-5yrs contaminated food/H2O/milk or person-to-person highly contagious - small inoculum 1-3day incubation ``` biphasic: starts as low abd pain diarrhea fever in 50% then 3-5 days: rectal burning tenesmus small volume bloody stool children - 1-3days adults - 1-7days ```
27
Enterohemorrhagic E coli - GE:
0157:H7 strain produces Shiga toxin bovine reservoir - raw beef/milk fecal-oral ``` acute onset >16hrs post-ingest severe abd cramps watery diarrhea bloody w/in 24hrs 1-8days 5% complicated -> HUS or TTP ```
28
Yersinia enterocolitica - GE:
raw pork/milk or contaminated water watery or bloody diarrhea fever may mimic appendicitis
29
Traveler's diarrhea:
Turista caused by contact w/endemic organism common: enterotoxic E coli & norovirus ``` N/V borborygmi abd pain, cramps diarrhea 12-72hrs post-ingest usu. self-limiting ``` fever & bloody diarrhea suggest more serious dz
30
Common parasites:
Giardia lamblia Cryptosporidium parvum Entamoeba histolytica
31
Giardia - GE:
fecal-oral, water or person-to-person traveler's pathogen (low IgA, malnutrition, hypochlorhydria) ingestion of cysts -> break down -> infx 7day incubation ``` mb asx mild, watery diarrhea abd bloating cramps flatulence 1-3wks bulky stools foul smelling self-limiting to chronic ```
32
Cryptosporidium - GE:
high rate in HIV, immune-compromised, daycare contaminated food/water/pets (CATS) profuse, watery diarrhea anorexia low fever 5days post ~2 weeks in immune-compromised: chronic, watery diarrhea up to 17days dehydration
33
Entamoeba - GE:
endemic, travel-assoc, fecal-oral HIV, AIDS, immunocompromised ``` mild: crampy abd pain intermittent diarrhea severe: bloody diarrhea abd pain tenesmus fever toxic megacolon ```
34
Drug & chemical-related GE:
* Rx: antacids, abx, antihelminthics, colchicine, digoxin * Heavy metal poisoning * Laxative abuse * Poisonous mushrooms or plants
35
IBD:
loss of tolerance to normal enteric flora triggered by inc permeability, imbalanced flora, stress ``` Crohn's dz (regional enteritis) Ulcerative colitis (UC) ```
36
Crohn's dz - presentation:
transmural inflammation of intestine (mesentery + nodes) ulceration, fissure, fistula, granulomas lesions btw areas of healthy tissue cobblestone appearance - aphthous ulcers, skip lesions exacerbations & remissions
37
Crohn's - etiology, risk factors, incidence:
``` unknown etio - genetic/infx/immuno/psych? smoking OCPs diet: refined sugar, low fiber, high animal fat dysbiosis, abx use early appendectomy 15-25yrs or 55-65yrs younger pop. 88% SI 2-4x higher Jewish caucasian A types higher socioeconomic F>M (slight) ```
38
Crohn's - ssx:
``` RLQ pain - steady, localized fatigue occult blood stool: usu formed (lower = looser) steatorrhea -> risk of gallstones 1/3 have perianal dz (fissure, fistula, abcess) ``` 4 patterns: inflammation- RLQ pain, like appendicitis obstruction- severe colic, distention, constipation, V diffuse jejunoileitis- 1+2 -> chronic debility abd fistula/abcess- late w/fever, painful mass, wasting
39
Crohn's - PE:
RLQ tenderness, assoc fullness or mass abd distension fever wt loss
40
Crohn's - complications:
``` intestinal obstruction! fistula -> abscess malabsorption persistent UTI pneumaturia perforation -> hemorrhage (rare) SCC ```
41
Crohn's - work up:
``` CBC - anemia, leukocytosis inc ESR & CRP low iron & vit B12 fecal lysozyme serology: ASCA, ANCA ``` plain film + barium enema upper GI contrast - string sign CT [US, MRI] colonoscopy - skip lesions, cobblestone appearance, longitudinal ulcers, narrowing, fistulas, sarcoid-type epithelial granulomas
42
Ulcerative colitis - presentation:
chronic, recurrent inflammatory disease of the colon or rectal mucosal layer. superficial ulceration usu. involves rectum (95%) continuous - NO skip areas
43
UC - etiology, risk factors:
``` immune-mediated, autoimmune FHx -> higher risk smoking -> negatively assoc (Crohn's more likely) environmental factors diet - dairy, sugar, low fiber, high fat 2-4x higher - Jewish; higher - caucasian M>F (slight) bimodal peak - 15-25 & 55-65yo ```
44
UC - ssx:
cramping abd pain series of bloody diarrhea attacks, asx btw stool with mucus, RBCs, WBCs - sigmoid tenesmus, watery stool, pus, blood, mucus - proximal SI systemic sx: malaise, fever, anemia, wt loss
45
UC - complications:
hemorrhage - MC toxic megacolon (danger of perforation) dysplastic cells -> risk of colon CA
46
UC - work up:
CBC - anemia, low platelets high ESR, CRP CMP - low albumin, K, Mg; high alk phos stool analysis plain film - dilation, perforation, obstruction, ileus barium enema - lead pipe appearance (loss of haustra) flex sig - Dx colonoscopy w/bx - confirm Dx, staging, monitoring
47
Compare & contrast UC & Crohn's:
USE CHART IN NOTES (in phone pics) but really. do it.
48
IBS -
Dx of exclusion MC GI disorder, 50% of pts to GE dr high frustration, counseling needed functional dyspepsia spastic colitis mucous colitis
49
IBS - etiology (postulated):
``` change in GI motility hypersensitivity of visceral afferents inc mast cells in gut - histamine mm hyper-reactivity psych illness abn nmda receptors HPA axis SIBO diet ```
50
IBS - red flag sx:
``` onset >50yo severe, unrelenting diarrhea nocturnal sx wt loss hematochezia FHx of IBD, celiac, CA ```
51
IBS - Rome III criteria:
1. relieved by defacation 2. onset assoc w/change in frequency 3. onset assoc w/change in form/appearance
52
IBS - PE:
diffuse abd tenderness over colon
53
IBS - work up:
Labs (used to dx/rule out other causes) CBC, CMP, hemoccult, breath test, celiac x-ray - motility (spasm) flex sig - mucus, spasm (or asx)
54
SIBO:
small intestine bacterial overgrowth inc # or type -> fermentation, inflammation, malabsorption gases & toxins produced
55
SIBO - overgrowth prevented by:
``` antegrade peristalsis gastric acid bile proteolytic enzymes sIgA intact IC valve ```
56
SIBO - causes:
``` anatomical anomalies - diverticula, stricture insufficient enzyme abn motility abn communication - fistula, bad valve immunocompromise alcoholism/cirrhosis pancreatitis ```
57
SIBO - Hx:
transient improvement in sx post-abx worse w/ probiotic tx worse w/ inc fiber intake
58
SIBO - ssx:
``` abd pain/cramps borborygmus eructation flatulence bloating watery diarrhea alternative w/constipation systemic - HA, jt pain, fatigue, rosacea ```
59
SIBO - PE:
abd distension succussion splash surgical scar?
60
SIBO - work up:
CBC - macroscopic (B12) or micro anemia, low ferritin Glucose breath hydrogen analysis (H2) methane breath test endoscopy w/jejunal aspirate

CPD II (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions