Lower GI (Exam 3)

Question 1

Appendicits

Answer 1

Inflammation of the appendix

Question 2

Appendicitis: Etiology

Answer 2

Appendicitis becomes obstructed which leads to inflammation

Question 3

Appendicitis: Complications

Answer 3

Gangrene

Abscess formation

Peritonitis

Question 4

Appendicitis Pain

Answer 4

RLQ in the periumbilical area with REBOUND pain

Can start as a dull ache and progresses over 4-6 hours

Question 5

Peak Incidence of Appendicits

Answer 5

10-12 years of age

Question 6

RLQ pain with sudden relief

Answer 6

This may indicates a rupture which can lead to peritonitis

Question 7

Peritonitis

Answer 7

Inflammation of the PERITONEUM

Serous membrane that lines abdominal cavity and covers visceral organs

Question 8

What happens to the peritoneum? during peritonits

Answer 8

Inflammation and this leads to fluid shifting (third spacing) which leads to hypovolemic shock and sepsis

Also causes decreased peristalsis and paralytic ileus (Obstruction)

Question 9

Peritonitis: Causes

Answer 9

Perforated Ulcers
Ruptured gallbladder
Pancreatitis
Ruptured spleen
Ruptured bladder
Ruptured appendix

Ruptures and Perforations

Question 10

Peritonitis: Clinical Manifestations

Answer 10

-Sudden and SEVERE abdominal pain

-Tenderness

-Rigid “Board-Like” Abdomen

-Fever increase, WBC increase, and increase HR

-Decrease in BP

Question 11

Irritable Bowel Syndrome

Answer 11

Chronic condition characterized by alterations bowel pattern due to changes in intestinal motility

-Chronic and frequent constipations (IBSC)

-Chronic and frequent diarrhea (IBSD)

Question 12

IBSC

Answer 12

Irritable Bowel Syndrome

Chronic and frequent constipations

Question 13

IBSD

Answer 13

Irritable Bowel Syndrome

Chronic and frequent diarrhea

Question 14

Irritable Bowel Syndrome: Symptoms

Answer 14

Abdominal distension, fullness, flatus, and bloating

Pain exacerbated by stress and relieved by defecation

Question 15

In IBS you might be intolerant to what foods?

Answer 15

Sorbitol, lactose, gluten

Question 16

IBS stool

Answer 16

Non bloody stool with extra mucous

Question 17

Psychosocial Stress and IBS

Answer 17

Emotional stress does not cause the illness but emotional stress does make the illness worse

IBS is stressful to live and may cause people to have more psychological problems because IBS causes people stress

Question 18

Triggers of IBS

Answer 18

stress
food
hormone changes
GI infections

Question 19

Inflammatory Bowel Disease: Types

Answer 19

Crohn’s disease

Ulcerative colitis

Question 20

IBD (Inflammatory Bowel Disease): Definition and Characterizations

Answer 20

A group of life changing chronic illnesses characterized by chronic inflammation of the intestines with exacerbations and remissions

Question 21

Inflammatory Bowel Disease is more common in

Answer 21

White Women Jweish Smokers

Question 22

IBD: Etiology

Answer 22

AUTOIMMUNE conditions in our system that are activated by an infection

Question 23

Crohn’s disease pathogenesis

Answer 23

Block lymp structure leads to FISSURE and ULCERS that develop in a patch pattern. Skip lesions and cobble stone appearance

Question 24

Crohn’s Disease: Complications

Answer 24

Malnutrition

Anemia

Scar tissue / obstructions

Fistulas

Cancer

Question 25

Crohns Disease: Clinical Manifestations

Answer 25

-Crampy lower abdominal pain in (RLQ) -Watery diarrhea -Palpable abdominal mass in RLQ -Mouth ulcers

Question 26

Ulcerative Colitis

Answer 26

Inflammation of the mucosa of the RECTUM and COLON

Question 27

Ulcerative Colitis typically develops when?

Answer 27

Third Decade of life

Question 28

Ulcerative Colitis is more common in

Answer 28

White european descent Ashkenazi Jewish descent

Question 29

What is associated with crohn's disease

Answer 29

GALS Granulomas All Layers and Skip Lesions

Question 30

Ulcerative Colitis: Pathogenesis

Answer 30

Inflammation beings in the recutm and extends the entire colon Inflammation lead to large ulcerations and necrosis causing CRYPT ABSCESSES Colon and recutm try to repair with new granulation tissue but this causes more problems and bleeds easliy

Question 31

Ulcerative colitis: manifestations

Answer 31

Similar to crohn's disease but has BLOODY Diarrhea

Question 32

Ulcerative Colitis: Complicaitons

Answer 32

Hemorrhage Perforations Cancer

Question 33

More Complications of Ulcerative Colitis

Answer 33

Fissures Abscesses Toxic Megacolon: Rapid dilation of the large intestine that can be life-threatening Colorectal Carcinoma Liver disease: From inflammation and scarring of bile ducts Fluid and electrolyte and PH imblanaces

Question 34

Diverticular Disease: Diverticulosis

Answer 34

Development of diverticula: small pouches in lining of colon that bulge outward through weak spots

Question 35

Diverticulosis: Eitology

Answer 35

May be congenital or acquired

Question 36

What causes diverticulosis

Answer 36

lower fiber diet with resulting chronic constipations

Question 37

Location of diverticulosis

Answer 37

Descending colon

Question 38

Diverticulosis: Clinical Manifestations

Answer 38

Usually asymptomatic Discovered accidentally or with presentation of acute diverticulitis

Question 39

DiverticuLITIS

Answer 39

Inflammation of one or more of the pouches (diverticula) Usually from retained fecal material

Question 40

DiverticuLITIS: Clinical Manifestations

Answer 40

Abdominal pain -- LLQ (Descending colon) Fever WBC- Increased Constipation or diarrhea ACUTE passage of large quantity of FRANK blood Can resolve spontaneously

Question 41

DiverticuLITIS: Complications

Answer 41

Perforation Obstruction