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PA > Case 1.1 - Disorders > Flashcards

Case 1.1 - Disorders Flashcards

1
Q

The third most common cause of cancer-related death in the US is?

A

Colon Cancer.

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2
Q

Genetic risk factor for colon cancer with a 100% development rate by age 40.

A

Familial adenomantous polyposis

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3
Q

What are three genetic risk factors for colorectal cancer?

A
  1. Familial Adenomatous Polyposis
  2. Lynch Syndrome
  3. Peutz-Jehgers
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4
Q

What is the most common cause of a large bowel obstruction in adults?

A

Colorectal Cancer

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5
Q

List some clinical manifestations for a patient with suspected colorectal cancer.

A
  • Iron Deficiency
  • Rectal Bleeding
  • Abdominal Pain
  • Changes in Bowel Habits
  • Ascites
  • Hepatomegaly
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6
Q

What is the diagnostic test of choice for colorectal cancer?

A

Colonoscopy with biopsy.

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7
Q

Apple core lesion is a classic finding on a barium enema for what disease?

A

Colorectal Cancer

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8
Q

What lab will be elevated in a patient with colorectal cancer?

A

Carcinoembryonic Antigen (CEA) Levels

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9
Q

Primary Treatment Regimen for colorectal cancer includes what?

A

Stage 1-3 = surgical resection

Stage 3-metastatic = chemotherapy (5FU)

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10
Q

Colorectal cancer screening begins at what age?

A

Age 50 with colonoscopy (q10yrs)

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11
Q

Describe the difference in affected regions of the body between ulcerative colitis and crohn disease.

A

Ulcerative colitis is limited to the colon, begins in the rectum with contiguous spread proximally.

Crohn Disease can affect any segment of the GI tract (mouth to anus) and does not have to be continuous.
Most common site for Crohn Disease is the terminal ileum.

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12
Q

Which inflammatory bowel disease (IBD) will be transmural in depth?

A

Crohn Disease

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13
Q

What is the hallmark sign of Ulcerative Colitits?

A

Blood diarrhea / hematochezia

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14
Q

Skip lesions with a cobblestone appearance is indicative of what disease?

A

Crohn Disease

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15
Q

What lab value will be positive for UC? for Crohn Disease?

A

UC will have a positive P-ANCA test

Crohn Disease will have a positive ASCA

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16
Q

What are some complications of UC?

A

Primary sclerosing cholangitis, colon cancer, and toxic megacolon.

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17
Q

What are some complications of Crohn Disease?

A

Perianal Disease (fistulas, strictures, abscess, and granulomas)

Malabsorption: Fe and B12

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18
Q

Smoking decreases a patients risk for what IBD?

A

Ulcerative Colitis

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19
Q

What is the diagnostic test of choice for UC? for Crohn Disease?

A

UC: flex sigmoidoscopy

Crohn Disease: Upper GI series with small bowel follow through.

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20
Q

First line medication for both ulcerative colitis and Crohn Disease is what class of medication? Examples?

A

Aminosalicylates (5-ASA)

  1. Mesalamine
  2. Sulfasalazine
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21
Q

What is the hallmark presentation of irritable bowel syndrome (IBS)?

A

Abdominal pain associated with altered defecation/bowel habits and pain is often relieved with defecation.

22
Q

What are three pathophysiologies of IBS?

A
  1. Abnormal motility
  2. Visceral Hypersensitivity
  3. Psychosocial Interactions
23
Q

What is the ROME IV Criteria for IBS?

A

Recurrent abdominal pain with 2 of the following:

  • Related to defecation
  • change in stool frequency
  • change in stool form (appearance)
24
Q

Management of IBS includes what two major lifestyle changes?

A
  1. smoking cessation

2. low fat/unprocessed food diet

25
Q

Outpouchings due to herniation of the mucosa into the wall of the colon along natural openings at the vasa recta of the colon are referred to as?

A

Diverticula

26
Q

Diverticula are most common where?

A

Sigmoid colon area due to high intraluminal pressure.

27
Q

The most common cause of acute lower GI bleeding is?

A

Diverticulosis

28
Q

Diverticulosis is associated with what?

A

Associated with a low fiber diet, constipation, and obesity.

29
Q

Diverticulitis are inflamed diverticula secondary to?

A

Obstruction and infection.

30
Q

What are the two most common clinical manifestations of diverticulitis?

A

Fever and LLQ abdominal pain

31
Q

Diverticulosis is best diagnosed with what test?

A

CT Scan

32
Q

Diverticulitis will have what value elevated on a CBC?

A

White Blood Cell Count.

33
Q

Treatment of Diverticulitis is?

A

Clear liquid diet, metronidazole, and another antibiotic.

34
Q

This disease is classified by small bowel autoimmune inflammation secondary to alpha-gliadin in gluten.

A

Celiac Disease.

35
Q

What are two clinical manifestations of Celiac Disease?

A
  1. Diarrhea
  2. Dermatitis Herpetiformis

Others

  • abdominal pain
  • abdominal distention
  • bloating
  • steatorrhea
  • growth delays
36
Q

A positive endomysial IgA Ab and transglutaminase Ab can help diagnose what autoimmune disorder?

A

Celiac Disease

37
Q

A definitive diagnosis of Celiac disease is made by doing what?

A

Small bowel biopsy.

38
Q

What is the primary treatment for Celiac Disease?

A

Gluten Free diet.

39
Q

A patient with loose stools, abdominal pain, flatulence and borborygmi after ingestion of milk / milk products is most likely suffering from what?

A

Lactose Intolerance

40
Q

What is the test of choice for diagnosing lactose intolerance?

A

Hydrogen breath test

41
Q

How would you describe an anal fissure?

A

A painful linear tear/crack in the distal anal canal.

42
Q

At patient presenting with severe painful rectal pain and bowel movements causing patient to refrain from having a bowel movement is likely suffering from what?

A

Anal fissure.

43
Q

What physical exam finding is associated with anal fissures?

A

Skin tags at posterior midline.

44
Q

A patient with chronic dull abdominal pain worse after meals and weight loss is likely suffering from?

A

Ischemic bowel disease, Chronic Mesenteric Ischemia.

45
Q

What is the best way to diagnose chronic mesenteric ischemia?

A

Angiogram confirms the diagnosis.

46
Q

What is the management for chronic mesenteric ischemia?

A

Bowel rest and surgical revascularization.

47
Q

Describe the classic presentation of appendicitis.

A

Onset of anorexia and periumbilical/epigastric pain. Followed by RLQ pain, nausea and vomiting.

48
Q

What are the four different physical exams that can be used to help diagnose appendicitis?

A

Rovsing sign: RLQ pain with LLQ palpation

Obturator Sign: RLQ pain with internal and external hip rotation with a flexed knee

Psoas sign: RLQ pain with right hip flexion/extension to resistance

McBurney’s point tenderness: 1/3 the distance from the anterior superior iliac spine and navel

49
Q

Diagnosis for appendicitis can be made with?

A

CT scan, ultrasound, and leukocytosis

50
Q

What is the first line treatment for gastroenteritis and diarrhea?

A

Fluid repletion, PO preferred then IV.

51
Q

What diet is used for gastroenteritis patients?

A

Bland low-residue diet

BRAT diet

52
Q

What virus is the most common cause of gastroenteritis in adults? in children?

A 
Adults = Norovirus
Children = Rotavirus

PA (4 decks)

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