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Clin Med II - GI Exam > Celiac Disease, IBS, Lactose Intolerance, & Colon Polyps > Flashcards

Celiac Disease, IBS, Lactose Intolerance, & Colon Polyps Flashcards

1
Q

define celiac disease

A

malabsorption d/o d/t an autoimmune immunologic response to gliadin (component in gluten)

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2
Q

celiac disease epidemiology

A
  • increased
  • 1:113
  • whites of N. European descent
  • infancy to 70s
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3
Q

celiac disease clinical features

A
  • delayed dx d/t vague sx
  • S+S x 10y
  • asx = incidental findings (still follow diet tx)
  • classic sx = diarrhea, steatorrhea, wt loss, weakness, abd distention, pediatric growth retardation
  • atypicl sx = fatigue, depression, delayed puberty, amenorrhea, infertility
  • may be related to a specific nutrient deficiency (Fe, Vit K, Vit A, Vit B12)
  • coinciding lactose intolerance
  • usually normal unless nutrient defiecieny
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4
Q

celiac disease etiology

A
  • idiopathic
  • gluten
  • genetics
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5
Q

celiac disease diagnostic studies

A
  • sm. intestine bx
  • celiac serology (IgA) if (-) = not celiac
  • labs to check nutrients
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6
Q

celiac disease treatment

A
  • strict elimination of gluten from diet
  • correct nutrient deficiency
  • support groups
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7
Q

celiac disease complications

A
  • CA, intestinal lymphoma
  • intestinal ulceration
  • associated w/ T1DM, Down Syndrome, Turner’s Syndrome, autoimmune
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8
Q

define dermatitis herpetiform

A

cutaneous varient of celiac dz

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9
Q

dermatitis herpetiform S+S

A
  • pruritic papulovesicles over extensors of extremities, trunk, scalp, and neck
  • little to no GI sx
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10
Q

dermatitis herpetiform diagnostic studies

A

sm. intestine bx

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11
Q

dermatitis herpetiform tx

A
  • dapsone
  • gluten free diet
  • refer to GI
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12
Q

define irritable bowel syndrome (IBS)

A

chronic functional diagnosis

  • lower abdominal pain and altered bowel habit
  • abdominal pain + 2/3: relief w/ defication, change in frequency of BM, or change in BM appearance
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13
Q

irritable bowel syndrome (IBS) epidemiology

A
  • female

- teens/early 20s

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14
Q

irritable bowel syndrome (IBS) etiology

A
  • idiopathic
  • dx of exclusion
  1. abn. motility
  2. visceral hypersensitivity of abd. area
  3. enteric infx (S+S w/in 1 year of bacterial gastroenteritis, female, stress)
  4. psychosocial (depression, anxiety, somatization)
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15
Q

irritable bowel syndrome (IBS) clinical features

A
  • S+S x 3mo
  • intermittent, crampy lower abd pain relieved w/ defication
  • type of IBS (i.e. w/ diarrhea, w/constipation, mixed)
    multitude of other sx
  • alarm sx = acute onset after 40-50y/o, nocturnal diarrhea, hematochezia, wt. loss, fever, (+) FHx of colon CA, IBD, celiac dz
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16
Q

irritable bowel syndrome (IBS) diagnostic studies

A
  • ROME criteria
  • stool for O&P if pt has traveled
  • colonoscopy
  • if diarrhea type IBS, eval for celiac
17
Q

irritable bowel syndrome (IBS) tx

A
  • educate + support pt
  • reinforce chronic nature
  • diet therapy
  • psychotics
  • probiotics
  • move away from finding a cause
  • plan to cope w/ sx
  • anti-spasmodics
  • anti-diarrheals
  • anti-constipation
  • psych therapies
18
Q

define lactase deficiency/lactose intolerance

A
  • inability to digest lactose d/t a shortage of lactase
19
Q

lactose intolerance epidemiology

A

non-european descent

20
Q

lactose intolerance pathophysiology

A

malabsorbed lactose fermented by intestinal bacteria, produces gas and organic acids
- non-metabolized lactose and organic acids incr. osmotic load ==> diarrhea

21
Q

lactose intolerance etiology

A
  • genetics

- 2nd to GI or surgery affecting sm. intestine mucosa

22
Q

lactose intolerance clinical features

A
  • bloating
  • gas
  • diarrhea
  • cramping
  • RED FLAG: wt loss
23
Q

lactose intolerance diagnostic studies

A
  • trial of lactose free diet

- hydrogen breath test

24
Q

lactose intolerance tx

A
  • pt comfort
  • some pt can tolerate some lactose
  • lactose free diet
  • lactase replacement
  • Ca supplements
25
Q

define colon polyps

A

small clump of cells the form in the lining of the colon

26
Q

colon polyps epidemiology

A
  • 50+ y/o male
  • industrialized nations
  • genetics
27
Q

colon polyps risk factors

A
  • incr. fat diet
  • incr diet w/ red meat
  • decr fiber diet
  • smoking
  • obesity
28
Q

colon polyps types

A
  • hyperplastic

- adenomatous

29
Q

describe hyperplastic colon polyps

A
  • sm. polyps located in rectum or sigmoid colon

- no malginancy potential

30
Q

define adenomatous colon polyps

A
  • 2/3 of all polyps
  • some cancerous potential
  • large lesion = incr CA (greater than 1cm)
31
Q

How are hyperplastic and adenomatous colon polyps ddx’d?

A

bx

32
Q

colon polyps S+S

A
  • asx

- ulcerate –> hematochezia

33
Q

colon polyps diagnostic studies

A
  • colonoscopy
  • polypectomy
  • surveillence

Clin Med II - GI Exam (14 decks)

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