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path II exam 3 > ch. 14 slide 67-109 > Flashcards

ch. 14 slide 67-109 Flashcards

1
Q

4 types of intestinal obstructions

A
  1. herniation
  2. adhesions
  3. intussusception- telescoping of prox. bowel into the distal segment
  4. volvulus- twisting a loop of bowel
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2
Q

meckel diverticulum

A

congenital; blind end pouch (SI); very common 2% of births, males 2x; MC asymptomatic

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3
Q

hirschsprung disease

A

congenital aganglionic megacolon- Prox. bowel is obstructed
rectum; sigmoid colon
1:5,000
MC in males; Severe in females

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4
Q

which arteries does ischemic bowel disease affect?

A

sup. & inf. mesenteric; Celiac

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5
Q

Ischemic bowel disease can be caused by?

A
  1. thrombosis: atherosclerosis
  2. arterial embolism: MI
  3. non-occlusive ischemia: heart failure, AAA
  4. misc.: volvulus, aneurysm, irradiation/trauma
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6
Q

Ischemic bowel disease acute vs. chronic

A

acute: sudden/severe abdom pain, nausea, vomit, bloody diarrhea
chronic: episodic bloody diarrhea, mimics IBD

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7
Q

ischemic bowel disease has a 50% mortality

A

true; sepsis or shock

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8
Q

what is angiodysplasia? where?

A

vascular lesion of colon-
in cecum or ascending colon
tortuous lesions, submucosal & mucosal vessels

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9
Q

who does angyodysplasia affect? cause?

A

~1% of adults, >50 yrs old;
20% of lower intestinal bleeds;
idiopathic, mechanical stress

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10
Q

hemorrhoids? caused by?

A

thin walled varices; anal & perianal vessels;

inc. intrabdominal pressure, straining, pregnancy

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11
Q

hemorrhoids are associated with liver cirrhosis

A

true; portal HTN

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12
Q

types of hemorrhoids

A

internal: above anorectal line
external: below anorectal line

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13
Q

malabsorption manifests as?

A

chronic diarrhea; cant absorb fats, carbs, proteins, vit, minerals, electrolytes, water

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14
Q

what is steatorrhea?

A

bulky, frothy, greasy, yellow/gray diarrhea

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15
Q

what is dysentery?

A

bloody, painful, small volume diarrhea

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16
Q

celiac disease aka?

A

celiac sprue

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17
Q

what is celiac disease?

A

gluten sensitive enteropathy; non-infectious malab.
IMMUNE-MEDIATED reaction to gluten
IgA/IgG Ab’s

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18
Q

Dermatitis herpetiformis is associated with?

A

celiac disease; 10% of patients get this.

pruritic, blisters on arms, legs, butt; neutrophils

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19
Q

environmental enteropathy aka?

A

tropical sprue

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20
Q

tropical sprue cycle

A

mucosal injury, malnut.,inflam

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21
Q

how do you get tropical sprue? who is at risk?

A

living in or recently visited tropics;

MC affects 2-3 yr olds.

22
Q

types of tropical sprue

A

infectious: responds to antibiotics
autoimmune: villus flattening

23
Q

what is lactase def.? types?

A

cant digest lactase;

  1. acquired (MC): youmg adulthood
  2. congenital: auto recessive, rare, life threatening
24
Q

infectious enterocolitis

A

microbial infxn.- abdom pain, incontinence, perianal discomfort, hemorrhage

25
Q

how many children die globally each day from infectious enterocolitis? U.S.?

A

12,000/day 1/2 <5 yrs. old globally

500 infants each YEAR in US

26
Q

cholera causes? transmitted by? MC in? lethal?

A

abrupt vomiting & watery diarrhea (rice water stools)
fecal - oral route
India/Africa
lethal 50-70% in acute cases

27
Q

vibrio cholerae is?

A

comma shaped gram - bacteria

28
Q

campylobacter enterocolitis MC in? mc bacteria?

A

MC pathogen in U.S.
E.Coli MC bacteria
can cause reactive arthritis or GBS

29
Q

acute self- limited colitis?

A

<1 mo.- campylobacter, shigella, e.coli, salmonella

30
Q

pseudomembranous colitis aka?

A

antibiotic- associated colitis;
ex: c-dif. overgrowth, colon
inflammation: neutrophils
enterotoxins->apoptosis

31
Q

risks for pseudomem. colitis?

A

hospitalization, older age, dec. immunity

32
Q

symptoms of pseudomem. colitis? Tx?

A

has pseudomembranes- cellular debris, leukocytes
fever, watery diarrhea/dehydration, ab pain, leukocytosis
Tx: vancomycin or metronidazole

33
Q

how do you get viral gastroenteritis? what is it?

A

direct contact with contaminated food or water
infection that leads to inflammation
1/2 of all gastroenteritis is viral

34
Q

MC viral gastroent. in children? adults?

A

rotavirus- children

norovirus- adults

35
Q

parasitic diseases affects? caused by? what is MC? how do you get it?

A
  • affects >1/2 world pop.
  • nematodes, hookworms, pinworms, tapeworms, protozoa
  • MC is giardia lamblia
  • spread by fecal contamination of water
36
Q

what is giardiasis?

A

Beaver fever- malab

37
Q

what is sigmoid diverticulum? aka?

A

acquired diverticulum-defects in the colon wall- diverticula; colonic diverticulosis

38
Q

risks of sigmoid diver.? Tx?

A

> 60 years old 50%; refined foods; constipation
20% asymptomatic= diverticulitis;
Increase fiber intake

39
Q

Irritable bowel syndrome (IBS) is?

A

altered bowel habits ie.: bloating, diarrhea, constipation, chronic/relapsing abdom pain

40
Q

IBS occurs in? Tx?

A

20-40 yr olds- females; 5-10 pop.

fiber, dec. carbs, stress management

41
Q

Crohn disease?

A

ENTIRE GI tract, MC in ileum, transmural inflammationMC

42
Q

Ulcerative colitis?

A

rectum, distal colon; mucosa & submucosa

43
Q

crohn disease symptoms?

A

melena, diarrhea, fever, SKIP lesions, ulcerations, arthritis

  • Fissures/strictures
  • granulomas
  • fibrosis
44
Q

which is MC crohns or UC?

A

Crohns- 1:500

45
Q

MC locations for Crohns?

A

terminal ileum
Ileocecal valve
cecum
RLQ pain

46
Q

UC is associated with? how common is it?

A 
superficial mucosal ulcerations
- begins in rectum, goes proximal
- has pseudopolyps
Associated with polyarthritis, sacroilitis, AS, eye irritation, toxic megacolon
-occurs 1:5,000
- 20-25 yr old
- Smoking is bad for it.
47
Q

UC begins in?

A

rectum/distal colon

48
Q

active UC results in?

A

superficial ulceration, pseudopolyps

49
Q

inactive UC results in?

A

atrophy

50
Q

UC characteristics

A 
not malab
pseudopolyps
non-granulomatous
distal colon/rectum
diffuse ulcerations
little to no fibrosis

path II exam 3 (3 decks)

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