ch. 14 slide 67-109 Flashcards
4 types of intestinal obstructions
- herniation
- adhesions
- intussusception- telescoping of prox. bowel into the distal segment
- volvulus- twisting a loop of bowel
meckel diverticulum
congenital; blind end pouch (SI); very common 2% of births, males 2x; MC asymptomatic
hirschsprung disease
congenital aganglionic megacolon- Prox. bowel is obstructed
rectum; sigmoid colon
1:5,000
MC in males; Severe in females
which arteries does ischemic bowel disease affect?
sup. & inf. mesenteric; Celiac
Ischemic bowel disease can be caused by?
- thrombosis: atherosclerosis
- arterial embolism: MI
- non-occlusive ischemia: heart failure, AAA
- misc.: volvulus, aneurysm, irradiation/trauma
Ischemic bowel disease acute vs. chronic
acute: sudden/severe abdom pain, nausea, vomit, bloody diarrhea
chronic: episodic bloody diarrhea, mimics IBD
ischemic bowel disease has a 50% mortality
true; sepsis or shock
what is angiodysplasia? where?
vascular lesion of colon-
in cecum or ascending colon
tortuous lesions, submucosal & mucosal vessels
who does angyodysplasia affect? cause?
~1% of adults, >50 yrs old;
20% of lower intestinal bleeds;
idiopathic, mechanical stress
hemorrhoids? caused by?
thin walled varices; anal & perianal vessels;
inc. intrabdominal pressure, straining, pregnancy
hemorrhoids are associated with liver cirrhosis
true; portal HTN
types of hemorrhoids
internal: above anorectal line
external: below anorectal line
malabsorption manifests as?
chronic diarrhea; cant absorb fats, carbs, proteins, vit, minerals, electrolytes, water
what is steatorrhea?
bulky, frothy, greasy, yellow/gray diarrhea
what is dysentery?
bloody, painful, small volume diarrhea
celiac disease aka?
celiac sprue
what is celiac disease?
gluten sensitive enteropathy; non-infectious malab.
IMMUNE-MEDIATED reaction to gluten
IgA/IgG Ab’s
Dermatitis herpetiformis is associated with?
celiac disease; 10% of patients get this.
pruritic, blisters on arms, legs, butt; neutrophils
environmental enteropathy aka?
tropical sprue
tropical sprue cycle
mucosal injury, malnut.,inflam
how do you get tropical sprue? who is at risk?
living in or recently visited tropics;
MC affects 2-3 yr olds.
types of tropical sprue
infectious: responds to antibiotics
autoimmune: villus flattening
what is lactase def.? types?
cant digest lactase;
- acquired (MC): youmg adulthood
- congenital: auto recessive, rare, life threatening
infectious enterocolitis
microbial infxn.- abdom pain, incontinence, perianal discomfort, hemorrhage
how many children die globally each day from infectious enterocolitis? U.S.?
12,000/day 1/2 <5 yrs. old globally
500 infants each YEAR in US
cholera causes? transmitted by? MC in? lethal?
abrupt vomiting & watery diarrhea (rice water stools)
fecal - oral route
India/Africa
lethal 50-70% in acute cases
vibrio cholerae is?
comma shaped gram - bacteria
campylobacter enterocolitis MC in? mc bacteria?
MC pathogen in U.S.
E.Coli MC bacteria
can cause reactive arthritis or GBS
acute self- limited colitis?
<1 mo.- campylobacter, shigella, e.coli, salmonella
pseudomembranous colitis aka?
antibiotic- associated colitis;
ex: c-dif. overgrowth, colon
inflammation: neutrophils
enterotoxins->apoptosis
risks for pseudomem. colitis?
hospitalization, older age, dec. immunity
symptoms of pseudomem. colitis? Tx?
has pseudomembranes- cellular debris, leukocytes
fever, watery diarrhea/dehydration, ab pain, leukocytosis
Tx: vancomycin or metronidazole
how do you get viral gastroenteritis? what is it?
direct contact with contaminated food or water
infection that leads to inflammation
1/2 of all gastroenteritis is viral
MC viral gastroent. in children? adults?
rotavirus- children
norovirus- adults
parasitic diseases affects? caused by? what is MC? how do you get it?
- affects >1/2 world pop.
- nematodes, hookworms, pinworms, tapeworms, protozoa
- MC is giardia lamblia
- spread by fecal contamination of water
what is giardiasis?
Beaver fever- malab
what is sigmoid diverticulum? aka?
acquired diverticulum-defects in the colon wall- diverticula; colonic diverticulosis
risks of sigmoid diver.? Tx?
> 60 years old 50%; refined foods; constipation
20% asymptomatic= diverticulitis;
Increase fiber intake
Irritable bowel syndrome (IBS) is?
altered bowel habits ie.: bloating, diarrhea, constipation, chronic/relapsing abdom pain
IBS occurs in? Tx?
20-40 yr olds- females; 5-10 pop.
fiber, dec. carbs, stress management
Crohn disease?
ENTIRE GI tract, MC in ileum, transmural inflammationMC
Ulcerative colitis?
rectum, distal colon; mucosa & submucosa
crohn disease symptoms?
melena, diarrhea, fever, SKIP lesions, ulcerations, arthritis
- Fissures/strictures
- granulomas
- fibrosis
which is MC crohns or UC?
Crohns- 1:500
MC locations for Crohns?
terminal ileum
Ileocecal valve
cecum
RLQ pain
UC is associated with? how common is it?
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.
UC begins in?
rectum/distal colon
active UC results in?
superficial ulceration, pseudopolyps
inactive UC results in?
atrophy
UC characteristics
not malab pseudopolyps non-granulomatous distal colon/rectum diffuse ulcerations little to no fibrosis
