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GI 2 > Chapter 17 Part 7 > Flashcards

Chapter 17 Part 7 Flashcards

1
Q

What are the symptoms of IBS?

A
  • abdominal pain
  • bloating
  • changes in bowel habits

-chronic, relapsing

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2
Q

True or False: IBS can be seen grossly and histologically

A

False; endoscopic and microscopic evaluations are normal

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3
Q

What are contributors to the possible pathogenesis of IBS?

A
  • psychologic stressors
  • diet
  • gut microbiome
  • abnormal GI motility
  • increased enteric response to GI stimuli
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4
Q

What is the most common patient population for IBS?

A
  • -females aged 20-40

- -high-income countries

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5
Q

What does the Rome Criteria for IBS?

A

-at least 3 months (with the onset at least 6 months prior) of recurrent abdominal pain/discomfort and two or more of the following:

  • improvement w/ defecation
  • onset was associated w/ change in stool frequency
  • onset was associated w/ change in stool appearance
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6
Q

What are the structures associated with Ulcerative Colitis?

A

-mucosa and submucosa of the rectum and colon

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7
Q

What are the structures associated with Crohn Disease?

A
  • anywhere in the GI tract, but ileum most frequently

- typically transmural

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8
Q

What is the population normally affected by IBD?

A
  • teenagers and early 20’s
  • UC is slightly more common in females
  • Caucasians
  • 4x more common in Ashkenazi Jews
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9
Q

What is seen at the epithelial surface of IBD?

A
  • disruption of the mucus layer
  • dysregulation of epithelial tight junctions
  • increased intestinal permeability
  • increased bacterial adherence to epithelial cells
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10
Q

Which form of IBD has stronger genetic factors?

A

-Crohn Disease

–50% concordance in monozygotic twins, whereas there’s only a 15% concordance rate for UC in monozygotic twins

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11
Q

CD or UC: Skip lesions

A

CD; patchy distribution results in cobblestone appearance of mucosa

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12
Q

CD or UC: continuous diffuse lesions

A

UC

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13
Q

CD or UC: Which has a thick wall and which has a thin wall?

A

CD - thick

UC - thin

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14
Q

CD or UC: pseudopolyps

A

UC; tips of pseudopolyps can fuse to create mucosal bridges

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15
Q

CD or UC: Which has deep, knife-like ulcers and which has superficial, broad-based ulcers?

A

CD - deep, knife

UC - superficial, broad

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16
Q

CD or UC: fibrosis

A

CD

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17
Q

CD or UC: granulomas

A

CD (in approx. 35%)

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18
Q

CD or UC: fistulas

A

CD

19
Q

CD or UC: fat/vitamin malabsorption

A

CD

20
Q

CD or UC: shows no recurrence after surgery

A

UC

21
Q

CD or UC: toxic megacolon

A

UC

22
Q

CD or UC: “creeping fat”

A

CD

23
Q

True or False: multiple ulcers in CD can coalesce into elongated, serpentine ulcers oriented along the axis of the bowel.

A

True

-UC ulcers are also aligned along the long axis of the colon, but are not typically serpentine

24
Q

What are the presenting symptoms of Crohn Disease?

A
  • abdominal pain (RLQ)
  • diarrhea
  • N/V
  • weight loss
25
Q

CD or UC: which has smoking as a risk factor and which has smoking as a protective factor

A

CD - risk

UC - protective

26
Q

True or False: initial attack of UC may be severe enough to constitute a medical or surgical emergency

A

True

27
Q

What biliary tract disorder may be seen in UC patients?

A

-primary sclerosing cholangitis

28
Q

What is the primary cellular infiltrate in CD?

A
  • neutrophils
  • -clusters in a crypt from “crypt abscesses”; repeated crypt destruction gives rise to bizarre branching and unusual orientations
29
Q

CD or UC: Paneth cell metaplasia

A

CD

30
Q

What are the presenting symptoms of Ulcerative Colitis?

A
  • attacks of bloody diarrhea w/ stringy mucoid material
  • lower abdominal pain
  • relief w/ defecation
31
Q

CD or UC: perinuclear anti-neutrophil cytoplasmic antibodies

A

UC

32
Q

CD or UC: antibodies to Saccharomyces cerevisiae

A

CD

33
Q

True or False: IBD can always be diagnosed as either CD or UC

A

False; 10% of IBD cases are Indeterminate Colitis

34
Q

CD or UC: perinuclear anti-neutrophil cytoplasmic antibodies

A

UC

35
Q

CD or UC: antibodies to Saccharomyces cerevisiae

A

CD

36
Q

What three factors play into risk of neoplasia in patients with IBD?

A

1) duration of disease (increased risk at 9yrs)
2) extent of disease (pancolitis vs. left-sided)
3) nature of inflammatory response (neutrophils)

37
Q

What is diversion colitis?

A

-colitis that develops in a diverted segment of bowel

38
Q

What is microscopic colitis, collagenous type?

A
  • -chronic, watery diarrhea w/o weight loss
  • -middle-aged and older women
  • -dense subepithelial collagen layer
  • -increased intraepithelial lymphocytes
  • -mixed inflammatory infiltrate
39
Q

What is microscopic colitis, lymphocytic type?

A
  • -chronic, watery diarrhea w/o weight loss
  • -markedly increased intraepithelial lymphocytes

–strong association w/ celiac disease and autoimmune diseases

40
Q

What are the GI implications of graft-versus-host disease?

A

-occurs following allogeneic hematopoietic stem cell transplantation

  • epithelial apoptosis of intestinal crypt cells
  • watery diarrhea; bloody diarrhea in severe cases
41
Q

What is sigmoid diverticular disease (diverticulosis)?

A

-multiple, acquired, pseudodiverticular outpouchings of colonic mucosa and submucosa

42
Q

What is the most common population for diverticulosis?

A
  • rare in people younger than 30
  • 50% of people over 60 in western world have it
  • -normally left-sided in the western world
43
Q

What are complications of diverticulosis (sigmoid diverticular disease)?

A
  • diverticulitis
  • -inflammation and increased pressure can lead to perforation because the diverticula is only invested my the mucosa and submucosa
44
Q

While occurring in only 20% of patients, what are the symptoms of sigmoid diverticular diseases (diverticulosis)?

A
  • intermittent cramping
  • continuous lower abdominal discomfort
  • constipation
  • distention
  • feeling of not being able to completely empty rectum

GI 2 (6 decks)

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