Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI > Colon > Flashcards

Colon Flashcards

1
Q

What’s the WHO definition for diarrhoea ?

A

> 3 loose stools or watery stools per day

Acute: < 14 days
Chronic > 14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name four causes of acute diarrhoea

A

Gastroenteritis
Diverticulitis
Antibiotic therapy
Constipation causing overflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

A child presents with diarrhoea since 3 days. She also gets abdominal ache and the mother describes that she is normally rather constipated .
What’s your diagnosis ?

A

Overflow diarrhoea due to constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A 21 year old man sees his GP for nausea associated with vomiting and diarrhoea for the last 2 days . He also gets occasional abdominal cramps .
What’s your initial diagnosis ?

A

Gastroenteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

A 45 year old male complains of left lower quadrant pain, diarrhoea and fever. Which condition do you need to think of?

A

Diverticulitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A 40 year old patient complains of diarrhoea for the last 2 days . Last week she was treated for tonsillitis by her GP.
What could be the diagnosis ?

A

Ask for antibiotic treatment

Can cause diarrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name 5 conditions that can cause chronic diarrhoea

A 
Crohns 
UC
IBS
Colorectal cancer
Coeliac disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

A 4 year

Old child presents with failure to thrive , diarrhoea , buttock wasting and abdominal pain. What’s the diagnosis ?

A

Coeliac disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

A 35 year
Old patient presents with diarrhoea , tiredness , weight loss and anaemia . He is currently treated for his autoimmune thyroiditis .
What condition do you suspect ?

A

Coeliac disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What type of bacterium is clostridium difficile?

A

Gram -

Rod shaped bacillus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does C diff cause and why is it so dangerous?

A

Pseudomembranous colitis

Can lead to toxic megacolon and organ failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In Cdiff how does the patient present?

A

Diarrhoea , fouly smelling , fever , high CRP and WCC

Systemically unwell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What’s the treatment of c diff

A

Metronidazole oral

  1. Oral vancomycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What’s the difference between a paralytic and a mechanical Ileus?

A

Impaired peristalsis vs mechanical obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does ileus lead to?

A

Distended bowel wall, hypoxia , odema -> bowel ischaemia -> necrosis -> Perforation -> septic shock or hypovolemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name the causes of a mechanical ileus?

A 
Small bowel 
Adhesions post Op 
Hernia 
Tumour 
Stricture
Large bowel 
Cancer
Stricture : IBD, diverticulitis 
Voluvulus
Adhesions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Give examples for an paralytic ileus

A 
Intraabdominal surgery
Endocrine ( Diabetes , hypothyroid )
Mesenteric Infarkt 
Inflammation : Appendix , peritonitis 
Hypokalaemia

Drugs: opioids , anti AcH, antidepressions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

On examination , how would you differentiate between paralytic and mechanical ileus ?

On x ray?

A

No bowels sounds vs high pitches tinkling sounds

Obstruction: dilation, air filled proximal , distal bowel collapsed

Paralytic : even distribution of gas , bowel distension, if voluvulus - kidney bean appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

A high serum lactate in a toxic megacolon patient suggests ?

A

Perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is constipation?

A 
<2 bowel actions per week
Or
Less than normal habit
Or 
Passing with difficulty 
Or
Incomplete defecation
21
Q

Give primary and secondary causes of constipation.

A

Primary
Diet , insufficient exercise

Secondary 
Carcinoma 
Opioids 
DM
Hypokalaemia 
Hypothyroidism
MS
Hirschpsrung
22
Q

What’s the first

Line examination to perform in patients with constipation ?

A

Digital rectal exam

23
Q

Give 3 possible treatment options in the management of an adult with constipation ( and now organic cause found )

A

Lifestyle - high fibre, more fluid, exercise

Osmotic laxatives e.g Macrogol
Stimulant laxatives eg senna

24
Q

What is a megacolon and which types are there ?

A

Dilation of colon in absence of mechanical obstruction due to loss of peristalsis

Toxic
Acute
Chronic e. G Hirschsprung

25
Q

What diagnostic criteria need to be met in order to diagnose a toxic megacolon ?

A

3 of the following systemic symptoms

  • tachycardia
  • fever
  • leukocytosis
  • anemia
1 of 
Dehydration
Hypotension
Altered mental state
Electrolyte imbalance
26
Q

What might be the cause for toxic megacolon?

A 
C diff , cmv 
Ulcerative colitis (Crohns )
27
Q

What’s the characteristic finding on the X-ray in toxic megacolon ?

A

Dilated colon with loss of haustra

28
Q

Explain the acute management of toxic megacolon and it’s complications

A

NG tube, nil by mouth
IV fluids , electrolytes

In Cdiff: metronidazole
In IBD: IV steroids

Surgery if not responsive

Complications
Ischaemia
Perforation
Sepsis

29
Q

What does Crohn’s disease commonly present with ?

A

Diarrhoea , bloody

Abdominal pain

30
Q

Name some extra- intestinal features that occur in Crohn’s disease ?

A 
Arthritis 
Erythema nodosum 
Episcleritis 
Osteoporosis 
Primary sclerosing cholangitis
Clubbing
Pyoderma gangrenous
Uveitis
31
Q

Name the histological / endoscopic features of Crohns

A

Mouth to Anus ( common terminal ileum)
Cobblestone appearance , ulceration
Transmural inflammation
Patchy

Perianal skin tags or ulcers / fistula / abscesses

32
Q

A small bowel enema is performed in a patient suspected of Crohn’s disease . What are classical findings?

A

Fistuale
Rose thorn ulcers
Strictures: Kantors string sign

33
Q

Name the management of a patient with Crohn’s disease

A

Inducing remission
- budesonide ( glucocorticoid ) (oral topical, iv )
-mesalazine (5ASA) second line
- azathiprine (add on)
In children : exclusive Enternal nutrition

Maintaining

  • azathioprine
  • MTX (second line )

Surgery

General advise stop smoking

34
Q

What’s ulcerative Colitis?

What does it commonly present with?

A

Inflammatory condition ALWAYS starting at rectum and never beyond ileocaecal valve - colon only !

Diarrhoea - bloody, mucous
Abdominal pain - left lower quadrant
Tenesmus
Extra intestinal features

35
Q

Name extraintestinal features of ulcerative colitis

A 
Arthritis 
Erythema nodosum 
Episcleritis ( more on Crohn's) 
Osteoporosis 
Primary sclerosing cholangitis ( common in UC)
Uveitis ( common in UC)
Pyoderma gangrenosum
Clubbing
36
Q

Describe the histological : endoscopic findings of ulcerative colitis

A 
Rectum and colon only
Bleeding 
Superficial inflammation limited to mucosa 
Continuous involvement 
Crypt abscesses 
Pseudopolyps
37
Q

A patient with ulcerative colitis undergoes barium enema . What are typical findings?

A

Loss of haustra
Psrudopolyps - superficial inflammation

If longstanding disease:
Drainpipe colon- narrow and short

38
Q

How to manage a patient wit UC?

A 
Inducing remission 
-rectal Mesalazine ( if distal)
-oral mesalazine ( aminosalicyclates)
-oral prednisolone (second line )
Maintaining
Oral mesalazine 
Azathioprine and mercaptopurine
39
Q

What are complications of UC?

A

Toxic megacolon

Adenocarcinoma

40
Q

What are

Complications of Crohn’s ?

A

Fistula formation
Abscess formation
Bowel obstruction
Malignancy

41
Q

Name some causes for diverticulosis

A 
Diet- high fat , meat and low fibres 
Age 
Obesity 
Smoking 
Marfan
Ehlers Danlos
42
Q

Describe the processes that lead to diverticula and further to diverticulitis

A

Unequal pressure or chronic constipation leading to out pouching of colon wall

Stool gets lodged in pouches can get inflamed , there is also more pressure and erosion of diverticular wall

43
Q

Name common features of diverticulitis

A 
Fever 
Left Lower quadrant abdominal pain 
Change in bowel habits 
Nausea , vomiting 
Sometimes palpable mass
44
Q

How would you investigate a patient with suspected diverticulitis ?

A 
Blood: leucocytosis , high CRP
Abdominal CT ( first line ) with contrast 
Ultrasound 
-pouches 
-free fluid
-fluid in fat

Colonoscopy ( but not if acute!! )

45
Q

What are complications of diverticulitis ?

A

Abscess
Obstruction
Perforation
Fistula

46
Q

Treatment of diverticulitis

A

Prevention by diet changes ( high fibres ) and exercise , fluids

Anitbiotics ( oral , IV if worse - hospital ) eg metronidazole + ciprofloxacin

Surgical

47
Q

What is a Meckels Diverticulum ?

A

A congenital diverticulum of the small intestine
Incomplete regression of opthalomesenteric duct (vitellointeatinal duct )

This duct connects yolk sac with midgut lumen and normally disappears after 6 weeks gestation

48
Q

What are features of a meckels diverticulum?

A 
2% in population 
2 inches long
2 feet from ileocaecal valve 
Mostly in kids <2
2 types of mucosal lining

Asymptomatic
Painless rectal bleeding
Can cause obstruction of intestine

Only treat when symptomatic ( surgery )

GI (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions