Brainscape's Knowledge GenomeTM

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


See full index

GI > colon part 2 > Flashcards

colon part 2 Flashcards

ibs, intussuseption, cancer, polyps

1
Q

.IBS combination of what 3 things

A

-altered motility(chemical imbalance in intesting)
-visceral hypersensitivity to intestinal distention
-psychosocial distress

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

.differential diagnosis: lactose intolerance, cholecystitis, chr pancreatitis, intestinal obstruction, chronic peritonitis, carcinoma of the pancreas or stomach

A

DD for IBS

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

.tx for IBS
1. constipation
2. diarrhea

A
  1. prokinetics: fiber, psyllium, maybe add polyethylene glycol after fiber.
  2. loperamide. anticholinergics/antispasmodics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

.common cause of chronic or recurrent abdominal pain in the US

A

IBS

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

.IBS

pathology

symptoms begin when

symptoms length

gender

exacerbated by what

A

unknown pathology/no organic cause

symptoms begin late teen/early 20s

sx more than 6 months

women mainly(2/3s)

exacerbated by menses or stress

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

.IBS

pain location

pain exacerbation

pain associated with what

A

pain can be anywhere or localized to hypogastrium or LLQ

pain worsened by food intake and relieved by defecation

pain associated with bowel distention from gas and spasm of gastric muscle. postprandial urgency is common

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

.IBS

PE

SX

A

PE: nml but may show a tender palpable sigmoid colon and hyperresonance on percussion over abdomen

sx: changes in stool frequency and character, constipation, diarrhea, dyspepsia, urinary frequency and urgency

will have alternating constipation and diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

.IBS tests to order

A

dx of exclusion
colonoscopy and abd CT

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

what is intussusception

A

invagination of proximal segment of the bowel into the portion just distal to it

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

intussusception

ages, following what

physical presentation

stools

complaints

A

children 3 months to 6 years. following a viral infection

child holding knees to chest

currant jelly stools

complaining of a colicky abdominal pain

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

what if intussusception occurs in an adult

A

think neoplasm

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

currant jelly stools

A

intussusception secondary to ischemia in the bowel

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

kid with severe colicky pain. sausage like mass felt on abdominal exam

adult symptoms

A

intussusception

adults have a more indolent course of crampy abdominal pain

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

dx for intussusception

A

kids: barium or air contrast enema
adults: no barium enema. do a CT

**ultrasonography is the test of choice: shoes a “target sign” must be taken during painful episode

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

tx for intussusception

A

air or barium enema for kids. surgery for adults

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

avoid a barium enema in what

A

intussusception in an adult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

.diverticulitis ages

A

60% of people older than 60 y/o and 20% become symptomatic

20% of pts with acute diverticulitis are younger than 40 years old

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

sudden onset of large volume hematochezia(bloody stools) which resolves spontaneously

A

diverticulitis

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

what to avoid in diverticulitits testing

A

avoid barium enema

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

diverticulitis

presentation

A

sudden onset abdominal pain, usually in LLQ or suprapubic region, with or without a fever

can be mild to severe infection with peritonitis

altered bowel movements as well as nausea and vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

diverticulitis

2 tests for dx

3 labs findings

2 tests to avoid

A

CT(to **dx) if pts do not respond to therapy

colonoscopy to provide definitive dx

occult blood in stool

mild to moderate leukocytosis

plain film to rule out free air

NO BARIUM ENEMA

no colonoscopy or sigmoidoscopy in acute disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

diverticulits tx

mild diverticulitis

ileus develops

surgery?

diet

A

low residue diet and broad spectrum antibiotics

(flagyl, FQ, 2nd or 3rd gen ceph)

NG tube for ileus

surgery in severe cases: peritonitis, large abscesses, fistulae, obstruction

high fiber diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

child holding knees to chest and vomiting

A

intussusception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

most common cause of acute lower GI bleeding in pts over 40 y/o

A

diverticulits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

ultrasonography shows a “target sign” and taken during painful episode

A

intussusception

also do a air enema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

.definition of toxic megacolon

A

nonobstructive, colon dilation of >6cm with signs of systemic toxicity

profound bloody diarrhea, distention, pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

.etio and def: chronic mesenteric ischemia

dx

A

atherosclerosis;

hypoperfusion relating to EATING;
POSTPRANDIAL pain

angiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

.where does ischemic colitis occur usually

A

splenic flexure and rectosigmoid junction; watershed area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

.dx for ischemic bowel disease

A

plain film radiography or CT show “thumbprinting”

**CT angiography is initial
conventional arteriography is definitive

30
Q

.tx of ischemic bowel disease

A

surgerical revascularization. hydration is a critical factor

31
Q

.what is hirschsprung’s disease

A

congenital aganglionosis(lack of neurons) of the colon, leading to functional obstruction in the newborn.

32
Q

.how does toxic megacolon occur in an adult

A

as a complication of UC, crohns, pseudomembranous colitis and specific infectious causes(c diff, campylobacter, shigella, amebiasis)

33
Q

.what to get dx toxic megacolon

A

abdominal plain film xray to show colonic dilation

34
Q

.what should be careful with when treating toxic megacolon

A

fluid and electrolyte imbalance

35
Q

.3 ways to dx colonic polyps

most of what come from polyps

A

barium enema, flexible sigmoidoscopy, colonoscopy

95% of adenocarcinoma come from polyps

36
Q

.acute mesenteric ischemia

s/s

dx

complication

A

*SEVERE pain out of proportion

CT angiogram!

lactic acidosis/gangrene

AMI emergent. Mortality remains high despite treatment

37
Q

.AMI etiology

A

arterial embolus or thrombosis (atherosclerosis) (Afib MC)

shock/hypoperfusion

venous thrombosis(hypercoagulable state)

38
Q

.sudden onset severe abdominal pain out of proportion, later will have involuntary guarding, rebound, and heme positive stool may develop

A

AMI

39
Q

.ischemic colitis s/s

A

LLQ crampy abd pain with ttp, bloody diarrhea

40
Q

.abdominal angina, pain occuring 10-30 min after eating, relieved by squatting or lying down. PE nml

A

CMI

41
Q

.risk factors:

age over 60

hx of a fib

vasculitis

hypercoagulable

use of vasoconstrictors(vasopressin, cocaine)

A

bowel ischemia

42
Q

survival rate in ischemic colitis

A

if diagnosed within 24 hours

survival rate is 50%

43
Q

.toxic megacolon presentation

A

fever, prostration(severe weakness), severe cramps, abdominal distention

rigid abdomen, localized diffuse rebound abdominal tenderness

44
Q

.fever, prostration(severe weakness), severe cramps, abdominal distention

rigid abdomen, localized diffuse rebound abdominal tenderness

A

toxic megacolon

*emergency

45
Q

.most common neoplastic polyp

highest risk of becoming cancerous

low risk for malignancy/most common non-neoplastic polyp

A

adenomatous

villous adenoma

hyperplastic

46
Q

how often should you evaluate family members of those with familial polyposis syndrome

A

every 1-2 years beginning 11 years old

discuss elective colectomy for an option for high risk individuals

47
Q

polyps symptoms

A

usually asymptomatic

although constipation, flatulence, and rectal bleeding may occur

bleeding polyps can cause iron deficiency anemia

48
Q

surgical resection of polyps

pts with history of polypectomy should follow up when

A

yes for lesions 2-3 cm

pts with history of polypectomy should follow up…

every 5-10 years with mild disease(up to 2 polyps less than 1cm)

every 3 years for moderate disease (3-10 small polyps or one greater than 1 cm)

every 1-2 years if more than 10 polyps are removed

49
Q

sausage shaped abdominal mass

A

intussusception

50
Q

stepladder appearance on abdominal xray

A

bowel perforation

51
Q

.Familial adenomatous polyposis screening

A

initiate screening at age 10-12 years with flex sig annually

52
Q

dx of colorectal cancer

A

occult blood in stool; flexible colonoscopy

** colonoscopy is the gold standard

53
Q

.what can u do to monitor but not detect colorectal cancer

A

carcinoembryonic antigen (not specific)

54
Q

.tx for colorectal cancer

A

surgical resection for local

chemotherapy for mets

55
Q

.3rd leading cause of cancer death in the world

2nd in US

A

colorectal cancer

56
Q

.colorectal cancer incidence and age

risk factor

race

A

90% cases occur in people older than 50 years old

hereditary non polyposis colorectal cancer leads to an extremely high risk of colon cancer (autosomal dominant)

pts with familial polyposis have a virtually 100% risk of developing the disease

hx of crohns or UC(worse)

african americans at an increased risk

57
Q

.dx for colorectal cancer

A

colonoscopy with bx dx test of choice

barium enema: apple core

lab: anemai poss

tumor marker: CEA

58
Q

.colorectal cancer

prognosis

A

good in early disease

its slow growing and symptoms appear late in the disease

59
Q

.colorectal cancer

screening

A

occult blood in stool can be an early marker and used in screen in adults older than 40 y/o

colonoscopy recommended for adults older than 50 years old or 10 before the earliest dx of colon cancer in a first degree relative

carcinoembryonic antigen be used to monitor, not detect the cancer

60
Q

.colorectal symptoms depending on locations

right side

left side

rectum

A

right sided lesions typically cause chronic blood loss and fatigue, iron defiency anemia. obstruction is uncommon

left sided lesions are often circumferential, causing change in bowel habits, abdominal pain, constipation/diarrhea, bloody stools, and obstructive symptoms. “apple core”

if lesion is found in the rectum: tenesmus, bright red blood, hematochezia

61
Q

.”apple coring” filling defect on descending colon on barium enema

A

colon cancer

62
Q

.which side of the colon is larger

A

right side

63
Q

.iron defiency anema in an elderly pt

A

indicates colorectal cancer until proven otherwise

64
Q

.iron defiency anema in an elderly pt

A

indicates colorectal cancer until proven otherwise

65
Q

.strep bovis (example in endocarditis) has a strong association with what

A

colon cancer

66
Q

.toxic megacolon due to UC, tx?

A

corticosteroids, manage underlying casue

67
Q

.toxic megacolon dx s/s

A

3 or more: fever >38 degrees, pulse >120, neutrophilic leukocytosis >10,500, anemia

1 of the following: hypotension, dehydration, electrolyte abn, altered mental status

68
Q

.antibx for toxic megacolon

A

flagyl plus ceftriaxone

69
Q

.thumbprint sign on CT abdomen

A

ischemic colitis

70
Q

.for medical decompression of colon, for pts at risk for perforation

A

netostigmine

71
Q

.how to dx IBS

A

ROME IV criteria

GI (14 decks)

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