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Clin Med- GI > Colon/Small intestine Lecture > Flashcards

Colon/Small intestine Lecture Flashcards

1
Q

Which gender is IBS seen more frequently in?

A

Women 2-3x more common

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2
Q

IBS is a diagnosis of…

A

exclusion

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3
Q

Pt education

Avoid triggers

Dietary therapy (high fiber)

Pharm therapy:
Antispasmodics, antidiarrheal, psychotropic, serotonin receptor agonists

A

Tx for IBS

(really specific/individualized for pt and case)

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4
Q

Medical emergency most of the time

Can be due to physical obstruction (foreign body, tumor, etc)
Can be due dysfunction of peristalsis

A

Bowel obstruction

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5
Q

Decrease or absence of intestinal paralysis

typically associated with trauma, surgery, infection or severe metabolic disease

A

Paralytic ileus

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6
Q

Volvulus

A

Twisting of intestine

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7
Q

Intussusception

A

Telescoping of intestine

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8
Q

Severe cramping abdominal pain
N/V

Inability to pass stool, gas
Increased bowel sounds early on, decreased late**
Abdominal swelling, distention

A

Bowel obstruction

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9
Q
A
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10
Q

Upright Xray may illustrate air fluid levels and multiple dilated loops of bowel

A

Bowel obstruction

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11
Q

When can you NOT give a barium swallow/enema?

A

If you suspect a perforation

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12
Q

NPO

Relieve pressure via nasal to stomach cannula

IV fluid, pain management

Relieve obstruction

Tx underlying issue if paralytic

Surgery often required

A

Bowel obstruction

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13
Q

Tissue death

Perforation

Sepsis

Death

A

Complications of failue ro recognize or treat a bowel obstruction

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14
Q

Inadequate flow of oxygenated blood to the intestines resulting in tissue death

A

Ischemic bowel

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15
Q

Inflammation and injury to the small intestine resulting in decreased blood flow

A

Mesenteric ischemia

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16
Q

Inflammation and injurt to the large intestine resulting in decreased blood flow

A

Ischemic colitis

17
Q

Acute= emergency!!!! high mortality rates

Chonic=blood supply present but insufficient to meet needs of intestines

A

Mesenteric ischemia

18
Q

Gold standard for diagnosing mesenteric ischemia?

A

CT of abdomen WITH contrast!

19
Q

Can be anywhere in GI tract

Multiple, interrupted lesions

A

Chron’s disease

20
Q

Only located in colon

Continuous lesions

A

Ulcerative colitis

21
Q

“Cure” for ulcerative colitis?

A

Colectomy

22
Q

Diagnostic test of choice for Chron’s/Ulcerative colitis?

A

Colonoscopy

23
Q

Acute toxic colitis with dilation and immbolity of colon

medical emergency!

Risk of rupture can lead to sepsis, death

A

Toxic megacolon

24
Q

Can occur as a complication of:

Ulcerative colitis
Chron’s
Psuedomembranous colitis
Infections: shigella, campylobacter, c.dif

A

Toxic megacolon

25
Q

Radiographic evidence of dilation..greater than 6cm in transverse colon

3 out of these 4:
temp over 101.5
HR over 120 bpm
Leukocytosis over 10.5
anemia

A

Toxic megacolon

26
Q
  1. reduce distention
  2. correct fluid/electrolytes
  3. treat toxemia, any contributing factors
A

Tx goals of toxic megacolon

27
Q

Abdominal pain

Fever

Nausea

A

classic triad for appendicitis

28
Q

Initial symptom in intermittent periumbilical or epigastric pain

in about 12 hours, localizes to RLQ (McBurney’s point), becomes constant, and is worsened by movement leading to rebound tenderness on PE

A

Appendicitis

29
Q

Autoimmune disorder of the small intestine, genetic component, manifests as abdominal pain, intermittent diarrhea, constipation, fatigue and anemia

A

Celiac disease

30
Q

Intolerance to gluten, ingestion of gluten triggers an immune response in turn causing damage to small intestine leading to nutritional deficits secondary to absorption issues

A

Celiac disease

31
Q

Diarrhea
Steatorrhea
Excessive gas, bloating, abdominal distention
Bowel pattern changes
Weight loss
Fatigue
Weakness

A

Celiac disease

32
Q

How is diagnosis of celiac confirmed?

A

Biopsy of small intestine

33
Q

Rare! (2% of GI cancers)

Symptoms:
Vague abdominal discomfort
Nutritional deficiency
Anorexia
Jaundice
Obstruction
**often not diagnosed until mets to other places

A

Small intestine cancers

34
Q

Elevated alk phos…can mean?

A

Something going on with the bone!

clue that there may be cancer going on somewhere!!! (ie colon cancer)

35
Q

Apple core lesion on X ray…CLASSIC for..

A

Colon cancer

36
Q

How often do you check:

Fecal occult blood test?

A

Every year after age 50

37
Q

How often do you check:

Flex sig?

A

Every 5 years over 50

38
Q

How often do you do colonoscopies?

A

Every 10 years over 50

39
Q
A

Clin Med- GI (8 decks)

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