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Y1 GASTROENTEROLOGY > Colonic Disease > Flashcards

Colonic Disease Flashcards

1
Q

What is a polyp?

A

A protrusion of an epithelial surface

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2
Q

What is an adenoma?

A

A benign epithelial tumour that produces glands

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3
Q

All polyps are adenomas. True/False?

A

False

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4
Q

What are the 3 types of polyp?

A

Pedunculated (stalks)
Serrated (from villous)
Flat

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5
Q

All adenomas are dysplastic and may form adenocarcinoma. True/False?

A

True

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6
Q

What is the primary treatment of adenocarcinoma of the colon?

A

Surgical excision - colectomy, colostomy and/or resection

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7
Q

Colorectal carcinoma is found most commonly on which side - right or left?

A

Left (75%)

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8
Q

What is a diverticulum?

A

Outpouching of epithelial lining

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9
Q

What is the difference between diverticulosis and diverticulitis?

A 
Diverticulosis = diverticular disease = the presence of diverticula
Diverticulitis = inflammation of diverticula
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10
Q

What is the proposed aetiology of diverticular disease?

A

Low fibre diet, high fatty diet

Reduces motility and increases colonic pressure

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11
Q

List some investigations for diverticular disease

A

Sigmoidoscopy
Barium enema
CT ABDOMEN - DIVERTICULITIS

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12
Q

Which part of the colon is most susceptible to diverticular disease?

A

Sigmoid colon

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13
Q

What is a fistula?

A

Pathological connection/link between two epithelial surfaces

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14
Q

What would a fistula between the colon and the bladder be called?

A

Colovesical fistula

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15
Q

What are the main management for diverticular disease?

A

IV fluids, bowel rest, IV antibiotics, increased fibre in diet
Percutaneous drainage
Hartmann procedure

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16
Q

Describe Hartmann procedure

A

Remove sigmoid colon and connect colostomy bag to descending colon

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17
Q

What are the most common organisms that cause infective colitis?

A

C. difficile
Campylobacter
E. coli

18
Q

Name some symptoms of acute and chronic colitis

A

Diarrhoea with/without blood
Cramping pain
Dehydration
Weight loss

19
Q

List investigations for acute and chronic colitis

A

AXR
Stool culture
Sigmoidoscopy
Barium enema

20
Q

Name some causes of large bowel obstruction

A

Colonic cancer
Volvulus
Faecal impaction
Pseudo-obstruction

21
Q

Which part of the colon is most commonly affected by ischaemic colitis?

A

Sigmoid colon (diverticular disease too - it just gets all the shit…)

22
Q

What is the most common cause of ischaemic colitis?

A

Atherosclerosis of mesenteric vessels

23
Q

Which organism is mostly behind antibiotic-induced colitis?

A

C. difficile

24
Q

How does C. difficile cause colitis?

A

Produces toxin A and B in response to broad-spectrum antibiotics which attack epithelium

25
Q

What is the classic presentation of collagenous colitis?

A

Watery diarrhoea

Normal endoscopy

26
Q

Familial adenomatous polyposis is a type of CRC caused by mutation in which gene?

A

APC (tumour suppressor) gene

27
Q

Hereditary nonpolyposis colorectal cancer is caused by mutation in which gene?

A

DNA mismatch repair gene

28
Q

HNPCC is more common than FAP. True/False?

A

True

29
Q

What are the symptoms of colorectal carcinoma?

A

Pain, anaemia, cachexia, lymphadenopathy
Abdominal mass, abdominal distension (ascites)
Rectal mass, PR bleeding, tenesmus, change in bowel habit

30
Q

How is CRC diagnosed?

A

Barium enema
CT colography
Sigmoidoscopy
Colonoscopy

31
Q

What is the screening test for CRC?

A

Faecal occult blood testing

32
Q

What is colonic volvulus? Where is it most common? How is it diagnosed? How is it treated?

A

Part of colon twists on mesentery, causing obstruction - typically elderly people
Sigmoid colon
AXR - COFFEE BEAN SHAPE
Sigmoidectomy

33
Q

What is colonic angiodysplasia? What are the signs? How is it diagnosed? How is it treated?

A

Small vascular malformation of gut, leading to bleeding and anaemia
Fresh PR bleeding in elderly
PR exam, colonoscopy, angiography
Embolization

34
Q

List some features of diverticular disease

A

LIF pain/ tenderness
Altered bowel habit
Nausea/ vomiting
Septic

35
Q

What classification system do we use for diverticulitis?

A

Hinchey’s classification

36
Q

What is the treatment for colitis?

A

IV fluids
IV steroids (NOT IN ISCHAEMIC)
GI rest
Surgery if failure to settle

37
Q

Name the four main types of colitis

A

Infective
Ulcerative
Crohns
Ischaemic

38
Q

List the main causes of PR bleeding

A 
Diverticulitis
Colorectal cancer
Haemorrhoids
Crohns/ UC
Angiodysplasia
39
Q

What are the symptoms of large bowel obstruction? How is it treated?

A 
Vomiting
Colicky pain
Constipation
Distension
Catheter, NGT, IV fluids, surgical stenting
40
Q

Mechanical GI onstruction with no cause found is known as…

What are the types?

A

Pseudoobstruction
ACUTE: Ogilves syndrome
CHRONIC: Weight loss due to malabsorption

41
Q

What staging method is used for CRC?

A

Duke’s Criteria

Y1 GASTROENTEROLOGY (24 decks)

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