Disorders of the Small and Large Bowel Flashcards
Diarrhea is defined as an increase in frequency or liquidity of stool or as stool weight greater than this amount
> 200 g/d
Duration of subacute diarrhea
14 days to 4 weeks
acute, less than 14 days; chronic, more than 4 weeks
Diagnosis: high volume and frequency diarrhea, bulimia, anorexia, weight loss, stool osmolar gap >50 mOsm/kg, stool magnesium >90 meq/L
Factitious diarrhea
Test to document protein malabsorption
Stool alpha 1-antitrypsin clearance test
Patients who have these HLA alleles (2) are at risk for celiac disease
HLA-DQ2 and HLA-DQ8
Best serologic test to screen for celiac disease
Tissue transglutaminase (tTG) IgA antibody
Mechanisms (2) of vitamin B12 deficiency in small intestinal bacterial overgrowth
(1) Bacterial consumption of the vitamin, and (2) premature cleavage from intrinsic factor
Effect of rapid intestinal transit on the result of hydrogen breath testing
False positive
Small bowel culture diagnostic of small intestinal bacterial overgrowth
Greater than 10^5 organisms/mL
Length of remaining small bowel in small-bowel syndrome
<200 cm
normal: 600 cm
Most severe complication associated with ulcerative colitis
Toxic megacolon
Most commonly affected segment in toxic megacolon associated with ulcerative colitis
Transverse colon
Most common dermatologic manifestations (2) of inflammatory bowel disease
Erythema nodosum and pyoderma gangrenosum
This refers to distal ileal involvement with severe extensive ulcerative colitis and may be confused with ileocolonic Crohn disease
Backwash ileitis
This treatment for inflammatory bowel disease has been associated with progressive multifocal leukoencephalopathy due to JC virus infection
Natalizumab
Antidiabetic drug that has a high likelihood of causing microscopic colitis
Acarbose
A chloride channel activator that increases intestinal fluid secretion and can be used in patients with constipation-predominant IBS or chronic idiopathic constipation
Lubiprostone
Drug that can help with opioid-induced constipation without negating the benefits of the analgesia
Methylnaltrexone
The most widely studied and accepted risk factor for irritable bowel syndrome
Infectious gastroenteritis
Two clinical findings that provide the best specificity for making an alternative diagnosis of colorectal cancer instead of IBS
Anemia and weight loss
Modest evidence suggests that this probiotic improves IBS symptoms
Bifidobacterium infantis
Cornerstone of treatment of IBS
High-fiber diet or fiber supplementation
Test of choice for diverticulitis
Abdominopelvic CT
Most common form of intestinal ischemia
Colonic ischemia
Most common cause of acute mesenteric ischemia
Superior mesenteric artery embolus (from the left atrium or ventricular mural thrombi)
Second most common cause of acute mesenteric ischemia
Nonocclusive mesenteric ischemia from a cardiovascular event
Gold standard test for acute mesenteric ischemia
Classic angiography
A phosphodiesterase inhibitor that can be used at the time of angiography to relieve mesenteric vasoconstriction in patients with embolic and nonembolic arterial occlusion as well as nonocclusive mesenteric ischemia
Papaverine
Term that refers to fear of eating, typically seen in patients with chronic mesenteric ischemia
Sitophobia
Screening test for chronic mesenteric ischemia
Doppler ultrasound
Definitive treatment for chronic mesenteric ischemia
Surgical revascularization
Alcohol intake of this level increases colorectal cancer risk by approximately 25%
30 g/d or more
Most common type of hereditary colorectal cancer
Hereditary nonpolyposis colorectal cancer (HNPCC)
Second most common cancer in HNPCC
Endometrial cancer
Most common location of Peutz-Jeghers syndrome-associated hamartomatous polyps
Small intestine
Minimum amount of stool specimen for stool DNA test as screening for colorectal cancer
30 g
