Disorders of the Small Bowel Flashcards
What is the likely diagnosis in a patient who presents two days post-abdominal surgery with absent bowel sounds, no passage of gas, mild distension, and no pain?
Post-op paralytic ileus
Uniform distribution of gas in the abdomen on imaging =
paralytic ileus
What is the likely cause of hypocalcemia in a patient who has steatorrhea?
Vitamin D deficiency
The primary etiology of appendicitis in children is ____; the most common etiology in adults is_____
- lymphoid tissue hyperplasia
- fecalith obstruction
RLQ pain, nausea, vomiting, anorexia (loss of appetite), and fever is suggestive of
Acute appendicitis
What vitamin deficiency may be caused by malignant carcinoid syndrome?
Niacin (B3) deficiency
The symptoms of carcinoid syndrome may be remembered with the mnemonic “Be FDR”: BronchospasmFlushingDiarrheaRight-sided heart disease
BronchospasmFlushingDiarrheaRight-sided heart disease(tricuspid regurgitation and pulmonary valve stenosis)
What is the diagnosis in a pregnant patient with right mid-to-upper quadrant or flank pain with peritoneal signs, but without uterine tenderness?
Appendicitis
Severe periumbilical abdominal pain out of proportion to physical exam, nausea, vomiting, diarrhea, fever, and leukocytosis is suggestive of:
Acute mesenteric ischemia
Diagnostics of meconium ileus?
1) X-ray showing gas-filled plug
2) Gastrografin water-soluble contrast enema showing microcolon
Causes of Paralytic ileus:
- Abdominal surgery,
- Trauma (e.g., retroperitoneal hemorrhage)
- Electrolyte imbalances (hypokalemia)
What imaging modality is preferred for diagnosis of acute or chronic mesenteric ischemia?
CT angiography
What is the treatment of choice in patients with thrombotic AMI who have signs of peritonitis, bowel perforation, advanced bowel ischemia and/or hemodynamic instability ?
Open mesenteric bypass surgery to restore arterial perfusion
What is the treatment of choice in patients with thrombotic AMI who are hemodynamically stable and do not have signs of peritonitis, bowel perforation, and/or advanced bowel ischemia?
Balloon angioplasty and stenting
What is the treatment of choice in hemodynamically stable patients with embolic AMI who do not have signs of peritonitis, bowel perforation, and/or advanced bowel ischemia?
Endovascular thrombectomy
Is celiac disease associated with normal or decreased urinary excretion of D-xylose (D-xylose test)?
Decreased
The______ helps distinguish GI mucosal damage from other causes of malabsorption (e.g. lactose intolerance, pancreatic insufficiency)
D-xylose absorption test
What is the likely diagnosis in an adolescent with a history of T1DM that presents with weight loss, iron deficiency anemia and a pruritic, vesicular rash on the elbows and knees?
Celiac disease
What is the most pathogenic component of gluten (celiac disease)?
Gliadin
Increased urine concentration of 5-hydroxyindoleacetic acid (5-HIAA), which is a product of serotonin metabolism, confirms the diagnosis of:
Carcinoid syndrome
Which trace mineral deficiency manifests as impaired taste, alopecia, and pustular skin rash?
Zinc deficiency
Is celiac disease associated with normal or decreased urinary excretion of D-xylose (D-xylose test)?
Decreased
