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G2F > Disorders of the small Bowel and Colon CIS > Flashcards

Disorders of the small Bowel and Colon CIS Flashcards

1
Q

acute diarrhea- most lasts?

A
  • most <4 days

- less than 2 wks

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2
Q

persistent diarrhea- lasts?

A

more than 2 weeks

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3
Q

chronic diarrhea- lasts?

A

> 1 month

-most likely non-infectious- IBD, IBS, chronic pancreatitis, DKA, diverticulitis

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4
Q

Campylobacter jejuni

A
  • Guillain Barre
  • bloody diarrhea!
  • chicken, eggs
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5
Q

Giardia lamblia

A
  • pear shaped trophozoite with 2 nuclei and 4 pairs of flagella
  • camping
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6
Q

Cytoisospora belli

A
  • protozoan organism that stains positive for acid fast bacilli
  • in HIV pts
  • watery diarrhea
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7
Q

Staph aureus

A
  • potato salad
  • rapid onset- 6 hrs
  • self limited
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8
Q

Bacillus cereus

A

-fried rice

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9
Q

Vibrio cholera

A
  • oysters; poor sanitation

- profuse watery (rice) stools

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10
Q

Clostridium difficile

A
  • foul smelling
  • after abx
  • complications- colon perforation and toxic megacolon
  • wash hands with soap and water
  • PPI (omeprazole)- risk
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11
Q

Clostridium difficile- tx

A
  • PO/IV Metronidazole
  • PO vancomycin
  • PO fidaxomicin
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12
Q

Antibiotic associated colitis- dx

A
  • TCdA (enterotoxin) and TCdB (Cytotoxin)- check stool for toxin assay!!
  • abx use- ampicillin, clindamycin, 3rd gen cephalosporins, fluoroquinolones
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13
Q

Salmonella typhimurium

A
  • turtles, eggs

- bloody diarrhea

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14
Q

Salmonella typhi

A
  • typhoid fever
  • gram-neg enteric bacillus
  • rose spots; relative bradycardia!!
  • invades mult RES organs, Peyer’s patches
  • high fever
  • travel, poor sanitation
  • carrier site- Gallbladder! most common
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15
Q

Yersinia

A
  • mimics appendicitis
  • bloody diarrhea!
  • Hemochromatosis- risk factor!!- HFE gene mutation
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16
Q

Clostridium perfringens

A
  • ham

- watery diarrhea

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17
Q

Strongolyoides

A
  • rhabditiform larvae in stool
  • HTLV1- risk factor
  • barefoot in soil
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18
Q

Cryptosporidium

A

-swimming pools

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19
Q

Entamoeba histolytica

A
  • bloody diarrhea
  • flask shaped ulcer
  • liver abscess
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20
Q

Vibrio vulnificus

A
  • coastal salt water
  • bullous skin lesion
  • cirrhotic pt
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21
Q

Listeria monocytogenes

A
  • deli meat

- pregnancy

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22
Q

Aeromonas hydrophila

A

-freh water

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23
Q

Echinococcus granulosus

A
  • dog tapeworm

- liver cysts

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24
Q

ETEC E coli

A

-travelers’ diarrhea!- most common cause

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25
Q

Ascaris lumbricoides

A

-small intestine obstruction

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26
Q

Schistosoma mansoni

A
  • liver cysts
  • esophageal varices
  • Africa
  • snails
  • bladder cancer
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27
Q

EHEC

A

-hemolytic uremic syndrome

28
Q

Vibrio parahemolyticus

A
  • bloody diarrhea

- oysters

29
Q

most common infectious causes of BLOODY diarrhea

A
  • salmonella
  • shigella
  • EHEC (0157 H7)
  • campylobacter
  • Yersinia enterocolitica
30
Q

most incidental finding of appendix

A

-carcinoid tumor

31
Q

MEN1

A
  • parathyroidism- constipation
  • zollinger ellison- gastrin
  • pituitary adenoma
  • pancreatic tumors
32
Q

chronic diarrhea- most common causes

A
  • medication adverse effects
  • IBS
  • lactose intolerance
  • none of these have nocturnal diarrhea, weight loss, anemia or +FOBT
33
Q

5-HIAA

A

-carcinoid

34
Q

breath test

A

-glucose/lactose- small bowel overgrowth

35
Q

IBS

A
  • idiopathic, >6months, abd pain with altered BMs

- no structural or biochemical abnormalities

36
Q

Rome III criteria for IBS dx

A
  • abd discomfort for 3 days/month for past 3 months, with sx onset >6 months
  • at least 2/3:
  • relieved w/ defecation
  • change in frequency of stool
  • change in form of stool
37
Q

low FODMAPS diet

A
  • (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols)- fermentable monosaccharides and short-chain carbohydrates
  • ex- fructose, lactose, fructans, wheat-based products, sorbitol
  • for IBS pts!!
38
Q

Neuroendocrine

A
  • VIP-oma
  • medullary thyroid carcinoma (calcitonin)
  • zollinger-ellison syndrome (gastrin)
  • carcinoid syndrome (5-HIAA)
39
Q

causes constipation

A
  • inadequate fiber and fluid intake
  • hypothyroidism
  • Ca channel blocker use
  • Ca supplementation
40
Q

Lesar-Trelat sign

A
  • many pigmented lesions

- colon cancer assoc

41
Q

constipation/fecal impaction- dx, tx

A
  • dx- digital rectal exam

- tx- enemas, digital disruption

42
Q

microscopic colitis- causes

A
  • idiopathic- medications can cause it
  • W>M; 5-6 decade
  • watery diarrhea
  • lymphocytic- lymphocytes and plasma cells
  • collagenous- thickened band of subepit colagen
43
Q

diverticulitis- sx, tx

A

risk for perforation so dont do scope!!!

  • ttp in LLQ,fever, FOBT positive, elevated WBC count
  • tx- start antibiotics; NPO/clear liquid diet
  • after sx resolution- diagnostic imaging to rule out colonic neoplasms
44
Q

diverticulosis bleed

A

painless bloody poops

45
Q

diverticular dz of the colon- risk factors, sx, dx, complications

A
  • inc age, CT dz, low fiber diet or chronic constipation (Debated)
  • sx- asymptomatic
  • dx- colonoscopy or barium enema
  • complications- GI bleed, diverticulitis
46
Q

types of polyps

A
  • adenomatous (70%)
  • serrated- sessile serrated, serrated adenoma
  • nonneoplastic- juvenile, hamartomas, infl
47
Q

colorectal cancer screening

A
  • FH
  • if 1st degree relative dx at 60 yo- begin screening at 40!!
  • begin screening at age 40 or 10 yrs younger than diagnosis of affected relative
48
Q

95% of colon adenocarcinoma- come from?

A
  • adenomas and serrated polyps!
  • advanced- higher risk of progressing to malignancy- if > 1 cm, high-grade dysplasia
  • asymptomatic- FOBT positive, iron def anemia
49
Q

ways to detect polyps

A
  • barium enema- poor diagnostic accuracy
  • CT colonosgraphy- less sensitive at catching < 10 mm
  • colonoscopy- gold standard!!!
50
Q

Cowden disease

A
  • PTEN mult hamartoma syndrome
  • hamartomatous polyps and lipomas thruout GI tract!
  • hair follicle tumors (around lips)- Trichilemmomas
  • cerebellar lesions
  • inc rate of malignancy
51
Q

lynch syndrome

A

-endometrial cancer- transvaginal US

52
Q

FAP- caused by, tx

A
  • 100-1000s of adenomatous polyps and adenocarcinoma
  • APC gene or MUTYH gene mutation
  • tx- prophylactic colectomy
53
Q

Peutz-Jeghers Syndrome

A
  • Hamartomatous polyposis syndrome- AD
  • mucocutaneous pigmented macules around lips
  • GI malignancy- 40%
54
Q

Familial juvenile polyposis

A
  • hamartomatous polyposis syndrome- AD
  • > 10 hamartomatous polyps- in colon
  • inc risk of adenocarcinoma!!
55
Q

Lynch syndrome (HNPCC)

A
  • AD
  • MMR gene mutation- MLH1, MSH2!
  • inc risk of CRC, endometrial cancer!!!
  • rapid polyp transformation to malignant- 1-2 yrs
56
Q

Gardner’s syndrome

A
  • adenomatous colon polyps
  • 95% develop colorectal polyps
  • osteomas of mandible, skull, long bones
  • supernumerary teeth, thyroid and adrenal tumors, desmoid tumors
  • AD
57
Q

Turcot’s syndrome

A
  • adenomatous colon polyps
  • brain tumors
  • colorectal cancer- 100% at 40 yo
  • AD
58
Q

Celiac dz- ab’s

A

-IgA tTG
-if IgA def- anti-DGP
(HLA-DQ2/8)

59
Q

celiac dx- sx

A
  • wgt loss, chronic diarrhea

- dermatitis herpetiformis, iron def anemia, osteoporosis

60
Q

celiac dz- at risk for?

A

malabsorption!

  • type 1 DM
  • osteoporosis- DEXA scan
61
Q

celiac dz- biopsy

A
  • complete loss of intestinal villi
  • intraepit lymphocytes
  • plasma cells with hypertrophy of intestinal crypts
62
Q

Whipple disease- dx, sx, tx

A
  • biopsy- PAS + macrophages with gram + bacilli (Tropheryma whipplei)
  • lose ADEK
  • fever, LAD, arthralgias, malabsorption
  • tx- antibiotics
63
Q

Short bowel syndrome- if <200 cm left of jejunum and no colon

A

-total parental nutrition!!!

64
Q

bacterial overgrowth- sx, caused by? dx?

A
  • malabs of fat soluble vitamins; steatorrhea
  • PPI, gastric surgery of small bowel, small intestine motility disorders, gastrocolic or coloenteric fistula
  • dx H breath test
  • tx- antibiotics
65
Q

TI resection

A
  • bile salts and vit B12 malabs

- give calcium supplementation- inc risk of oxalate kidney stones

G2F (17 decks)

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