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Z Year3 Gastro Conditions > Diverticular Disease > Flashcards

Diverticular Disease Flashcards

1
Q

What are the risk factors for diverticular disease?

A
  1. Male
  2. Over 50
  3. Low fibre diet
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2
Q

What are the gastro symptoms of diverticular disease?

A
  1. Left lower quadrant abdominal pain
  2. Leukocytsosis
  3. Fever
  4. Rectal bleeding
  5. Bloating
  6. Constipation or diarrhoea
  7. Guarding/tenderness in left lower quadrant
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3
Q

What are possible differential diagnosis of diverticular disease?

A
  1. Endometriosis
  2. Colorectal cancer
  3. Appendicitis
  4. Ulcerative colitis
  5. Crohn’s disease
  6. Urinary tract infection (UTI)
  7. Pyelonephritis
  8. Ischaemic colitis
  9. Pelvic inflammatory disease
  10. Irritable bowel syndrome
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4
Q

What bloods do you order for diverticular disease?

A
  1. FBC
  2. U+Es
  3. CRP
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5
Q

What is FBC like in diverticular disease?

A

leukocytosis

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6
Q

What are U+Es like in diverticular disease?

A

uraemia, elevated creatinine

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7
Q

What is the CRP like in diverticular disease?

A

high

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8
Q

What imaging may you carry out for diverticular disease?

A

contrast CT

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9
Q

What may you find on contrast CT for diverticular disease?

A
  1. thickening of bowel wall
  2. mass
  3. abscess
  4. streaky mesenteric fat
  5. may show gas in the bladder in cases of fistula
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10
Q

What do you immediately need to think about with someone presenting with acute diverticular disease?

A

sepsis??

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11
Q

What is the 1st line treatment for asymptomatic diverticulosis?

A

dietary and lifestyle modifications

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12
Q

What is the 1st line treatment for symptomatic diverticulosis?

A

1st line: dietary and lifestyle modifications
Consider:
Analgesia
Antispasmodic

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13
Q

What is the 1st line treatment for acute diverticulitis uncomplicated?

A 
1st line: analgesia
Consider:
Antispasmodic
Oral antibiotics
Plus low-residue diet
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14
Q

What is the 1st line treatment for acute diverticulitis with complicated acute rectal bleeding?

A 
1st line: stratify as table or unstable and manage bleeding
Plus:
1.	Supportive therapy
2.	IV antibiotics
3.	Analgesia
4.	Low-residue diet
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15
Q

What is the 2nd line treatment for acute diverticulitis with complicated acute rectal bleeding?

A 
2nd line: surgery 
Plus:
1.	Supportive therapy 
2.	IV antibiotic
3.	Analgesia
4.	Low residue diet
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16
Q

What is the 1st line treatment for acute diverticulitis: complicated with abscess, perforation, fistulae or obstruction?

A 
1st line: radiological drainage/surgery 
Plus:
1.	IV antibiotic
2.	Analgesia
3.	Low-residue diet
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17
Q

What is the 1st line treatment for ongoing recurrent diverticulitis?

A

elective surgery

18
Q

What are the possible complications of diverticular disease?

A
  1. Fistula
  2. Colorectal neoplasm
  3. Abscess
  4. Perforation
  5. Strictures, obstruction
19
Q

What is the prognosis of diverticular disease like?

A
  1. Recures in 1/3 of patients

2. Post surgery ¼ remain symptomatic

20
Q

What is a diverticulum?

A

an outpouching of the gut wall usually at sites of entry of perforating arteries

21
Q

What is diverticulosis?

A

means that diverticula are present

22
Q

What is diverticular disease?

A

means that diverticula are present and symptomatic

23
Q

What is diverticulitis?

A

inflammation of a diverticulum

24
Q

Where is diverticulosis found most?

A

within sigmoid colon

25
Q

How common is diverticular disease?

A

30% of westerners have diverticulosis by age 60

26
Q

What is diverticular disease?

A

Herniation of mucosa and sub mucosa through muscle layer of colonic wall

27
Q

What is psuedodiveticular disease?

A

muscle layer does NOT Outpouch

28
Q

What is true diverticular disease?

A

muscle layer DOES Outpouch

29
Q

What is a diverticulum?

A

1 outpouching

30
Q

What is diverticula?

A

multiple outpouchings

31
Q

What is diverticulosis?

A

presence of outpouching but ASx

32
Q

What is diverticular disease?

A

diverticulosis WITH Sx

33
Q

What is diverticulitis?

A

inflammation + infection of outpouching

34
Q

What is the patho of diverticular disease?

A
  1. Taeniae coli (muscle that runs along the colon)
  2. present in bands
  3. herniation of the mucosa occurs in between these bands
35
Q

What side are the diverticulum found?

A
  1. WEST: L side of colon (descending colon + sigmoid)
  2. NEVER found in the rectum
  3. Right side of colon more common in asia
36
Q

What is the diagnostic test for diverticular?

A
  • Barium Enema

- CT

37
Q

What imaging is done for diverticular disease and what does it show?

A
  1. Barium Enema: saw tooth appearance of lumen – DIAGNOSTIC not if v sick as risk of perforation
  2. Colonscopy if diverticular disease
38
Q

What is important to remember when giving medication and diveritcular disease?

A
  1. Laxative post surgery: osmotic not stimulant

2. No constipating analgesia e.g. opiods (morphine)

39
Q

What are symptoms for divertciluosis?

A
  • ASx

- May have blood in stool

40
Q

What are symptoms for diverticulitis?

A
  1. Left illiac fossa bain
  2. Tachycardia
  3. Fever
  4. Abdo distenstion

Z Year3 Gastro Conditions (48 decks)

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