Diverticulitis Cases Flashcards
A patient present with asking for advice on diet and further screening after seeing “presence of a diverticula” on her colonoscopy report after routine screening, she has no symptoms, how do you advise her?
advise her to consume a high fiber diet to reduce the work of her colon and to take in adequate hydration, also tell her to come in if she begins to experience any abdominal tenderness or other symptoms consistent with diverticulitis such as bubbles in her urine
also let the patient know that no further screening is needed
A patient present after seeing “presence of a diverticula” on her colonoscopy report after routine screening, she has no symptoms, she want to know if she can still have walnuts, which are her favorite snacks, how do you advise her?
tell her that she may still have nuts, avoidance of seeds and nuts is not recommended
a 57 yo patient presents with an aching pain over her LLQ that has worsen over the past 3 weeks, over this period she has developed a fever averaging 99.9 degrees F. She has felt nauseous most days than not and has began to notice bubbles in her urine. You order a CBC what do you expect to see?
a mild to moderate leukocytosis
a patient presents with an aching pain over her LLQ that has worsen over the past 3 weeks, over this period she has developed a fever averaging 99.9 degrees F. She has felt nauseous most days than not and has began to notice bubbles in her urine. What is your imaging test of choice? what do you expect to see?
CT scan of A/P with contrast
expect to see localized bowel wall thickening and fat stranding
also presence of colonic diverticula
a patient presents with an aching pain over her LLQ that has worsen over the past 3 weeks, over this period she has developed a fever averaging 103 degrees F. She has felt nauseous most days than not and is unable to tolerate anything by mouth. What is your treatment plan?
Admit
NPO, IV Fluids
IV antibiotics
Consult GI, Surgery
a patient presents with an aching pain over her LLQ that has worsen over the past 3 weeks, over this period she has developed a fever averaging 99.9 degrees F. Her CT revels uncomplicated diverticulitis. What is your treatment plan?
oral antibiotics again gram negative / anaerobic bacteria for 10 days
Clear liquid/Low Residue diet
Close follow up within 2 days
Repeat imaging/ hospitalize if worsening despite treatment
Your 53 y/o patient has just began feeling better after an acute episode of diverticulitis, what are your recommendation to her?
a diet high and fiber
a colonoscopy in about 6 to 8 weeks
Your patient present with recent bloating and cramping but is more concerned with the newly onset presence of blood in his stool. He states that there is no pain associated with the bleeding. How do you advise this patient?
Let him know that diverticular bleeding is a common cause of GI bleeding and it is usually self limited
Your patient present with recent bloating and cramping but is more concerned with the newly onset presence of blood in his stool. He states that there is no pain associated with the bleeding. He is worried though because the blood amount seem to be getting larger and he feels dizzy many time throughout the day. How do you manage this?
We may need to hospitalize this patient in order to maintain his blood volume, this may include transfusions. Once initial resuscitation complete, locate source of bleeding through flex sig or colonoscopy. We then would also treat the bleeding site through endoscopic therapy, angiographic therapy or in some cases surgery.
Your patient present with recent bloating and cramping but is more concerned with the newly onset presence of blood in his stool. He states that there is no pain associated with the bleeding. You run a BMP what should you not see?
you should not see an elevated BUN
