Final Flashcards
Chronic transmural inflammatory disease of the distal ileum & colon. Rectum is not involved. Pt has perianal fistulas or abscesses & non-bloody diarrhea. Smoking increases the likelihood
Crohn’s Disease AKA Regional Enteritis; Granulomatous Ileitis, Ileocolitis
Discontinuous lesions assoc. w/ Crohn’s Disease are AKA?
Skip lesions
Chronic inflammatory disease arising in the mucosa & submucosa of the colon. Smoking decreases risk.
Ulcerative colitis
What is the M/C clinical presentation of Ulcerative colitis?
Bloody Diarrhea
Diverticula M/C’ly occur in what part of the colon?
Sigmoid colon
Diverticula that contain all layers of the affected area are called what?
True diverticula
False or pseudo diverticula have mucosa only going through what layer?
Muscular layer
Multiple diverticula in the colon is called what? Typically asymptomatic but can become inflamed & bleed
Diverticulosis
What individuals are typically affected by diverticulosis?
> 40 yr old. Individuals w/ a low fiber diet
Inflammation of the diverticula is called what?
Diverticulitis
What % of diverticula that become inflamed resolve on their own?
75%
This is a congenital anomaly in distal ileum w/i 100cm (3ft) of ileocecal valve that occurs M/C’ly in older children. Represents persistent prox. end of yolk sac, sometimes becomes attached to inside of umbilicus. M/C diverticulum in the small bowel
Meckel’s Diverticulum
Acute longitudinal tear or ulcer in squamous epithelium of anal canal from large stool passage w/ secondary infection
Anal fissures
Anorectal abscesses are M/C’ly caused by what?
Bacterial infection
Tube-like tract w/ one opening in the anal canal & the other usually in the perianal skin. Assoc. w/ Crohns
Anorectal Fistula
Episodic rectal pain lasting <20mins d/t spasm of levator ani muscle
Levator Syndrome
Acute abscess or chronic drainage sinus in the sacrococcygeal region (cyst formation under skin)
Pilonidal Disease
Inflammation of anus & the distal rectal mucosa from infection (STD or bacterial), IBD or radiation
Proctitis
What is the M/C etiology of proctitis?
STD’s
Proctitis may develop d/t long term use of what type of medication?
Antibiotics
Painless protrusion of rectum thru the anus
Rectal prolapse
What is the M/C benign tumor of the esophagus?
Leiomyoma (excellent prognosis for recovery)
What are the 2 M/C malignant tumors of the esophagus?
Squamous cell carcinoma (M/C)
Adenocarcinoma (2nd M/C)
What are features of squamous cell carcinoma?
Caused by alcohol/tobacco
M/C occurrence in Asia & South Africa
M/C in African Americans
What are features of adenocarcinoma?
Caused by smoking (but not alcohol)
Seen in distal esophagus (Barrett’s)
50% Caucasian esophageal cancers
M/C’ly affects males
What is the 2nd M/C cancer worldwide?
Stomach cancer
What bacteria plays a significant role in stomach cancer?
H. pylori
Type of cancer that makes up 95% of all stomach cancers?
Gastric adenocarcinoma
What sign is not commonly assoc. w/ small bowel tumors?
Polyps
Polyps of the colon & the rectum are M/C’ly seen in what part?
Sigmoid area
Any mass of tissue that arises from the bowel wall & protrudes into the lumen is known as what?
Polyps
Primary adenocarcinoma of the pancreas M/C’ly occurs in what part of the pancreas?
Pancreatic head (80%)
What two things ARE NOT risk factors for primary adenocarcinoma in the pancreas?
Alcohol
Caffeine
Gastrin-producing tumor located in pancreas or duodenal walls. Gastric acid hyper-secretion leads to peptic ulcer
Zollinger-Ellison Syndrome AKA Z-E syndrome, Gastrinoma
What is the most metabolically complex organ in the body?
Liver
Free fluid in the peritoneal cavity M/C’ly caused by portal hypertension from liver disease is called what?
Ascites
Yellowing of the skin, sclera & other tissues caused by excess circulating hyperbilirubinemia
Jaundice
What are s/s assoc. w/ jaundice?
Nausea
Vomiting
Dark urine
Conjugation (4th step) during bilirubin metabolism allows what to happen to bilirubin?
Becomes water soluble and can pass through kidneys
Syndrome that causes impaired excretion of bilirubin. Liver itself is healthy but dark
Dubin-Johnson Syndrome
Rare & severe unconjugated hyperbilirubinemia. Most pts die before 1 yr of age
Crigler-Najjar Syndrome
What is consider normal pressure in the portal system?
5-10mmHg
What are the 2 M/C etiologies for portal hypertension?
Liver cirrhosis
Hepatic Vascular Abnormalities (increased resistance to blood flow from ds w/i liver)
Alcohol causes liver injury that can progress to what 3 pathologies?
Fatty liver
Alcoholic hepatitis
Cirrhosis of liver
What are 3 major factors assoc. w/ alcoholic liver disease?
Quantity of alcohol consumed
Duration of alcohol abuse
Nutritional status of pt
Where is alcohol absorbed in the GI tract?
Readily absorbed from stomach & sm. intestine. Can’t be stored, goes straight to liver
What is the difference in prognosis b/w fatty liver/alcohol hepatitis vs fibrosis/cirrhosis?
Fatty liver/alcohol hepatitis is reversible
Fibrosis/cirrhosis is not reversible
This liver ds is a leading cause of death worldwide
Liver cirrhosis
Type of hepatitis that is spread primarily by fecal-oral contact & may occur in areas of poor hygiene (daycare)
Hep A AKA Infectious Hepatitis
Type of hepatitis that is transmitted via blood or blood products, or bodily fluids, & can be spread via sexual intercourse
Hep B AKA Serum hepatitis
Type of hepatitis that requires the presence of Hep B
Hep D AKA Delta agent
Type of hepatitis that is transmitted via fecal-oral route d/t contaminated water & found in developing countries. Much more virulent in pregnant women
Hep E AKA Epidemic hepatitis (was part of non-A & non-B hepatitis)
Type of hepatitis that is the M/C blood-borne infection & leading cause of chronic liver disease. Seen in drug users, not usually sexually transmitted
Hep C (was part of non-A, non-B hepatitis)
Type of hepatitis that is related to hep C virus
Hep G
If you seen a pt w/ viral hepatitis, you must do what?
Report to local health department
A person that was previously healthy/stable that suddenly in a short time deteriorates is a red flag for what pathology?
Hepatocellular Carcinoma (Hepatoma) (primary liver cancer)
What sign is assoc. w/ gallbladder & bile duct disorders?
Murphy’s Sign
Presence of one or more calculi in the gallbladder. Can be either asymptomatic (85%) or produce biliary colic pain (RUQ)
Cholelithiasis AKA Gallstones
What are the 2 types of gallstones (don’t think soft tissue rad)?
Cholesterol stones - 85% of gallstones in western world
Pigment stones - 15% of gallstones
Inflammation of the gallbladder (acute or chronic)
Cholecysitis
M/C complication of cholelithiasis. Develops over hours from cystic duct obstruction by gallstones
Acute cholecystitis
Formation or presence of stones in the bile ducts, usually pigment stones.
Choledocholithiasis
Bacterial infection of the bile ducts (E. coli, Klebsiella, Enterobacter)
Cholangitis
Symptoms assoc. w/ Cholangitis are called Charcot’s triad which is composed of what?
Abdominal pain
Jaundice
Fever or chills
Painful or uncomfortable urination (common in UTI’s)
Dysuria
Urine output over 3 liters per day (2500ml)
Polyuria
Bed-wetting. Involuntary passage of urine while sleeping
Enuresis (nocturnal enuresis)
The male reproductive system is controlled by a feedback circuit involving what endocrine organs
Hypothalamus
Pituitary
Testes
Male sexual dysfunction is when drugs or physical & psychological disorders affect any one of what 4 sexual functions?
Libido
Erection
Ejaculation
Orgasm
Type of incontinence where urgent need to void just before uncontrolled urine leakage occurs
Urge Incontinence (M/C in elderly)
Type of incontinence that occurs w/ abrupt increase in intra-abdominal pressure i.e. coughing, laughing, sneezing, etc
Stress incontinence
Type of incontinence w/ dribbling of urine from overly full bladder
Overflow incontinence
Type of incontinence w/ loss of urine d/t cognitive or physical impairments (stroke/dementia)
Functional Incontinence
Type of neurogenic bladder that occurs from peripheral nerve or spinal cord damage at S2-S4
Flaccid neurogenic bladder
Type of neurogenic bladder that occurs from brain or spinal cord damage above T12 (Stroke)
Spastic neurogenic bladder
Pain along the T-11/T-12 dermatome is a symptom of what urinary tract problem?
Obstructive Uropathy AKA Urinary Tract OBstruction
95% of UTI’s occur when bacteria do what?
Ascend from urethra to bladder & then move upward to kidney
What is the M/C bacteria to cause UTI?
E. coli
Bacterial infection of the urethra. S/s include dysuria & urethral discharge (pus)
Urethritis
Bacterial infection of the bladder. S/s include sudden onset, increased freq., painful urination, nocturia, low grade fever, abdominal symptoms
Cystitis
Hereditary disorder of renal cyst formation causing gradual enlargement of both kidneys & can lead to renal failure. May also have hepatic/pancreatic/intestinal cysts, colonic diverticula, or hernias
Cystic kidney disease (Polycystic kidney disease)
Rapid onset, rapid decrease in renal function over days
Acute renal failure
Accumulation of nitrogenous products in blood. Assoc. w/ acute renal failure
Azotemia
Decrease in renal function that develops slowly over months to years
Chronic Renal failure
What is the difference b/w Nephritic Syndrome & Nephrotic Syndrome?
Nephritic Syndrome presents w/ hematuria
Nephrotic Syndrome presents w/ proteinuria
Orchitis (inflammation of the testes) is M/C’ly caused by what?
Mumps
Fibrosis of the corpus cavernosus sheaths of the penis. Painful erection & deviated, usually to involved side
Peyronie’s Disease
Inability to retract the foreskin of the penis
Phimosis
Entrapment of the penis foreskin in the retracted position
Paraphimosis
Painful, persistent, abnormal erection unaccompanied by sexual desire or excitation
Priapism
Excessive accumulation of sterile fluid w/i tunica vaginalis
Hydrocele
Scrotal swelling w/ non-sterile fluid (pus). D/t complication of severe epididymitis
Pyocele
Accumulation of blood w/i tunica vaginalis secondary to trauma
Hematocele
Spermatic cyst similar to hydrocele. Painless at upper poles of testes
Spermatocele
Collection of large veins, usually in L scrotum. Bag of worms appearance that goes away when laying down
Varicocele
Testicular torsion M/C’ly occurs in which teste?
L teste
Digital rectal exam can be used to determine what about the prostate?
Size
Symmetry
Texture
Nodules
What is the M/C risk factor for bladder cancer?
Smoking
What stage of renal cancer is when the tumor has spread to the vena cava or renal vein?
Stage IIIA
What stage of renal cancer is when the tumor is confined to a renal capsule?
Stage I
What stage of renal cancer is when the tumor has invaded adjacent organs & has distant metastases?
Stage IV
What stage of renal cancer is when the tumor is not extending beyond Gerota’s fascia membrane around kidney/adrenal/fat?
Stage II
What stage of renal cancer is when the tumor has spread to the regional lymph nodes?
Stage IIIB
What is the M/C type of penile cancer & who is affected most?
Squamous cell carinoma
Usually occur in elderly uncircumcised men w/ poor local hygiene
What is penile cancer caused by?
HPV
Bowen’s Disease
Erythroplaia of Queyrat
What is the M/C non-dermatologic cancer in men over the age of 50? M/C in african americans
Prostate cancer
Over what age are most prostate cancers found?
Over 65 w/ median age of 72 (75%)
How is tx for prostate determined?
Depends on age of pt & extent of the tumor. <70yr old = radical prostectomy
What is the M/C solid cancer in males aged 15-35?
testicular cancer
What is the M/C type of urethral cancer?
Squamous cell
