gallbladder, intestines - Sheet1

Question 1

What is cholelithiasis?

Answer 1

Stones in the gallbladder.

Question 2

What is cholecystitis?

Answer 2

Inflammation of the gallbladder.

Question 3

How is cholecystitis classified?

Answer 3

Acute or chronic.

Question 4

What are the risk factors for cholelithiasis and cholecystitis?

Answer 4

Female gender, post-menopausal women on estrogen, younger women on contraception, sedentary lifestyle, familial tendency, and obesity.

Question 5

What is the etiology of cholelithiasis?

Answer 5

Unclear.

Question 6

What is the mechanism of cholelithiasis?

Answer 6

The balance that keeps cholesterol, bile salts, and calcium in solution is altered, leading to precipitate formation.

Question 7

What are the manifestations of cholelithiasis?

Answer 7

Asymptomatic or severe symptoms, including biliary colic, diaphoresis, tachycardia, and dark, amber urine.

Question 8

What diagnostic tests are used for cholelithiasis?

Answer 8

Ultrasound, ERCP, liver function tests (LFTs), and pancreatic enzymes.

Question 9

What is the most common etiology of cholecystitis?

Answer 9

Obstruction by gallstones or biliary sludge.

Question 10

What are less common causes of cholecystitis?

Answer 10

Adhesions, neoplasms, anesthesia, and opioids.

Question 11

What is the mechanism of cholecystitis?

Answer 11

Inflammation of the mucous lining or the entire wall of the gallbladder, which can lead to fibrotic changes over time.

Question 12

What are the manifestations of cholecystitis?

Answer 12

Indigestion, moderate to severe pain, fever, chills, jaundice, nausea/vomiting, restlessness, leukocytosis, epigastric tenderness and rigidity, and RUQ pain that may refer to the right shoulder or scapula.

Question 13

What diagnostic tests are used for cholecystitis?

Answer 13

Same as those for cholelithiasis: ultrasound, ERCP, LFTs, and pancreatic enzymes.

Question 14

What is intestinal obstruction?

Answer 14

A partial or complete blockage of the small intestine or colon.

Question 15

What are the two types of intestinal obstruction?

Answer 15

Mechanical and non-mechanical.

Question 16

What is a mechanical obstruction?

Answer 16

A specific occlusion, such as adhesion, tumor, or hernia.

Question 17

What is a non-mechanical obstruction?

Answer 17

A neuro/muscular or vascular issue, such as paralytic ileus (the most common form).

Question 18

What are the risk factors for intestinal obstruction?

Answer 18

Prior surgery, endometriosis (due to adhesions).

Question 19

What are the complications of intestinal obstruction?

Answer 19

Hypovolemic shock, intestinal infarction, ischemia, and dead bowel.

Question 20

What causes hypovolemic shock in intestinal obstruction?

Answer 20

Obstruction leads to distention, increasing pressure, capillary permeability, and fluid/electrolyte movement into the peritoneal space, causing hypotension.

Question 21

What are the manifestations of intestinal obstruction?

Answer 21

Abdominal pain, nausea/vomiting, distention, constipation, and bowel sounds: high-pitched above obstruction, absent below. Flatulence is the best indication of bowel motility.

Question 22

What are the manifestations of small vs. large intestine obstruction?

Answer 22

Small intestine: Rapid onset, frequent emesis (relieves pain), some feces produced. Large intestine: Gradual onset, rare emesis, constipation.

Question 23

What diagnostic studies are used for intestinal obstruction?

Answer 23

H&P, abdominal x-rays, CT scan, EGD/Colonoscopy, labs (CBC, electrolytes).

Question 24

What is a hernia?

Answer 24

A protrusion of an internal organ, such as the intestine, through an abnormal opening or weakened area of the wall.

Question 25

What are the common types of hernias?

Answer 25

Inguinal (femoral), umbilical, ventral (incisional), hiatal.

Question 26

What are the etiologies of hernias?

Answer 26

Increased intraabdominal pressure, weakened abdominal muscles, heavy lifting, pregnancy, straining, chronic coughing, sneezing.

Question 27

What are the manifestations of a hernia?

Answer 27

Visible protrusion (especially when muscles are tensed), pain (especially when strangulated), vomiting, distention.

Question 28

What diagnostic tests are used for hernias?

Answer 28

H&P, ultrasound, CT/MRI.

Question 29

What is diverticulosis?

Answer 29

The presence of non-inflamed diverticula.

Question 30

What is diverticulitis?

Answer 30

Inflammation of one or more diverticula, typically related to bacterial invasion or hypoxic injury.

Question 31

What are the risk factors for diverticular disease?

Answer 31

Low fiber intake, obesity, inactivity, smoking/ETOH use, immunosuppression, and Western country residency.

Question 32

What is the mechanism of diverticulosis/diverticulitis?

Answer 32

Weak areas in the bowel lead to inadequate fiber intake, slower transit time, increased stool hardness, and intraluminal pressure, causing diverticula formation.

Question 33

What are the manifestations of diverticulosis?

Answer 33

Usually asymptomatic.

Question 34

What are the manifestations of diverticulitis?

Answer 34

Cramping lower abdominal pain, nausea/vomiting, bloating, fever, elevated inflammatory markers, lower GI bleeding.

Question 35

What diagnostic tests are used for diverticulosis/diverticulitis?

Answer 35

KUB, CT scan, CBC.

Question 36

What is ulcerative colitis?

Answer 36

A chronic inflammatory disease that causes ulceration of the colonic mucosa, most commonly in the rectum and sigmoid colon.

Question 37

What are the risk factors for ulcerative colitis?

Answer 37

Age (20-40), white race (especially Ashkenazi Jewish descent), family history.

Question 38

What is the etiology of ulcerative colitis?

Answer 38

Unknown.

Question 39

What is the mechanism of ulcerative colitis?

Answer 39

Inflammation begins in the rectum and can advance to the entire colon (pancolitis), forming small erosions that develop into ulcers, leading to abscess formation, necrosis, ulceration, and narrowing of the colon lumen due to edema.

Question 40

What are the manifestations of ulcerative colitis?

Answer 40

Intermittent exacerbations with continuous cramping abdominal pain, fever, frequent diarrhea, bowel urgency, bloody stools, dehydration, weight loss, anemia.

Question 41

How is ulcerative colitis diagnosed?

Answer 41

H&P, radiographic imaging, colonoscopy with biopsy.

Question 42

What is Crohn’s disease?

Answer 42

An idiopathic inflammatory disorder that impacts the GI tract from mouth to anus, commonly affecting the small intestine and proximal large colon.

Question 43

What are the risk factors for Crohn’s disease?

Answer 43

Age (usually diagnosed before 30), white race (especially Ashkenazi Jewish descent), family history, cigarette smoking, urban residence.

Question 44

What is the mechanism of Crohn’s disease?

Answer 44

Inflammation begins in the intestinal submucosa, usually in the ascending and transverse colon, and spreads. It affects one side of the intestinal wall, leaving the other side unaffected, with “skip” lesions. Fissures, fistulae, and strictures may develop.

Question 45

What are the noteworthy characteristics of Crohn’s disease?

Answer 45

“Skip” lesions, ulcerations creating fissures, fistulae formation between the intestine and bladder, rectum, or vagina, and strictures causing obstructions.

Question 46

What are the manifestations of Crohn’s disease?

Answer 46

Intermittent exacerbations with diarrhea, rectal bleeding, weight loss, abdominal pain, anemia, folic acid/vitamin D deficiency, hypoalbuminemia.

Question 47

How is Crohn’s disease diagnosed?

Answer 47

H&P, colonoscopy with biopsy, capsule endoscopy, radiographic imaging.