Gastrointestinal (Diseases Only)

Question 1

Crohn’s Disease

Answer 1

Crohn disease is a chronic transmural inflammatory bowel disease that may occur in any part of the GI tract. Symptoms include WATERY diarrhea and abdominal pain. Abscesses, internal and external fistulas, and bowel obstruction may arise. Extraintestinal symptoms, particularly arthritis, may occur.

Question 2

Celiac Disease

Answer 2

Celiac disease is an immunologically mediated disease in genetically susceptible people caused by intolerance to gluten, resulting in mucosal inflammation and villous atrophy, which causes malabsorption. Symptoms usually include diarrhea and abdominal discomfort.

Question 3

Diverticular Disease

Answer 3

Diverticular disease is characterized as symptomatic diverticulosis.

Question 4

Diverticulitis

Answer 4

Diverticulitis is inflammation and/or infection of a diverticulum.

Question 5

Diverticula

Answer 5

Diverticula are saclike mucosal pouches that protrude from a tubular structure.
True diverticula of the GI tract contain all layers of the GI wall. Esophageal diverticula and Meckel diverticula are true diverticula.
False or pseudo-diverticula are mucosal and submucosal protrusions through the muscular wall of the bowel. Colonic diverticula are pseudodiverticula.
A single pouch is called a diverticulum and ≥ 2 pouches are called diverticula. These terms are occasionally used incorrectly.

Question 6

Diverticulosis

Answer 6

Diverticulosis is the presence of one or more diverticula.

Question 7

Ulcerative Colitis

Answer 7

Ulcerative colitis is a chronic inflammatory and ulcerative disease arising in the colonic mucosaj (superficial) , characterized most often by BLOODY diarrhea. Extraintestinal symptoms, particularly arthritis, may occur. Long-term risk of colon cancer is elevated compared to unaffected people.

Question 8

Inflammatory Bowel Disease

Answer 8

Inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, is a relapsing and remitting condition characterized by chronic inflammation at various sites in the GI tract, which results in diarrhea and abdominal pain.

Question 9

Appendicitis

Answer 9

Appendicitis is acute inflammation of the vermiform appendix, typically resulting in abdominal pain, anorexia, and abdominal tenderness. Diagnosis is clinical, often supplemented by CT or ultrasonography. Treatment is surgical removal of the appendix.

Question 10

Inguinal hernia

Answer 10

An inguinal hernia is a protrusion of the abdominal contents through an acquired or congenital area of weakness or defect in the abdominal wall just above the inguinal ligament (groin). Many inguinal hernias are asymptomatic, but some become incarcerated or strangulated, causing pain and requiring immediate surgery. Diagnosis is clinical. Treatment is elective surgical repair.

Question 11

Abdominal Wall Hernia

Answer 11

A hernia of the abdominal wall is a protrusion of the abdominal contents through an acquired or congenital area of weakness or defect in the wall. Many hernias are asymptomatic, but some become incarcerated or strangulated, causing pain and requiring immediate surgery. Diagnosis is clinical. Treatment is elective surgical repair.

Question 12

Ileus

Answer 12

Ileus is a temporary arrest of intestinal peristalsis. It occurs most commonly after abdominal surgery, particularly when the intestines have been manipulated. Symptoms are nausea, vomiting, and vague abdominal discomfort. Diagnosis is based on x-ray findings and clinical impression. Treatment is supportive, with nasogastric suction and IV fluids.

Question 13

Acute GI Perforation

Answer 13

Any part of the GI tract may become perforated, releasing gastric or intestinal contents into the peritoneal space. Causes vary. Symptoms develop suddenly, with severe pain followed shortly by signs of shock. Diagnosis is usually made by the presence of free air in the abdomen on imaging studies. Treatment is with fluid resuscitation, antibiotics, and surgery. Mortality is high, varying with the underlying disorder and the patient’s general health.

Question 14

Hiatus hernia

Answer 14

Hiatus hernia is a protrusion of the stomach through the diaphragmatic hiatus. Most hernias are asymptomatic, but an increased incidence of acid reflux may lead to symptoms of gastroesophageal reflux disease (GERD). Diagnosis is by barium swallow. Treatment is directed at symptoms of GERD if present.

Question 15

Meckel diverticulum

Answer 15

Meckel diverticulum is a true diverticulum and is the most common congenital anomaly of the GI tract, occurring in about 2% of people. It is caused by incomplete obliteration of the vitelline duct and consists of a congenital sacculation of the antimesenteric border of the ileum.

Question 16

Gastritis

Answer 16

Gastritis is inflammation of the gastric mucosa caused by any of several conditions, including infection (Helicobacter pylori), drugs (NSAIDs, alcohol), stress, and autoimmune phenomena (atrophic gastritis). Many cases are asymptomatic, but dyspepsia and GI bleeding sometimes occur. Diagnosis is by endoscopy. Treatment is directed at the cause but often includes acid suppression and, for Helicobacter pylori infection, antibiotics.

Question 17

Peptic Ulcer

Answer 17

A peptic ulcer is an erosion in a segment of the GI mucosa, typically in the stomach (gastric ulcer) or the first few centimeters of the duodenum (duodenal ulcer), that penetrates through the muscularis mucosae. Nearly all ulcers are caused by Helicobacter pylori infection or NSAID use.

Question 18

Gastroenteritis

Answer 18

Gastroenteritis is inflammation of the lining of the stomach and small and large intestines. Most cases are infectious, although gastroenteritis may occur after ingestion of drugs and chemical toxins (eg, metals, plant substances). Acquisition may be foodborne, waterborne, or via person-to-person spread. In the US, an estimated 1 in 6 people contracts foodborne illness each year. Symptoms include anorexia, nausea, vomiting, diarrhea, and abdominal discomfort.

Question 19

Irritable bowel syndrome

Answer 19

Irritable bowel syndrome is characterized by recurrent abdominal discomfort or pain with at least two of the following characteristics: relation to defecation, association with a change in FREQUENCY of stool, or association with a change in CONSISTENCY of stool

Question 20

Pancreatitis

Answer 20

Pancreatitis is classified as either acute or chronic.

Acute pancreatitis is inflammation that resolves both clinically and histologically.

Chronic pancreatitis is characterized by histologic changes that are irreversible and progressive and that result in considerable loss of exocrine and endocrine pancreatic function. Patients with chronic pancreatitis may have a flare-up of acute disease.

Question 21

Helicobacter pylori

Answer 21

Helicobacter pylori is a common gastric pathogen that causes gastritis, peptic ulcer disease, gastric adenocarcinoma, and low-grade gastric lymphoma. Infection may be asymptomatic or result in varying degrees of dyspepsia