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Pathology Block 11 > GI Disorders II > Flashcards

GI Disorders II Flashcards

1
Q

What is celiac disease triggered by

A 
GLUTEN:
Barley
Rye 
Oats 
Wheat
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2
Q

Number 1 autoimmune disorder in the US

A

Celiac disease

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3
Q

How much of the population has celiac disease

A

1%

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4
Q

Immune response in Celiac disease

A

T cell mediated immune response, increases level of Ab

-related to other autoimmune disorders

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5
Q

Most patients with celiac disease are

A

Genetically predisposed

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6
Q

Do all clerical disease patients have symptoms?

A

No

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7
Q

Symptoms of Celiac

A

Diarrhea, either constant or off and on
Abdominal pain
Bloating

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8
Q

Other symptoms of celiac

A

Irritability or depression

Skin rash

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9
Q

How do you distinguish Celia disease from other GI problems

A

Skin rash

-herpes rash

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10
Q

Dx of Celiac disease

A

History important
Sero test: IgA: anti tTG increased
Biopsy to confirm

Gut is flattened
BROW flattened

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11
Q

Treatment for celiac disease

A

Regeneration of gut lining with gluten free diet

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12
Q

What percent of African american have lactose intolerance

A

75%

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13
Q

What percent of Asian Americans have lactose intoleracne

A

Asian Americans

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14
Q

Lactose not broken down, produces gas

A

Lactose intolerance

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15
Q

How to manage lactose intolerance

A

Limit amount of milk and dairy products and give them other nutrients to bring them back to health

  • maintain protein and energy intake
  • eat yogurt with live active cultures
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16
Q

Two related chronic inflammatory disorders

A

Chrons disease and ulcerative colitis

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17
Q

When do you see chrons disease and ulcerative colitis

A

Teen to 30s

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18
Q

Location of crohns

A

Any potion of the GI tract, rectal sparing

SKIP lesions

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19
Q

Location of ulcerative colitis

A

Colon
Continuous inflammation
Rectal involvement

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20
Q

Relapse in chrons and ulcerative colitis

A

Can occur

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21
Q

Pain in crohns

A

Common in lower right abdomen

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22
Q

Pain in ulcerative colitis

A

Lower left abdomen

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23
Q

Morphology of crohns

A

Colon all is thickened

Transmural inflammation: cobblestones mucosa, ulcers, and fistulas

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24
Q

Morphology of ulcertive colitis

A

Colon wall is thinner
Mucosal inflammation
Pseudopolyps
Crypt absences and ulcers

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25
Q

Complications of crohns

A

Strictures, fistfuls, perinatal disease

Malabsorption, and nutritional depletion

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26
Q

Complications of ulcerative

A

Severe stenosis, toxic megacolon, colorectal carcinoma

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27
Q

Bleeding in crohns

A

Bleeding from rectum during movement is uncommon

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28
Q

Bleeding in ulcerative colitis

A

Bleeding from rectum during bowel movement is common

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29
Q

Ocular findings for crohns

A

Non-granulomatous uveitis

Prevalence: 1-10%

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30
Q

Ocular findings in ulcerative colitis

A

Non-granulomatous uveitis

Prevalence: 1-5%

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31
Q

Uveitis related to inflammatory bowel disease

A

Can occur in Crohn’s disease and ulcerative colitis

May be the initial complaint

32
Q

Tx for crohns and ulcerative colitis

A

Antiinflammatory agents
Immunosuppressive agents
Steroids
Surgery

33
Q

Prognosis for chrons and ulcerative colitis

A

Chronic condition requiring constant monitoring

34
Q

Chronic, recurrent functional abdominal disroders

A

Irritable bowel syndrome (IBS)

35
Q

Epidemiology of IBS

A

5-10% US population with peak at 20-29 years of age

36
Q

What is the the only bowel disorder that is highest in females

A

IBS

37
Q

What is IBS more common in

A

Females
Trigger is stress, psychological or physical
Food: processed food, high fructose corn syrup and milk formulas in infants antibiotics

38
Q

Recurrent abdominal pain or discomfort 3 days/month for past 3 months with symptoms of >6 months associated with 2 or more of the following in IBS:

A

Pain relief with defacation
Change in bowel habits
Change in stool form

39
Q

Tx of IBS

A
  • stress management
  • no special diet just increase fiber
  • avoid: fatty foods, gas-producing foods, alcohol and caffeine
  • drugs: antispasmodic, anticholinergic, serotonin antagonsit
40
Q

Acquired hernitations of the colonic mucosa and submucosa through the uscularis propriety

A

Diverticulosis (pseudo or false)

41
Q

Where does diverticulosis most commonly occur

A

In the sigmoid colon and can vary in size and number, although typically they are between 5 and 10mm in diamter

42
Q

Refers to the presence of diverticula in an individual who is asymptomatic, whereas ________ refers to the presence of diverticula associated with symptoms which occur is in 20% of individuals

A

Diverticulosis

Diverticular disease

43
Q

Diverticulosis and age

A

More common in old age

44
Q

Symptoms of diverticulosis

A

Abdominal pain (LL quad)
Nausea and vomiting
Tenderness
Fever

45
Q

Dx of divertovculoiosis

A

History
Barium enema
Ct scan
Ultrasound

46
Q

Complications of diverticulosis

A
  • diverticulitis
  • perforation with peritonitis
  • abscess
  • hemorrhage
  • bowel obstruction
  • fistulas
47
Q

What is he worst symptom of diverticulosis

A

Fistulas with bladder

pneumoturia: feels like passing air with urine

48
Q

Peak incidence of appendicitis

A

10-19 yeats

49
Q

Pain in appendicitis

A

Periumbilical pain: dull and steady

50
Q

Differentiate crohns from appendicitis

A

Appendicitis has rebound pain air tenderness when pressing on it

51
Q

Progression of appendicitis

A

Progresses over 4-6 hours and localized to right lower quadrant

52
Q

What si the hallmark of appendicitis

A

Rebound pain or tenderness

53
Q

Dx of appendicitis

A

1: clinical signs and symptom
2: WBC count > 10,000
3. Ultrasound
4. Exploratory laparotomy
5. Ct Shane

54
Q

Complication of appendicitis

A

Sudden pain relief may indicate rupture of appendix and may lead to peritonitis

55
Q

Treatment for appendicitis

A

Surgery

56
Q

Number one cancer of GI

A

Colorectal cancer

57
Q

Peak age of colorectal cancer

A

60-70

58
Q

How many people get colorectal cancer before age 50

A

20%

59
Q

How many people die per year of colorectal cancer

A

1/3rd of them die

60
Q

Risk factors for colorectal cancer

A
  • age
  • family history
  • chrons or iulcerative colitis
  • familial adenomatous polypososis
  • diet
61
Q

Pretoection against colorectal cancer

A

Vit A, C, E

62
Q

Number one cause of cancer

A

A benign cancer

63
Q

Colon cancer presentation

A
  • symptoms later in course of disease
  • bleeding: highly significant early symptom
  • other less alarming symptoms include: change in bowel habits, diarrhea constipation, sense of urgency, sense of incomplete emptying, PAIN is usually a late symptom
64
Q

Stage I colorectal cancer growth

A

Submucosa

65
Q

Stage II

A

Muscualris layer

66
Q

Stage III

A

Beyond msucularis and nodes

67
Q

Stage IV

A

Metastasis

68
Q

Stage I TX

A

Complete surgical removal

69
Q

TX for stage II and III

A

Decrease size of tumor with radiation and then do surgery

70
Q

Stage IV treatment

A

Use all resources, but surgical removal first step and then chemo therapy and radiation

71
Q

DX and TX of colorectal cancer

A
  • barium imagining
  • colonoscopy with biopsy
  • CT Scan
  • MRI and ultrasonography

TX is surgical removal

72
Q

Prognosis of colorectal cancer

A

4TNM stages

  • stage I: t5 year survival rate of 90-100%
  • stage IV (metastatic) poor prognosis
73
Q

What is key to preventing colorectal disorders

A

Prevention

-fresh, healthy diet, avoid irritants

74
Q

Significant symptom in gut disorders

A

Bleeding in stool

75
Q

All of the following play a role in irritable bowel syndrome expect

A

Abnormal GI motility

-it’s a functional disorder

76
Q

Achalasia can lead to what cancer

A

Esophageal squamous cell carcinoma

Pathology Block 11 (8 decks)

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