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Clinical Pathology > GI FInal > Flashcards

GI FInal Flashcards

1
Q

IBD is most common among what race, specifically what descent?

A

most common among caucasians, specifically jewish descent

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2
Q

Crohn’s Disease typically takes place where? describe location

A

occurs anywhere but rectum is often spared, and has skip lesions

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3
Q

Ulcerative Colitis takes place where? describe location

A

UC takes place in sigmoid colon, starts at the rectum, and is continous

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4
Q

What part of the intestine does crohn’s ileitis typically effect?

A

terminal ileum 85%

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5
Q

crohn’s ileocolitis typically occurs where?

A

small and large intestine 40-55% of time

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6
Q

Name the condition: “cobblestone appearance”

A

Crohn’s disease

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7
Q

What is the term used when Crohns disease affects the entire depth of the bowel wall

A

transmural

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8
Q

T/F Granulomas can be seen on a crohns disease biopsy of tissue

A

T

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9
Q

Common symptoms of Crohns disease 3

A

Constant abdominal pain, weight loss, diarrhea

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10
Q

PE signs of crohns

A

+/- low grade fever, RLQ abdominal tnederness, possible abdominal mass, perineal abnormailites

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11
Q

Steps of progressive bowel obstruction of crohns

A
  1. inflammation causes thick tissues. 2. fistula heal and leave fibrosis 3. can lead to strictures
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12
Q

Abnormal lab results of crohns

A

CBC, ESR, CRP, nutritional deficiences

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13
Q

A vertebral fracture is a complication to what GI condition? why?

A

Crohns, d/t vitramin d deficiency, inc. glucocorticoid intake, and hypocalcemia

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14
Q

procedure of choice for diagnosing crohns?

A

colonoscopy, better than tissue biopsy

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15
Q

T/F for the majority of the time crohns and UC are not distinguishable from each other

A

False, 85% they are distinguishable

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16
Q

4 possible treatment for crohns

A

antiinflammatories, antibiotics, nutritional support, and surgery

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17
Q

Which is more common: crohns or UC?

A

UC

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18
Q

UC superficial or deep inflammation?

A

superficial mucosal infalmamation

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19
Q

Symptoms of UC 5

A

abrupt onset, bloody diarrhea, lower abdominal pain, rectal bleding, tenesmus

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20
Q

Tenesmus def

A

urgency to have bowel movement with incomplete feeling of evacuation

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21
Q

How is UC abodminal pain relieved?

A

relieved by having a bowel movement

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22
Q

UC tends to have abdominal masses, whereas crohns does not. T/F

A

F. Crohns=possible Abdominal masses; UC= NO abdominal masses

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23
Q

Mild UC = bleeding? fever? number of bowel movements?

A

rectal bleeding, no fever, less than 4 BM

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24
Q

Moderate UC= bleeding? BM?

A

moderate bleeding, 4-6 BM

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25
Q

Severe UC=Bleedings? Fever?

A

Severe bleeding and FEVER, with some hemorrhage, perforatin, gangrene

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26
Q

complications to UC

A

toxic megacolon, colon cancer

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27
Q

complications to both UC and Crohns

A

colon cancer

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28
Q

T/FTreating bowel disease will most likely rid pyoderma gangrenosum.

A

False

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29
Q

2 extraintestinal findings of IBD

A

pyoderma gangrenosum and erythema nodosum

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30
Q

Dysentery Def

A

bloody diarrhea of any cause

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31
Q

Bacterial causes of dysentery commonly include

A

shigella, salmonella, e coli, campylobacter

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32
Q

most common cause of travelers diarrhea

A

E coli

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33
Q

most common parasitic cause of dysentery for travelers to india/tropical locations

A

Entamoeba histolytica

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34
Q

Mechanism of transmission of infectious dysentery

A

consumption of food/water that contains fecal material of pathogens of human/animals

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35
Q

Treatment for dysentery

A

PCP hydration, antibiotics

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36
Q

Common treatment contraindication for dysentery is

A

anti diarrheal meds

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37
Q

Possible side effects of antidiarrheal meds in dysentery pts 3

A

hemolytic uremic syndrome, toxic megacolon, fever

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38
Q

most common cause of non bloody acute diarrhea? second most commoN?

A

infectious agents is 1. medications is 2

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39
Q

acute, non bloody diarrhea is usually accompanied by nausea vomiting, called ?

A

gastroenteritis

40
Q

Nonbloody diarrhea etiology 2. what are they called

A

working with children=rotavirus

drinking out of a stream=giardia

41
Q

Food poisoning def

A

ingestion of a toxin produced by bacteria

42
Q

Bacillus cereus is most commonly ingested after eating what

A

fried rice

43
Q

which of the following can be ingested following eating potato salad?

A

staph aureus

44
Q

which of the following can be ingested following eating seafood?

A

vibrio species

45
Q

which of the following can be ingested following eating pourly reheated meals/poultry

A

clostridium perfringens

46
Q

anti diarrheal meds are safe for

A

non dysentery diarrhea patients

47
Q

foods that are easily digested when someone has diarrhea

A

toast, banana, apple sauce,

48
Q

antibiotic induced diarrhea can be cause by 2 things

A
  1. reduced digestive function

2. allowing the overgrowth of pathogens like Clostridium difficile

49
Q

DEF: hematochezia

A

fresh blood in the stool

50
Q

patient over 50 Y.O. with painless bleeding, DX

A

colon cancer till proven otherwise

51
Q

benign painless hematochezia can be caused by

A

hemorrhoids, colon cancer, eating beets

52
Q

Duodenum is

A

retro peritoneal

53
Q

3 functions of the small intestine

A

1 nutrient absorbition and digestion. 2. delivery of undigested waste/waste to large intestine 3. Immune system, GALT, 70% of immune system

54
Q

liver and gall bladder provide BLANKK while pancreas provides BLANKK

A

liver/GB=bile; pancreas=bi carb and enzymes

55
Q

food that has been properly digested enters absorptive epithelial cells called

A

enterocytes

56
Q

chyme absorbtion into enterocytes occurs via 2

A

active transportation and passive diffusion

57
Q

where is the main nutrient absorption location

A

jejunum

58
Q

where does water and small ions get absorbed?

A

in between enterocyte cells at tight junctions

59
Q

2 main types of diarrhea

A

osmotic and secretory

60
Q

osmotic diarrhea=

secretory diarrhea=

A

O.D=water is drawn in by indigested particles,stops when pT fasts
S.D= intestinal crypt cells secrete too much water, DOES NOT STOP WHEN PT FASTS

61
Q

why does a person have smelly poop and farts with lactose sensititvity?

A

the unabsorbed lactose gets into the colon and the colonic bacteria produces CO2 and H2 gases

62
Q

T/F Prolonged chronic lactose sensitivity with intake of lactose can lead to weight loss and cramping abdominal pain

A

False, NO weight loss with lactose sensititivty

63
Q

Describe the lactose hydrogen breath test, whats a positive test?

A

person ingests lactose, 3-8 hrs later hydrogen in breath is measured, inc. hydrogen =lactase deficienty

64
Q

Explain the reaction of GALT when gluten is ingested?

A

GALT senses that gliadin is an enemy, causing enhanced lymphocyte respoinse and autoantibodies produced. leading to inflammatory cascade, villous atrophy, and decreased asorptive ability,

65
Q

The symptoms of celiacs disease 6

A

diarrhea, flatus, smelly stools, abdominal distension, fatigue, weight loss

66
Q

dermatologic sign of celiacs disease

A

dermatitis herpetiformis

67
Q

Diagnostic labs for celiacs diseae 2`

A

anti-tissue transglutaminase antibody and IGA

68
Q

Diagnositic procedure of choice for DDX celiacs

A

endoscopic biopsy of distal duodenum showing villous atrophy

69
Q

BLANKK the number two cancer killer in the U.S.

A

colorectal cancer

70
Q

lifestyle risks of developing colorectal cancer 6

A

obesity, smoking, drinking, diabetes, low fiber high fat, no exercise

71
Q

describe the sequence of pathophysiology of colorectal cancer

A

normal mucosa–>adenamouts polyps–> carcinoma

72
Q

polyps def

A

discrete lesions that protrudes into the intestinal lumen from the mucosa

73
Q

what is the mechanism of cancerous cell change in colorectal cancer? 2

A

deactivation of tumor supressor genes or mutation in genes leading to oncogene activation

74
Q

most colon cancers are due to BLANKKK mutations, sporadic or inheritied

A

sporadic

75
Q

Lynch syndrome is AKA and involves what side of the colon?

A

herditary nonpolyposis colorectal cancer

76
Q

2 types of polyps that can lead to cancer, which is more common?

A

adenomatous and serratus, adenomatous is more common

77
Q

what size of polyp has the highest increased risk of malignancy?

A

greater than 2.5 cm

78
Q

sessile or pedunculated shaped polyp has a higher risk of malignancy?

A

sessile has a higher rate of malignancy

79
Q

two types of colon cancerous lesions that can form,

A

bulky adenocarcinoma and annular constricting carcinoma( apple core lesion)

80
Q

most common location in colon for colon cancer to occur is the

A

rectosigmoid colon

81
Q

3 sxs of colon cancer?

A

asymptomatic till late stage. 1. bleeding 2. weight loss 3. change in frequency of bowel movements

82
Q

colon cancer can produce high levels of BLANKK that can be used s a tumor marker.

A

carcinoembrionic antigen

83
Q

what test is preferred for fecal occult blood testing?

A

fecal immunochemical testing is most sensitive and specific

84
Q

sigmoidoscopy should be done every BLANKK years, colonsoscopy should be done every BLANKK years?

A

sigmoid=5 years; colonsoxcopy = 10 years

85
Q

regular screening shoudl occur in patients that are blankk y.o?

A

50-75 years old

86
Q

If patient is positive for family hx of colon cnacer, when should screening begin?

A

at age 40 or 10 eyars before family members diagnosis

87
Q

Describe the Rome III IBS criteria

A

recurrent abdomjinal pain at least 3 days per month in the last 3 months with 2 or more of: improved w/ defecation, change in frequency, change in stool appearance

88
Q

if present, abdominal tenderness is located where in IBS

A

LLQ

89
Q

What antibiotic is recommended for IBS?

A

rifaximin

90
Q

duverticulosis is most common in what area of the colon?

A

sigmoid colon

91
Q

what is the most common cause of hematochezia in patients that are older than 60 y.o

A

diverticulosis

92
Q

Lab findins for diverticulitis show BLANKK. A BLANKK imaging can show diverticulitis.

A

LAB= leukocytosis. CT scan showsdiverticultis

93
Q

What disease can cause chronic constipation? what hormone would you want to evaluate in the blood?

A

hypothyroidism, TSH

94
Q

leading cause of appendix inflammation is by a

A

fecalith

95
Q

peritonitis is most commonly caused by

A

infection

96
Q

Is peritointis pain sensitive?

A

VERY

97
Q

a secondary cause of perionitis is commonly

A

a perforation of a hollow viscus

Clinical Pathology (10 decks)

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