GI Health Maintenance Flashcards
What cancer are the following risk factors for: older than 50, h/o polyps, inflammatory bowel dz, african american or jewish descent, type II DM
colorectal cancer
Type of polyps that do NOT increase risk of colorectal cancer
hyperplastic
Mutation in what gene is related to familial adenomatous polyposis?
APC gene
develop thousands of polyps in the colon and rectum from teens to early adulthood. Cancer develops as early as age 20. By age 40 almost all people with this disorder have colon cancer if the colon isn’t removed to prevent it
familial adenomatous polyposis
Defect in either the gene MLH1 or MSH2 but can be caused by other gene mutations. Multiple polyps develop. Lifetime risk of colorectal cancer in people with this condition may be 80%. Women with this are susceptible to endometrial cancer
HNPCC aka Lynch syndrome
Treatment of what previous cancers increases risk for colorectal cancer?
testicular and prostate cancer
Screening procedure that doesn’t require sedation or a specialist. Done every 5 yrs. Only views 1/3 of colon.
flexible sigmoidoscopy
Preferred screening method that can view entire colon. Can biopsy and remove polyps. Done every 10 yrs. Requires full bowel prep and sedation
colonoscopy
Screening procedure that can view entire colon. Doesn’t require sedation. Need full bowel prep and done every 5 yrs. Can’t remove polyps and can only detect polyps >1cm
double contrast barium enema
Screening procedure that can view entire colon, is done every 5 yrs, requires bowel prep, doesn’t require sedation. Will need colonoscopy if abnormal
virtual colonoscopy
Test that doesn’t require bowel prep, done at home, has to be done yearly, and require 3 different stool samples. May produce a lot of false positives
Fecal occult blood test (FOBT)
Dietary restrictions for Fecal occult blood test (FOBT)
avoid NSAIDs, vitamin C, red meats
What is the main difference between fecal immunochemical test (FIT) and Fecal occult blood test (FOBT)?
No pre-test dietary or medication restrictions for FIT
At what age should African Americans begin colonoscopies?
45 yrs
How often should a patient with inflammatory bowel disease (UC and Crohn’s) have a colonoscopy?
every 1-2 yrs
How often should a patient with a personal h/o of adenomatous polyps or colon cancer have a colonoscopy?
1 yr post resection then every 3-5 yrs
At what age should should a patient with familial adenomatous polyposis begin colorectal screening?
yearly flexible sigmoidoscopy beginning at age 10-12 years
At what age should a patient with hereditary nonpolyposis colon cancer (HNPCC) being colorectal screening?
colonoscopy every 1-2 years beginning at age 20-25 years or 10 years before the youngest case in the immediate family
What cancer are the following risk factors for: HBV, HCV, hereditary hemochromatosis, cirrhosis?
Hepatocellular carcinoma
What patient populations are screened for hepatocellular carcinoma?
all cirrhotic patients and those w/chronic Hep B who are Asian/African or have family h/o
If Casper the Ghost (who is obviously caucasian) had a chronic Hepatitis B + infection, what would be the screening guidelines for him?
Start men > 40. His girlfriend would start screening at 50 yrs
What is the recommended screening test for hepatocellular carcinoma?
liver ultrasound every 6 months
What cancer has the following risk factors: >55yrs, male, ETOH/tobacco use, obesity, and diet high in processed meats?
esophageal cancer
Term for narrowing of distal esophagus
achalasia
Term for esophageal papillomas
tylosis
Medical conditions that can benefit from increasing the intake of dietary fiber
hemorrhoids, constipation, diarrhea, diverticulosis
helps pull water into the colon making the stool softer and easier to pass and helps treat constipation
insoluble fiber
helps to absorb water from the colon and can bulk up the stool to treat chronic diarrhea
soluble fiber
Complications of chronic constipation
hemorrhoids, anal fissures, diverticulosis
Daily fiber recommendations for men and women
Women - 25 grams per day. Men - 38 grams per day
Percent of population between ages of 60 and 80 that have diverticular disease
~50%
Risk factors for this medical condition include: large meals, laying down after a meal, obesity, ETOH, carbonation, coffee, tea, smoking, pregnancy
GERD
What condition do the following meds cause to worsen: NSAIDs, beta-blockers, Ca channel blockers, bronchodilators, TCAs, Dopamine active drugs?
GERD
