Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GK F3 E3 > IBS 1 > Flashcards

IBS 1 Flashcards

1
Q

Which gender is IBS MC in? What age range is MC?

A

MC Female

Usually 18-34y/o

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which condition?

  • Disturbance of GI motility (pain w/ abnl BM that is relieved w/ BM)
  • Visceral hypersensitivity
  • Co-morbid psych isuues
A

IBS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

T/F: IBS is abdominal pain associated with BMs with many objective findings

A

FALSE.

IBS is abdominal pain a/w BMs, howevere, IBS does NOT have objective findings… only sxs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What criteria is used to diagnose IBS?

A

Rome IV Criteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the components of the Rome IV criteria (used to dx IBS)

A

Recurrent abd pain at least 1 day/week x3 months

+

w/ bowel movement

Change in stool frequency/form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

If you suspect a patient might have IBS, what else must you test for due to the fact that it can look exactly like IBS?

A

Celiac disease

(screen w/ IgA TTG or celiac panel)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A subgroup of patients report what prior to onset of IBS?

A

Acute viral or bacterial gastroenteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What would the physical exam look like in IBS?

A

Normal, +/- abd tenderness

Vitals normal, no pallor, no rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What rash is seen in IBS? In Celiac Disease? In IBD?

A

IBS- none

Celiac- Dermatitis herpetiformis

IBD- erythema nodosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 9 Red flag symptoms of IBS?

A

1. Age of onset >50

2. Rectal bleeding or melena

3. Nocturnal diarrhea

  1. Progressive abd pain
  2. Unexplained weight loss
  3. Lab abnormalities (anemia, incr. WBC, incr. CRP, Incr. sed rate)
  4. Fam hx of IBD or colon cancer
  5. Recent abx (C. diff)
  6. Recent travel
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the most important piece of IBS management?

A

Positive clinician-patient relationship–> these patients show improvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the treatment IBS in pts w/ mild & intermittent symptoms that don’t impair quality of life

A
  • Lifestyle modification
  • low FODMAPs diet- decrease fat intake, less oligo, di and monosaccharides, etc
  • +/- lactose/gluten avoidence
  • +/- fiber/psyllium
  • Exercise 20-60 min 3-5 days/week
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do you treat someone w/ IBS-C that has severe sxs that impair their quality of life? (5)

A
  • Lifestyle & diet modifications
  • Osmotic laxatives- Miralax (if fail soluble fiber)
  • Lubiprostone (If MiraLax doesn’t work)–> only women 18+
  • Dicyclomine, Hyoscyamine (antispasmodics) for pain/bloating
  • +/- Tricyclic antidepressants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do you treat someone w/ IBS-D that has severe sxs that impair their quality of life? (6)

A
  • Lifestyle/diet modifications
  • Loperamide
  • Bile acide Sequestrants- Cholestyramine (esp. if IBS s/p cholecystectomy)
  • Antispasmodics- Dicyclomine, Hyoscyamine
  • +/- Tricyclic antidepressants
  • Antibiotic- Rifaximin (if significant bloating)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 2 medications options to manage abdominal pain and bloating in IBS

A

Antispasmodics:

  1. Dicyclomine
  2. Hyoscyamine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What should you give patients with IBS without constipation and WITH significant bloating?

A

Antibiotics- Rifaximin x2wks

17
Q

Which meds are good to give in a patient with IBS-D post cholecystectomy?

A

Bile acid sequestrants

18
Q

What is the difference between IBS-C and constipation

A

Constipation looks like IBS-C but NO PAIN

19
Q

Is constipation MC in men or women?

A

women

20
Q

Criteria for diagnosing what?

  • Rome IV (provider) Criteria- 2+ for the following 3 months, w/ sx onset >6 months prior to dx
    • Straining
    • lumpy/hard stools
    • sensation of incomplete evacuation
    • Sensation of anorectal blockage
    • Manual maneuvers to facilitate defecation
    • <3 spontaneous BMs per week
  • Patient criteria- straining, hard stools, unproductive urges, infrequency, feeling of incomplete evacuation
A
  • Constipation
21
Q

What are the 6 components of the Rome IV (provider) criteria for diagnosing constipation

A
  • 2+ for the following 3 months, w/ sx onset >6 months prior to dx
    • Straining
    • lumpy/hard stools
    • sensation of incomplete evacuation
    • Sensation of anorectal blockage
    • Manual maneuvers to facilitate defecation
    • < 3 spontaneous BMs per week
22
Q

What are the 3 causes of constipation?

A
  1. Slow transit constipation (unknown cause)
  2. Pelvic floor dysfunction (inability to evacuate rectal contents- esp. women)
  3. medications
23
Q

If you have a patient with constipation that has red flags (age, presence of occult blood, weight loss), how should you evaluate?

A

colonoscopy or flex sig

24
Q

What do most patients c/o constipation receive as tx?

A

Trial of fiber supplementation and close follow up

25
Q

What 2 diagnostic studies can be used in evaluating patients with refractory constipation?

A
  1. Colonic transit study
  2. Anorectal manometry (sphincter pressure)
26
Q

What 3 physical exams can be performed when evaluating a patient with constipation?

A
  • Anal wink
  • DRE
  • Pelvic- looking for rectocele
27
Q

What are the 7 components of management for constipation?

A
  • Adjust causative meds
  • correct metabolic abnormalities
  • push fluids
  • increase exercise
  • increase fiber to 20-30g/d
  • Minimize laxative use (PEG- MiraLax)
  • Go when pt has urge
28
Q

What is the main complication of constipation?

A

fecal impaction–> can lead to LBO

29
Q

How do patients present if they have a fecal impaction/LBO? (4 sxs)

A
  1. Anorexia
  2. Nausea
  3. Vomiting
  4. Abdominal pain
30
Q

How do you manage a fecal impaction?

A

Manual removal of stool and/or w/ enemas

GK F3 E3 (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions