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Hospital Based Medicine And Surgery > L12: Diverticular Disesease And IBD > Flashcards

L12: Diverticular Disesease And IBD Flashcards

1
Q

What is diverticular disease

A

Outpouching of the bowel wall

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2
Q

What layers of the bowel are involved in Diverticular disease

A

The full component of the bowel

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3
Q

What is the main area of the colon that can become affected

A

Sigmoid colon
Descending colon
Any part of the bowel

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4
Q

What are the causes of diverituclar disease

A

Unknown

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5
Q

What are the factors linked to the cause of Diverticular disease

A

Old age
Developed countries
Low fibre diet
Constipation and small faecel volume

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6
Q

How does diverticular disease occur

A

It occurs in weakness of the bowel wall i,e where the vessels enter, when you create a high pressure across the colonic wall it will pop the bowel wall outwards and form a pouch

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7
Q

How can we investigate diverticulitis

A

Ct scan
Colonoscopy
Ultrasound
Cystoscopy- too see faecal material in the bladder

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8
Q

What can diverticular disease cause

A

Rectal bleeding
Diverticulitis e.g infection
Pericolic abscess
Fistula to the bladder or stricture

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9
Q

What is the management of Diverticular disease

A

Avoid straining
High fibre diet
Diverticulitis: antibiotics, analgesia and fluid
Abscess, ritual and perforation- surgery

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10
Q

How does diverticulitis present

A

Left side pain, change in bowel habit, fever

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11
Q

What is irritable bowel syndrome

A

A disorder of the GI function in the absence of known pathology or structure

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12
Q

What criteria is used for ibs

A

Rome 111 criteria

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13
Q

What does the Rome 111 criteria involve

A

A recurrent abdominal pain or discomfort for at least 3days per month in the last 3 months associated with 2 or more of:

  1. Relieved by defecation
  2. Change in frequency of stool
  3. Change in consistency of stool
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14
Q

What are the supportive symptoms in ibs

A 
Less than 3 bowel movements per week
More than 3 bowel movement per week
Abnormal stool form
Lumpy hard stool
Watery stool
Straining
Urgency and bloating
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15
Q

What are the subtypes of ibs

A

Ibs-d diarrhoea
Ibs c- constipation
Ibs m-mixed

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16
Q

What is the cause of ibs

A

Unknown

17
Q

What is coeliac disease

A

Lactose intolerance

18
Q

What are the symptoms for coeliac disease

A

Diarrhoea
Bloating
Abdominal discomfort

19
Q

What is the management of ibs

A

Give diagnosis and reassurance
Listen to concerns
Lifestyle advice
Placebo

20
Q

What type of diet would be useful for constipation

A

High fibre diet

21
Q

What type of diet would be helpful dope diarrhoea

A

Lactose exclusion

22
Q

What are the other pharmacological management for ibs

A

Antiaspasmodics: to reduce the pain by relaxing smooth muscle
Tricyclics antidepressants for pain relief
Loperamide or codiene to treat urgency and diarrhoea
Isphagula husk for constipation who cannot tolerate increased fibre
Linaclotide- if laxative not effective

23
Q

What is malabsorption

A

Defective mucosal absorption of nutrients

24
Q

What is coeliac disease

A

Sensitivity to gluten

25
Q

What is the presentation of coeliac disease

A 
Failure to thrive
Anaemia
Mouth ulcers
Haematinic deficiency 
Antibody test- TTG, endomysial/gliadin are positive and serum iga 
Duodenal biopsy
26
Q

What is the gold standard for coeliac disease

A

Duodenal biopsy

27
Q

What will coeliac disease show in the duodenal biopsy

A

Villous atrophy

28
Q

What is the treatment of coeliac disease

A

Gluten free diet

Replace haematinic and calcium

29
Q

What is pancreatic insuffiency

A

Due to alcohol, pancreatitis, cystic fibrosis and pancreatic tumours

30
Q

What is the presentation of pancreatic insuffiency

A

Steatorrhea- cant absorb fat or protein therefore stools are fatty
Weight loss

31
Q

What is the diagnosis of pancreatic insufficiency by

A

Ct abdomen scan- shows atrophy and calcification of pancreatic parenchyma
Faecal elastase test

32
Q

What is the treatment of pancreatic insufficiency

A

Pancreatic enzyme supplements

33
Q

What is giardia lamblia the main cause of

A

Travellers diarhoea

34
Q

What investigations can be carried out for giardia lamblia

A

Low b12
Iron deficiency
Stool culture
Duodenal biopsy

35
Q

What is the treatment for giardia lamblia

A

Metronidazole

36
Q

What is Whipples disease presentation

A 
A rare disease characterised by:
Pyrexia
Arthralgia
Weight loss
Malabsorption
37
Q

What will the blood test investigation show in Whipples disease

A

Anaemia of chronic disease

B12 and folate are normal

38
Q

What is the diagnosis of Whipples disease by

A

By duodenal biopsy that will show PAS positive macrophages

Hospital Based Medicine And Surgery (30 decks)

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