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GI Exam II > Large Group 3 - Lower GI > Flashcards

Large Group 3 - Lower GI Flashcards

1
Q

Diverticulosis is found on which side of colon?

A

Antimesenteric

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2
Q

Most diverticula are localized where?

A

Distal colon

*but can occur anywhere in colon, just not the rectum

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3
Q

How are uncomplicated diverticulosis usually found?

A

Incidental findings

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4
Q

Diverticulosis can present as what other bowel syndrome?

A

Irritable bowel syndrome

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5
Q

2 common complications of Diverticular Disease

A

Diverticulitis and Bleeding

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6
Q

What is complicated diverticulitis?

A

Presence of an abscess, fistula, obstruction, or perforation

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7
Q

What is simple or uncomplicated diverticulitis?

A

Inflammation in the absence of complications

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8
Q

Most common complaint of diverticulitis?

A

LLQ pain

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9
Q

Right sided- diverticulitis is common in which ethnic region?

A

Asia

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10
Q

Name the syndrome: LLQ pain, low grade fever, mild leukocytosis, urinary sx

A

Diverticulitis

*Urinary sx due to bladder irritation from the inflamed sigmoid

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11
Q

Tx for uncomplicated diverticulitis

A

ciprofloxacin with metronidazole

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12
Q

Tx for uncomplicated diverticulitis

A

amoxicillin-clavulanate

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13
Q

Tx for uncomplicated diverticulitis

A

SMX-TMP and metronidazole

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14
Q

Tx for complicated diverticulitis

A

ampicillin, gentamicin, metronidazole

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15
Q

Tx for complicated diverticulitis

A

pipercillin-tazobactam

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16
Q

When is surgery implicated for diverticular Dz?

A

after first attack of complicated diverticulitis or after two or more episodes of UNcomplicated within 12 mos

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17
Q

Most common intestinal ischemia?

A

Colonic - 70%

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18
Q

What is Griffith’s point also known as?

A

Splenic flexure

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19
Q

Sudek’s point is also known as?

A

Rectosigmoid junction

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20
Q

Why is right colon a watershed area?

A

Sometimes Marginal a. of Drummond is poorly developed in that area, causing low perfusion states

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21
Q

Most common locations for colonic ischemia *watershed areas

A

splenic flexure and sigmoid colon

22
Q

LLQ pain can be two diseases. Name them.

A

Colonic ischemia or diverticulitis

23
Q

How do you diagnose and Tx colonic ischemia?

A

CT at watershed areas, colonoscopy, biopsy

24
Q

Colonoscope demarcation zone

A

colonic ischemia

25
Q

Complication from surgery

A

Strictures (Scar)

26
Q

Third most common US cancer?

A

Colon cancer

27
Q

Risk of colorectal cancer if two 1st degree relatives have it?

A

3-4

28
Q

Risk of colorectal cancer if one 1st degree relative under 50yo has it?

A

3-4

29
Q

Risk of colorectal cancer if one 1st degree relative has it?

A

2-3

30
Q

Risk of colorectal cancer if 2nd or 3rd degree relative has it?

A

1.5

31
Q

Risk of colorectal cancer is no family Hx?

A

1

32
Q

Mutation for Familial Adenomatous Polyposis

A

APC mutation on chromosome 5

33
Q

What is the heredity mode for FAP? (how is it carried?)

A

autosomal dominant

34
Q

What age is colorectal cancer seen in FAP?

A

45yo

35
Q

What is Tx for unaffected FAP carrier?

A

prophylactic colonectomy

36
Q

Does ampulla of Vater see FAP cancers?

A

yes

37
Q

HNPCC is also called?

A

Lynch syndrome

38
Q

How is HNPCC carried?

A

autosomal dominant

39
Q

Are the lesions proximal or distal with HNPCC?

A

proximal bowel

40
Q

Mismatch repair genes are mutated in which Dz?

A

HNPCC

MSH2, MLH1, MSH6

41
Q

Most common hereditary colon cancer Dz

A

Hereditary nonpolyposis colorectal cancer

HNPCC - 5%

42
Q

Which polyp type is most commonly cancerous? hyperplastic or adenomatous?

A

Adenomatous. (give rise to 90% colorectal cancers)

43
Q

This mutation leads directly to adenoma polyp formation

A

K-ras

44
Q

Name the gene disturbances leading to adenoma

A

K-ras–>DCC deletion–>p53 deletion

45
Q

What leads to hyperproliferative epithelium?

A

Methylation abnormalities

46
Q

If a pt with colon cancer is jaundice, what is the most simple explanation?

A

liver metastasis

47
Q

Which stage of colorectal cancer is curative?

A

Stage 1

48
Q

Test of choice for Colorectal Cancer?

A

colonoscopy

49
Q

Screening age for colorectal cancer?

A

50 with no FamHx. 45 if AA

50
Q

If you have a FamHx with someone having colon ca under age 60, when should you be screened?

A

40yo every 5 years

51
Q

Surg Tx for Chronic UC

A

Total colectomy and ilieoanal pullthrough to create a rectum

GI Exam II (5 decks)

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