Lower GI

Question 1

lower GI

Answer 1

small intestines and below

Question 2

what is appendicitis

Answer 2

inflammation of the appendix

Question 3

cause of appendicitis

Answer 3

• appendix is obstructed which leads to inflammation

Question 4

complications of appendicitis

Answer 4

gangrene
abscess formation
peritonitis

Question 5

key points of appendicitis

Answer 5

classic pain: RLQ in periumbilical area
rebound pain: pain severe when release pressure off site
sudden pain relief: ma indicate rupture, peritonitis

Question 6

what is peritonitis

Answer 6

inflammation of the peritoneum

Question 7

what is the peritoneum

Answer 7

serous membrane that lines the abdominal cavity and covers visceral organs

Question 8

what happens when the peritoneum becomes inflammed

Answer 8

fluids shift resulting in third spacing which can lead to hypovolemic shock and sepsis, dec peristalsis, intestinal obstruction

Question 9

causes of peritonitis

Answer 9

perforated ulcers
ruptured gallbladder, spleen, bladder, appendix
pancreatitis
when stuff that should be in your gut gets outside your gut

Question 10

clinical manifestations of peritonitis

Answer 10

sudden and SEVERE ab pain
tenderness
rigid, board like abdomen –> hard to touch
NV
fever, inc WBC
inc HR, dec BP –> from pain but mostly fluid shifts (third spacing)

Question 11

treating peritonitis

Answer 11

can treat but usually treat whatever caused it and it will subside on its own

Question 12

what is irritable bowel syndrome

Answer 12

chronic condition characterized by alterations in bowel patterns due to changes in intestinal motility
- either have constipation or D

Question 13

symptoms of IBS

Answer 13

vary by ind
- ad distention, fullness, flatus, bloating
- intermittent ab pain exacerbated by stress and relieved by defecation
- bowel urgency
- intolerance to certain foods (gluten, sorbitol, lactose)
- non bloody stool that contains excess mucus

Question 14

what is the relationship btw psychosocial stress and IBS

Answer 14

IBS is never the result of psychological causes but stress can exacerbate IBS
- IBS can also cause an inc in stress, like to live with etc

Question 15

cause of IBS

Answer 15

unknown, thought to be triggered by stress, foods, hormone changes, GI infections, menses

Question 16

what is inflammatory bowel disease

Answer 16

chronic illnesses that are life changing that are characterized by chronic inflammation of the intestines and exacerbations and remissions

Question 17

two types of inflammatory bowel diseases

Answer 17

crohn’s and ulcerative colitis

Question 18

IBD affect who

Answer 18

women
caucasians
Jewish decent
smokers

Question 19

thought cause of IBD

Answer 19

genetic autoimmune that is activated by an infection

Question 20

crohns disease pathogenesis

Answer 20

• lymph structures of GI tract are blocked and tissue becomes engorged and inflamed
• deep linear fissures and ulcers develop in a patchy pattern in the bowel wall (skip lesions and cobblestone appearance)

Question 21

complications of crohns

Answer 21

malnutrition
anemia
scar tissue and obstructions
fistulas –> connection btw structures that shouldnt be connected
cancers

Question 22

clinical manifestations of crohns disease

Answer 22

crampy lower ab pain (RLQ)
watery D
systemic: wt loss, fatigue, malabsorption of nutrients
palpable abdominal mass (RLQ)
mouoth ulcers
s/s of fistulas
granulomas and skip lesions

Question 23

what is ulcerative colitis

Answer 23

inflammation of the mucosa of the rectum and colon

Question 24

when does ulcerative colitis typically occur

Answer 24

3rd decade of life

Question 25

UC typically develops in which people

Answer 25

white, european decent (esp. ashkenasi jews occasionally black rare in asians

Question 26

UC pathogenesis

Answer 26

inflammation begins in the rectum and extends in a continuous segment that may involve the entire colon - inflammation leads to large ulcerations - necrosis of the epithelial tissue can result in abscesses (crypt abscesses) colon and rectum try to repair damage with new granulation tissue but this tissue is fragile and bleeds easily

Question 27

clinical manifestations of UC

Answer 27

ab pain bloody D systemic: wt loss, fatigue, no appetite, fever

Question 28

complications of UC

Answer 28

hemorrhage perforation cancer malnutrition anemia strictures fissures abscesses toxic megacolon colorectal carcinoma liver disease fluids, electrolyte, and PH imbalances higher risk for DVT, VTE

Question 29

what is toxic megacolon

Answer 29

rapid dilation of large intestine that can be life threatening

Question 30

why can UC cause liver disease

Answer 30

inflammation and scarring of the bile ducts

Question 31

what is the pathogenesis of diverticulosis

Answer 31

development of diverticula which are small pouches in the lining of the colon that bulge through weak spots

Question 32

why does diverticulosis occur

Answer 32

- may be congential or acquired - thought to be caused by low fiber diet resulting with chronic C

Question 33

where do diverticula typically occur

Answer 33

descending colon

Question 34

difference btw diverticulosis vs diverticulitis

Answer 34

losis= outpouching itis= outpouching with inflammation or infection

Question 35

clinical manifestations of diverticulosis

Answer 35

usually asymptomatic discovered accidentally or with presentation of acute diverticulitis

Question 36

what is diverticulitis

Answer 36

inflammation of one or more of the pouches (diverticula)

Question 37

what usually causes inflammation of diverticula

Answer 37

retained fecal material in diverticula

Question 38

clinical manifestations of diverticulitis

Answer 38

LLQ ab pain fever inc WBC C or D acute large passage of frank blood may resolve spontaneously

Question 39

complications of diverticulitis

Answer 39

perforation peritonitis obstruction