Lower GI Disorders (Quiz 2) Flashcards
how can C. diff colitis present
- present with diarrhea all the way to toxic megacolin
how do you diagnose C. diff colitis
- finding toxin (toxin A)
treatment of C. diff colitis
- oral vancomycin first
- metronidazole otherwise
when does C. diff colitis occur
- following antibiotic usage
what do you see on gross pathology with C. diff colitis
- pseudomembranes: yellow-green exudates
what do you see on histopath with C. diff colitis
- volcano lesions
- mucosal necrosis
which populations predominantly have diverticulosis
- older age
- predominantly westerners
which side of the body presents with diverticulosis
is rectal involved?
- lower left quadrant
- rectal not involved
pathogenesis of diverticulosis
- aging and low fiber diet leads to weakening of the colonic wall and increased intralumenal pressure
- leads to colonic diverticular disease
what are sac-like herniation of mucosa and submucosa into the colonic wall
most common location
- diverticula
- sigmoid colon
where do diverticula occur
- sites of colonic wall weakness
- where blood vessels penetrate muscularis propria
what the majority of symptoms of diverticulosis
- asymptomatic
pathogenesis of diverticulitis
- fecalith impacted within diverticulum
- abrades mucosa and causes inflammation
- can lead to perforation
how to diagnose diverticulitis
- CT scan
do you do a colonoscopy or barium enema on those suspected of having diverticulitis
why?
no
- can lead to perforation
management of diverticulitis
- clear liquid diet or NP
- broad spectrum antibiotics
what is characterized by mucosal necrosis with surrounding inflammation
- diverticulitis
which layer of the colon is not present within a typical colonic diverticulum
- muscularis propria
pathogenesis of appendicitis
- fecalith leads to ischemia
- leads to mucosal edema or necrosis
- bacterial invasion
- can perforate
what condition is Rovsing’s sign, Psoas sign, and Obturator sign associated with
- appendicitis
what do you see on CBC with appendicitis
- increased WBC (PMNs)
radiographic diagnosis of appendicitis
- ultrasound or CT
when does the appendix appear erythematous and edematous during appendicitis
- when inflammation extends deeper into wall
management of appendicitis
- broad spectrum antibiotics
- surgery
________ can lead to perforation in appendicitis
- transmural necrosis
primary slow transit constipation due to
- colonic inertia
secondary slow transit constipation due to
- metabolic
- neurologic
- medications
what is a functional outlet obstruction
what in the history could give you indication of this
- contractions of puborectalis muscle with closure of anal canal
- excess straining
- digital maneuvers for evacuation
