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CPD II > Lower GI - Part III > Flashcards

Lower GI - Part III Flashcards

1
Q

DDX for RUQ pain

A 
Hepatitis
Cholecystitis/Cholelithiasis
Peptic Ulcer Disease
Pancreatitis
Myocardial Ischemia
Pericarditis
Ruptured Aortic Aneurism
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2
Q

DDX for Epigastric pain

A 
GERD
Gastritis
Peptic Ulcer Disease
Pancreatitis
Myocardial Ischemia
Pericarditis
Ruptured aortic aneurism
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3
Q

DDX for LUQ pain

A 
Spleen infarct
Splenic rupture
Gastritis
Gastric Ulcer
Pancreatitis
Hiatal Hernia (incarcerated)
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4
Q

DDX for Right Flank pain

A

Kidney Inflm

Pyelonephritis

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5
Q

DDX for Periumbilical pain

A

Early appendicitis
Gastroenteritis
Bowel obstruction
Peritonitis

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6
Q

DDX for Left Flank pain

A

Kidney inflm

Pyelonephritis

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7
Q

DDX for RLQ pain

A 
Appendicitis
Inflammatory bowel disease
Cecal diverticulitis
Inguinal hernia
Nephrolithiasis
Female: Ovarian cyst, Salpingits, Enometriosis, Ectopic pregnancy
Male: testicular or epididymal inflm
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8
Q

DDX for Suprapubic pain

A

Cystitis
Acute urinary retention
Female: Uterine cramps, Cervicitis, Endometriosis, PID
Male: acute prostatitis

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9
Q

DDX for LLQ pain

A 
Diverticulitis
Inflammatory bowel disease
Irritable bowel syndrome
Nephrolithiasis
Female: Ovarian cyst, Salpingits, Enometriosis, Ectopic pregnancy
Male: testicular or epididymal inflm
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10
Q

Diffuse early abdominal pain DDX

A

early appendicitis, gastroenteritis, intestinal obstruction, mesenteric ischemia, peritonitis, IBS

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11
Q

Extra abdominal causes of abdominal pain

A 
early appendicitis, gastroenteritis, intestinal obstruction, mesenteric ischemia, peritonitis, IBS, 
abdominal wall (hematoma), infectious (herpes zoster), metabolic (DKA, porphyria, sick cell disease), thoracic (MI, PE, radiculitis), toxic (spider bite, heavy metal poisoning, opioid withdrawal)
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12
Q

Diarrhea

A

defined by >200g/day of stool weight (normal is 100-200g/d)
increase in stool fluidity
or >3 BM a day

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13
Q

Pathophysiology of diarrhea

A

1) osmotic (too much water is drawn into the bowels, increase amount of poorly absorbable solutes)
2) secretory (increase in active secretion (Cl, water) or an inhibition of absorption (Na, water) with little to no structural damage
3) exudative (mucus, blood, protein inflammation)
4) motility (inc. or decreased contact btwn GI contents and mucosal surface)

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14
Q

Red flags of diarrhea

A

blood, pus, fever, signs of dehydration, chronicity, unintended wt loss, failure to thrive in kids
complications include: dehydration & electrolyte imbalance

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15
Q

definition of constipation

A

difficult to pass, infrequent, hardness of stool, incomplete feeling

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16
Q

Causes of acute constipation

A

obstruction, adynamic ileus, medications

17
Q

Causes of chronic constipation

A

carcinoma, hypothyroid, CNS disorders, slow transit, irritable bowel syndrome

18
Q

Red flags of constipation

A

abdominal distention, vomiting, blood in stool, weight loss, sever or worsening symptoms

19
Q

definition of gas

A

colonic bacterial fermentation of nutrients, air swallwoing

20
Q

Types and causes of gas

A

1) belching - caused by air swallowing, carbonated beverages, voluntary
2) bloating/distention - caused by air swallowing, IBS, gastroparesis, eating d/o, gynecologic
3) flatus - diet, carbohydrate insufficiency, celiac, pancreatic insufficiency

21
Q

Red flags of gas

A

weight loss, blood in stool (can be benign like in hemorrhoids,)

22
Q

definition of GI bleeding

A

gross or occult blood

hematochezia (gross blood)- suggests lower GI bleed

23
Q

causes of small bowel bleeding (occult)

A

angioma, A-V malformation, tumors, Meckel’s diverticulum

24
Q

causes of colon, anus bleeding (frank)

A

anal fissure, colitis, carcinoma, polyps, diverticular disease, IBD, hemorrhoids

25
Q

definition of dyschezia

A

difficulty evacuating (feel urge, but cannot defecate

26
Q

cause of dyschezia

A

from discoordination of rectal muscles and sphincter: hypotonia, prolapse

27
Q

stool findings correlating with small intestines

A 
watery in appearance, 
large in volume, 
increased frequency, 
blood possible but never gross
pH possibly < 5 hpf
28
Q

stool findings correlating with colon

A 
mucoid and/or bloody in appearance, 
small in volume, 
highly increase in frequency, 
blood commonly gross, 
pH >5
WBC commonly >10 hpf
29
Q

Labs: O& P (ova and parasites)

A

to find protozoa, worms, worm eggs, other parasites

if one family member is positive, usu tx whole family

30
Q

Stool culture

A

perform: immunocompromised patient, severe, inflammatory diarrhea, in those with IBD to distinguish between flare and infection

31
Q

Fecal occult blood (hemoccult)

A

to detect upper GI bleed

32
Q

Fecal leukocytes

A

when assessed along with occult blood can help confirm bacterial cause of diarrhea

33
Q

Fecal lactoferrin (latex agglutination assay)

A

marker for fecal WBCs. Used to distinguish between inflammatory diarrhea (bacterial infxn, IBD) and non-inflammatory causes (viral infxn, IBS)

34
Q

Fecal lysozyme

A

N= absence of colonic inflammation and suggests irritation only
used as a marker to measure success of treatment for IBD

35
Q

Comprehensive digestive stool analysis (CDSA)

A

markers for digestion, absorption, metabolism, plus microbiology

36
Q

Salival secretory secretory IgA (sIgA)

A

low in: celiac, IBD, allergy, chronic infx, chronic stress, more susceptible to GI infection
high in: acute GI infxn

37
Q

serology

A

eg Celica testing for antibodies

38
Q

bowel transit time

A

variable, but usu start to see test substance at 12-14 hrs

39
Q

Anoscopy

A

in-office procedure for visualizing hemorrhoids

CPD II (4 decks)

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