Pathophysiology of the Colon - Atwell

Question 1

Rapid association diagnosis.

Chronic abdominal pain and diarrhea

Answer 1

IBD

[Suggestive symptoms (e.g., diarrhea, crampy abd pain, bleeding) lasting > 2 weeks
Negative work-up for other causes of colitis (infection, ischemia, medications)]

Question 2

Rapid association diagnosis.

Weight loss, new constipation, anemia

Answer 2

Neoplasia

Question 3

Rapid association diagnosis.

Sudden onset of painless hematochezia bleeding, elderly patient

Answer 3

Diverticular hemorrhage

Question 4

Rapid association diagnosis.

Hematochezia with an abrupt-onset, crampy, lower abdominal pain and urgent need to defecate. May be after surgery or MI

Answer 4

Ischemic colitis

Question 5

Rapid association diagnosis.

Acute dysentery, travel, ill contacts, or antibiotic use

Answer 5

Infectious diarrhea

Question 6

Rapid association diagnosis.

Chronic, microcytic anemia

Answer 6

Neoplasia or AVM. (blood loss)

Question 7

Rapid association diagnosis.

NSAIDs

Answer 7

Drug-induced colitis.

Question 8

Rapid association diagnosis.

History of pelvic radiation

Answer 8

Radiation proctitis.

Question 9

Rapid association diagnosis.

Mild secretory diarrhea in an elderly woman.

Answer 9

Microscopic colitis.

Benign conditon. No increased cancer risk. Only diagnosable microscopically, hence the name.

Can be collagenous or lymphocytic infiltrate.

Endoscopy will be normal.

Question 10

LLQ pain, nausea, fever. How is the diagnosis made, and what is the diagnosis?

Answer 10

Diverticulitis. Obstruction of diverticulum resulting in inflammation.

CT or MRI. No biopsy for this one. Most others require biopsy.