Potpourri of Common GI Diseases Flashcards
6 Common risk factors for PUD
H pylori infection NSAID use Other drugs (cocaine, meth, glucocorticoids, etc) Smoking Alcohol Stress
3 tests for H pylori
Blood test (test for IgG antibodies - but only tells you if you have ever been infected) Breath test (for urea) Stool test
When is imaging helpful in PUD?
When patients present with complications such as a massive UGI bleed or perforation
Not helpful for epigastric pain/discomfort (you need a scope)
What is the first line imaging modality used when there is suspected non-traumatic intra-abdominal pathology
X-ray
Looking for free air from a perforation
Then CT to identify the site of perforation
MISO for types of diarrhea
Metabolic (malabsorption, medication)
Infectious (immune, ischemia)
Secretory (structural)
Osmotic
4 signs of celiac on histology
Severe villous atrophy
Crypt hyperplasia
Enterocyte disarray
Intense inflammation of the lamina propria and epithelial cell layer
What main micronutrient is absorbed in the
- Duodenum
- Jejunum
- Ileum
- Iron
- Folate
- B12
Best tool to diagnose celiac
Biopsy
Imaging is not required and may not be helpful
CT can be useful to investigate complications
2 examples of complications in celiac
Lymphoma
Intussusception
6 characteristics of a high risk phenotype of crohns
Young Extensive disease Non-inflammatory Extra-intestinal manifestation Active smoker Steroid use
2 pros and 2 cons of imaging for Crohn’s
Pros: characterizing disease (small bowel involvement can distinguish Crohns from UC), identifying complications (obstruction, fistulas)
Cons: not needed for diagnosis, radiation
How do you distinguish dilated small bowel from large bowel on X-rays?
Large bowel: haustra (bands stop halfway)
Small bowel: valvulae conniventes (bands go all the way across)
Normal diameter of the
- Small intestine
- Large intestine
- Cecum
- 3 cm
- 6 cm
- 9 cm
In Crohn’s, CT can identify what 2 things?
Transmural inflammation (predisposes to strictures, fistulas, sinus tracts Complications (obstruction, abscesses)
For fistulizing Crohn’s what 2 medications do you use for
- Induction of remission
- Maintenance of remission
- Steroids and biologics
2. Biologics and immunomodulators (AZA/6MP, MTX)
Toxic megacolon
Clinical term for an acute toxic colitis with dilatation of the colon (also called toxic colitis)
Colonic dilatation and signs of systemic toxicity
Fever, tachycardia, leukocytosis, anemia (3 of them)
Any 1 of dehydration, altered mental status, electrolyte abnormality, hypotension
Best imaging test for toxic megacolon
CT
