Sm Intestine and Colon Path Pt 2

Question 1

Most common cause of acute diarrhea

Answer 1

infectious diarrhea

Question 2

Dx of C diff colitis

Answer 2

PCR of stoool

for toxin-producing strains

Question 3

Ulcerative colitis vs Crohn’s disease

Answer 3

UC: continuous, confluent inflammatory changes of mucosa (not transmural) that begins in rectum
Crohn’s: transmural skip lesions

Question 4

Which may involve small bowel? UC or Crohn’s

Answer 4

Crohn’s

UC only affects colon

Question 5

UC manifestations

Answer 5

blood diarrhea, proctitis

Question 6

Crohn’s manifestations

Answer 6

variable, abdominal pain, mild diarrhea, fever

Question 7

Indeterminant colitis

Answer 7

overlap of UC and Crohn’s

Question 8

Serology
UC
Crohn’s

Answer 8

UC: pANCA +
CD: ASCA +

Question 9

UC complications

Answer 9

megacolon
fistula formation
colitis-associated dysplasia –> adenocarcinoma

Question 10

Crohn’s complications

Answer 10

fistula formation

colitis-associated dysplasia –> adenocarcinoma

Question 11

Quiescent colitis

Answer 11

persistent crypt architectural distortion w/o active inflammation

Question 12

Diversion colitis

Answer 12

colitis of blind distal segment that is excluded from fecal stream
following surgery to form ostomy
caused by short-chain FA deficiency

Question 13

Neonatal necrotizing enterocolitis

Answer 13

transmural necrosis –> bacterial overgrowth –> gas formation (pneumocosas intestinalis)

Question 14

Microscopic colitis

types

Answer 14

lymphocytic colitis

collagenous colitis

Question 15

Lymphocytic colitis
disease category
findings

Answer 15

microscopic colitis
increased lamina propria chronic inflammation, plasma cells, increased intraepithelial lymphocytes and surface epithelial damage

Question 16

Collagenous colitis
disease category
findings

Answer 16

microscopic colitis

band of subepithelial collagen + inflammatory changes

Question 17

Presentation of microscopic colitis

Answer 17

watery diarrhea

gross colonoscopy benign

Question 18

Drug induced enterocolitis
colonoscopy findings
drugs

Answer 18

patchy, superficial ulcers

NSAIDs, chemo, Abx –> C. diff, graft-v-host

Question 19

IBS Dx

Answer 19

clinically

chronic relapsing syndrome, often either diarrhea- or constipation-predominant

Question 20

Ischemic bowel disease

etiologies

Answer 20

arterial/venous obstruciton

hypoperfusion

Question 21

Likely bowel segments affected by ischemic bowel disease

Answer 21

at water shed areas

ie splenic flexure, rectal area

Question 22

Complications of ischemic bowel disease

Answer 22

transmural necrosis

Question 23

Angiodysplasia

Answer 23

malformed submucosal and mucosal blood vessels

Dx: colonoscopy

Question 24

Outpouchings of diverticuli are commonly seen in this area

Answer 24

where vessels or nerves penetrate mucosal layer

–> when they perf, they bleed

Question 25

Tx of diveriticulitis

Answer 25

clear liquid diet (bowel rest)
Abx
high fiber
surgery

Question 26

Solitary rectal ulcer syndrome

etiology

Answer 26

malfunction of puborectalis muscle –> excessive straining

rectal mucosal prolapse –> ulcers and polypoid lesions

Question 27

Solitary rectal ulcer syndrome

manifestations

Answer 27

young

blood in stool, alternating diarrhea and constipation