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GI Week 4 > Sm Intestine Colon Path- Nelson > Flashcards

Sm Intestine Colon Path- Nelson Flashcards

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1
Q

What are the major differences between ulcerative colitis and crohn’s disease?

A

UC:

  • inflammation of mucosa (maybe submucosa- NOT transmural)
  • Involves rectum and maybe colon
  • Continuous

Crohns:

  • transmural inflammation
  • Can involve anywhere in the GI tract
  • Skip lesions
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2
Q

What is inflammatory bowel disease?

A

Inappropriate mucosal immune reaction to luminal bacteria (in genetically susceptible individuals!)

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3
Q

Most common cause of acute diarrhea?

A

Infectious diarrhea!!!

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4
Q

How do you diagnosis clostridium Difficile?

A

Stool PCR assay to look for toxin-producing strains

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5
Q

What type of colitis is associated with C. diff?

A

psuedomembrane colitis - mucosal surface EXUDATE of necrotic epithelial cells, neutrophils, mucin, and fibrin

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6
Q

For indeterminate colitis, how would would one distinguish UC from CD?

A

Serologic studies!

CD = ASCA positive
UC = pANCA positive
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7
Q

Name some gross features of crohn’s disease?

A

Transmural inflammation:
Cobblestone mucosa
Creeping Fat
Bowel wall thickening

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8
Q

Gross morphology of ulcerative colitis?

A

Mucosal and submucosal inflammation only:

Psuedopolyps!

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9
Q

Non-caseating granulomas is associated with which inflammatory bowel disease?

A

CROHNS!

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10
Q

What is a long term complication of both CD and UC?

A

Development of intestinal adenocarcinoma

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11
Q

Diversion colitis

A
  • Colitis in a blind distal segment of the colon (excluded from fecal stream)
  • Following surgery that made a diverting ostomy
  • Due to deficiency of short-chain fatty acids (normally produced from fermentation of dietary starches by normal colonic bacterial flora)
  • These starches are absent in the diverted segment, due to changes in the luminal microbiota and diversion of the normal fecal stream
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12
Q

Clinical presentation for microscopic colitis?

A

Chronic watery diarrhea

NORMAL colonoscopic exam

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13
Q

Two types of microscopic colitis?

A
  • Lymphocytic colitis

- Collagenous colitis

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14
Q

Lymphocytic colitis

A
  • Increased lamina propria chronic inflammation
  • Increased intra-epithelial lymphocytes
  • Surface epithelial damage
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15
Q

Collagenous colitis

A

Band of sub-epithelial collagen is seen in addition to inflammatory changes

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16
Q

Radiation enterocolitis

A

Occurs when GI tract is irradiated

Can be acute or chronic

Can develop ulcers, strictures, fistula, serosal adhesions

17
Q

Neonatal necrotizing enterocolitis

A

First week of life in premature infants

Small and large bowel with transmural necrosis

18
Q

What class of drugs is commonly implicated in drug-induced enterocolitis?

A

NSAIDS!

19
Q

Chronic, replapsing abdominal pain or discomfort
Bloating
Changes in bowel habits (diarrhea or constipation)

Absence of any known causative agent that could explain symptoms

A

Irritable bowel sydnrome

20
Q

Irritable bowel syndrome is most common in which population?

A

Middle-aged women!

21
Q

List some causes of ischemic bowel disease

A

Acute arterial obstruction/thrombosis = atherosclerosis, aortic aneurysm, etc

Mesenteric venous thrombosis = portal hypertension, trauma, neoplasms, etc.

Hypoperfusion = cardiac failure, shock, vasoconstrictive drugs, etc.

22
Q

What are the bowel segments most likely to be affected by ischemia?

A

Splenic flexure (SMA and IMA watershed zone)

Sigmoid Colon

Rectum (IMA, pudendal artery, iliac artery watershed zone)

23
Q

Complication of transmural bowel necrosis?

A

Sepsis due to break down of mucosal barriers (w/ septic shock/death)

24
Q

What is angiodysplasia?

A

malformed submucosal and mucosal blood vessels

25
Q

Possible complications of sigmoid diverticulitis?

A

Abscess
Obstruction
Perforation
Fistula

26
Q

How do you treat sigmoid diverticulitis?

A

Clear liquid diet (bowel rest)
Antibiotics
Followed by high fiber diet

27
Q

Define solitary rectal ulcer syndrome

A

Disorder caused by malfunction of the puborectalis muscle, leading to excessive straining on defecation

GI Week 4 (8 decks)

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