Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI > Small Bowel > Flashcards

Small Bowel Flashcards

0
Q

Most common cause of pediatric diarrhea

A

Rotavirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Types of diarrhea

A

Infectious, malabsorption, osmotic, increased motility, secretory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Ddx of chronic diarrhea

A

Secretory: carcinoid tumor or VIPoma
Malabsorption/maldigestive/osmotic: bacterial overgrowth, pancreatic insufficiency, mucosal damage, lactose intolerance, celiac dz, laxative abuse, short bowel syndrome
Inflammatory: IBD
Increased motility: IBS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When to workup acute diarrhea

A

Further workup if patient has a high fever, bloody diarrhea, or diarrhea > 4-5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Watery vs. bloody diarrhea organisms

A

Watery: Vibrio cholera, ETEC, Giardia, C diff, rotavirus, Cryptosporidium

Bloody: EHEC, Salmonella, Shigella, Campylobacter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Campylobacter:

-Hx, Exam, Tx

A

Hx: most common etiology of bacterial diarrhea; ingestion of contaminated food/water; affects young children and young adults

Exam: Fecal RBCs and WBCs; p/w bloody diarrhea, fever, and no abdominal pain

Tx: erythromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

C diff

-hx, exam, tx

A

Hx: a/w recent antibiotic use (especially clinda) and recent hospitalization
-be careful about toxic megacolon

Exam: p/w fever, abdominal pain, systemic toxicity; fecal RBCs and WBCs
-causes colitis; dx w/ toxin in stool; sigmoidoscopy shows pseudomembranes

Tx: PO metronidazole or PO vanc; IV metronidazole if pt can’t tolerate PO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Entamoeba histolytica

-hx, exam, tx

A

Hx: 2/2 ingestion of contaminated food or water (Trave)

Exam: severe abdominal pain and fever; fecal RBCs and WBCs; endoscopy shows flask-shaped ulcers”
-mimics IBD if chronic

Tx: steroids can cause fatal perforation. DON’T USE STEROIDS; tx w/ metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

E. coli 0157:H7

-Hx, exam, tx

A

Hx: bloody diarrhea, ingestion of raw meat; lasts 5-10 days

Exam: p/w severe abdominal pain, low-grade fever, vomiting, and bloody diarrhea; fecal RBCs and WBCs
-rule out GI bleed and ischemic colitis; HUR is a potential complication (thrombocytopenia and renal failure)

Tx: avoid antibiotics or antidiarrhea therapy because they increase HUS risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Salmonella

-hx, exam, tx

A

Hx: 2/2 ingestion of contaminated poultry or eggs

Exam: p/w prodromal HA, fever, myalgia, and abdominal pain

  • Fecal WBCs
  • sepsis is a concern as 5-10% of pts become bacteremic; sickle cell pts are prone to osteomyelitis

Tx: oral quinolone or TMP-SM if pts are bacteremic or have sickle cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Shigella

-Hx, exam, tx

A

Hx: very contagious, transmitted fecal-oral

Exam: fecal RBCs and WBCs; bloody diarrhea
-can cause severe dehydration and febrile seizures

Tx: TMP-SMX to prevent spread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Intestinal villous atrophy

A

a/w Celiac disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Dermatitis herpetiformis

A

a/w celiac dz
grouped, papulovesicular pruritic skin lesions
symmetrically located on extensor surfaces of elbows, knees, buttocks, and posterior scalp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Frequent, loose, watery stools which are pale, foul-smelling, bukly
a/w abdominal pain, flatus, bloating, weight loss, nutritional deficiencies, and fatigue

A

Malabsorptive diarrhea
ddx: mucosal (Celiac, Whipples dz, tropical sprue), bile salt deficiency (bacterial overgrowth), pancreatic insufficiency, or short bowel syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pellagra

A

Sx: Diarrhea, dementia, dermatitis, death
-high sensitivity to sunlight; ataxia, confusion, insomnia; beefy, red glossitis; dilated cardiomyopathy;

Vitamin B3 (niacin) deficiency 2/2 decreased niacin or tryptophan intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Lactose intolerance:

-pathophysiology, common populations, hx/PE, Dx, Tx

A

Pathophysiology: lack of lactose; can occur after gastroenteritis transiently; common in Asian, Native Americans, and Africans

Hx/PE: abdominal bloating, flatulence, cramping, watery diarrhea after milk ingestion
Dx: empiric lactose-free diet that improves symptoms
-Hydrogen breath test reveals increased hydrogen after ingestion of lactose

Tx: avoid dairy products

16
Q

Carcinoid syndrome vs. carcinoid tumor

A

Syndrome: after tumor mets to liver
Tumor: presence of carcinoid tumor

17
Q

What do carcinoid tumors produce?

A

Serotonin

18
Q

Why are there no sx before carcinoid tumor metastasizes?

A

Serotonin undergoes first-pass metabolism in the liver

19
Q

Carcinoid syndrome

-sx, dx, tx

A

Flushing, diarrhea
Abdominal cramps, wheezing, right-sided cardiac valvular lesions

Dx: high urine levels of 5-HIAA; CT and In-111 octreotide scans can localize the tumor

Tx: octreotide and surgical resection

20
Q

Constipation, abdominal distention, mucous stools and abdominal pain that relieved by bowel movements

A

Irritable bowel syndrome

21
Q

Partial vs complete SBO

A

Partial: continued passage of flatus
Complete: no passage of flatus or stool

22
Q

Causes of small bowel obstruction

A

Most common: adhesions, hernias

Neoplasms, intussusception, gallstone ileus, stricture, volvulus

23
Q

Typical symptoms of an SBO

A

Crampy abdominal pain at 4-5 minute intervals
Vomiting: proximal = early and bilious; distal = late and feculent
Exam: distention
Bowel sounds: high-pitched tinkles and peristaltic rushes

24
Q

Pt w/ hx of carcinoid tumor (resected) who presents with symmetric, dry, b/l hyperpigmented skin lesions, persistent diarrhea, and complaints that she is not herself anymore (irritable, confused, forgetful). Likely diagnosis?

A

Pellagra 2/2 carcinoid syndrome recurrence
-Carcinoid tumors produce serotonin which is derived from tryptophan. Tryptophan is also the precursor of niacin, so patients with carcinoid tumors may be using all of their tryptophan for serotonin production and not making enough niacin

25
Q

Dx of small bowel obstruction

A

Abxominal films stepladder pattern of dilated small-bowel loops, air fluid levels, and paucity of gas in the colon

26
Q

Tx of partial and complete SBO

A

Partial: NPO, NG tube, IVF, correction of electrolyte abnormalities, and Foley to monitor fluid status
-if sx > 3 days, then do ex-lap
Complete: ex-lap

27
Q

Gallstone ileus

A

SBO where gallstone erodes through intestinal wall into the lumen of the GI tract and lodges in the ileocecal valve

28
Q

Obstruction vs. ileus

A

Obstruction: physical obstruction in the bowel causing backup
Ileus: loss of peristalsis without structural obstruction

Obstruction has hyperactive bowel sounds while ileus has none

29
Q

X ray differences between ileus and SBO

A

SBO has air in small bowel, none in colon (distal to the SBO)
Ileus has diffuse air present throughough the GI tract

30
Q

Tx for ileus

A

NPO, NG suction, TPN, IVF

31
Q

2 most common causes of mesenteric ischemia

A

Thrombotic occlusion: acute thrombosis in the SMA. primary risk = atherosclerosis
Embolism: from heart; risks = a-fib and stasis from a decreased ejection fraction

32
Q

Intestinal angina

A

Episodes of pain after eating related to increased blood needs for the gut and inability to get it due to atherosclerosis

33
Q

Pneumatosis intestinalis

A

Air within the bowel
In neonates = necrotizing enterocolitis
In adults it can mean mesenteric ischemia

34
Q

Tx of acute bowel ischemia

A

Volume resuscitation and antibiotics
Acute arterial thrombosis/embolus: anticoagulation and laparotomy
Venous thrombosis: anticoagulation
Surgical resection of infarcted bowel

GI (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions