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DEMS_BTRAN > Unit1_Pathophysiology&Diz > Flashcards

Unit1_Pathophysiology&Diz Flashcards

(49 cards)

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1
Q

WHat is the disease ~w/ the following Sx:?

  • Hematochezia
  • Mucus in stool
  • Tenesmus
A

Ulcerative Colitis

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2
Q

What is the disease ~w/ the following Sx:?

  • Nausea/vomiting
  • Steatorrhea
  • Fistula symptoms
A

Crohn’s Diz

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3
Q

Where is the abd. pain in Crohn’s pt.?

A

mid or lower abd pain

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4
Q

Where is the abd. pain in Ulcerative Colitis pt.?

A

LOWER abd pain

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5
Q

What Sx/signs are common in both Ulcerative Colitis & Crohn’s pt.s?

A

Chronic diarrhea

Weight loss

Fatigue

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6
Q

What is the gold standard test used to dX IBD?

A

Direct visualization and biopsy

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7
Q

What region of the bowel does Crohn’s diz affect?

A

Entire GI tract

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8
Q

What region of the bowel does Ulcerative Colitis affect?

A

Colon only!

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9
Q

Does Ulcerative Colitis result in Fistulae or abscesses?

A

NO.

Crohn’s has fistula and abscesses!

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10
Q

Which type of IBD are strictures common in?

A

Crohn’s!

UC does NOT result in Strictures.

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11
Q

A “skip lesions” distribution is ~w/ with which IBD?

A

Crohns

UC has a DIFFUSE distribution.

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12
Q

Which IBD has inflammation that is transmural?

A

Crohns. m

UC inflammation is Mucosa +/- SM

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13
Q

Which IBD has supperficial and confluent ulcers?

A

Ulcerative Colitis

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14
Q

Which IBD has granulomas?

A

Crohn’s (20-35% of pt.)

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15
Q

Which IBD is ~w/ obstruction, malabsorption and recurrence after colectomy?

A

Crohn’s!

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16
Q

Which IBD is ~w/ toxic Megacolon?

A

Ulcerative Colitis

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17
Q

What are the extra-intestinal manifestationals of IBD (mostly in UC):

Eyes: ?

Skin: ?

A

Eye: Scleritis, episcleritis.

Skin: Pyoderma gangrenosum, erythema nodosum.

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18
Q

What are the extra-intestinal manifestationals of IBD (mostly in UC):

Liver/Bile duct: ?

Joints: ?

A

Liver/bile duct: Primary sclerosing cholangitis (PSC) and cholangiocarcinoma.

Joints: Sacroiliitis, Ankylosing spondylitis.

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19
Q

Is Microscopic colitis a A.I. disease?

A

YES!

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20
Q

What is the clinical presentation of Microscopic Colitis?

Study These Flashcards
A

Mild, chronic secretory diarrhea.

  • water, non-bloody. 4-10 stools/day
  • minimal to no weight loss.
  • salt and water loss in the colon
21
Q

What other diz has a mild association with Microscopic Colitis?

Study These Flashcards
A

celiac disease

22
Q

What is the pX of Microscopic Colitis?

Study These Flashcards
A

good!

  • No bleeding, dehydration, or other complications
  • No increase in cancer risk or mortality
23
Q

How do you dX Microscopic Colitis?

Study These Flashcards
A

Colonoscopy - usually normal, b/c its microscopic, can’t see anything with the naked eye.

Biopsy is definitive

  • Lymphocytic infiltration of mucosa and SM (LC)
  • Thickened collagenous band (CC) in submucosa

Can’t make dX based on imaging, or other labs!
BIOPSY ONLY WAY!!!

24
Q

Chronic inflammation with lymphocytic infiltration, is the histological finding of which type of Microscopic Colitis?

Study These Flashcards
A

Lymphocytic colitis

25
Thickened subepithelial collagen band +/- lymphocytic surface injury, is the histological finding of which type of Microscopic Colitis?
Collagenous colitis
26
What colitis is commonly in watershed vascualr area like the splenic flexure, rectosigmoid junction,
Ischemic colitis: Fundamental insult = acute compromise in colonic bloodflow.
27
What is the endoscopic findings of Ischemic colitis?
edema, ulceration, +/- bleeding confined to a vascular region.
28
What is the clinical ppt. of Ischemic colitis?
- Abrupt-onset, crampy, lower abdominal pain - Urgent need to defecate - Mild diarrhea and/or hematochezia. - Clinical Presentation depends on…cause, extent of vascular compromise, speed of development, degree of collateralization, comorbid conditions - EVEN THOUGH THESE ARE THE TYPICAL SIGNS/SYMPTOMS, MOST IMPORTANT THING IS FOR PHYSICIAN TO HAVE A HIGH INDEX OF SUSPICION. (HTN, high risk factors)
29
How long does it take to recover from an event of Ischemic colitis?
1-2 weeks, typical
30
What are other/rare causes of Ischemic colitis?
Vasculitis – Lupus (SLE), Polyarteritis Nodosa (PAN), Henoch-Schonlein Substance abuse - cocaine, amphetamines Medications - estrogens, migraine medications Mesenteric thrombosis - Protein C/S deficiency, Factor V Leiden def., etc. Rare: Marathon running, extreme dehydration
31
Pt. w/ Acute (< 4-week) diarrhea ---> think!?
Travel to developing countries - Traveler’s diarrhea (GNR). Undercooked beef - E. Coli. Contaminated poultry, eggs, milk, lettuce - Salmonella/Shigella, Campylobacter, Yersinia. Antibiotic use, hospitalization - C. Difficile. Anal intercourse - Syphilis, gonorrhea, HSV proctitis.
32
What HLA type is ~w/ IBD?
HLA-B27 associated with IBD
33
_____________ : outpouching of colon wall composed of mucosa and submucosal layers that herniate outward through muscularis propria but are contained by serosa
Diverticulosis
34
What is the top risk factors for Diverticulosis?
low fiber diet!! low fiber diet → decreased stool bulk → increase peristaltic squeeze pressure and intra-colonic pressure → mucosal herniation through focal defects in bowel wall
35
What is the common complciation of Diverticulosis?
Diverticular hemorrhage. - usually from right colon. Painless hematochezia, often heavy, typically stops w/in 2-3 days
36
____________ : fecalith obstruction of diverticulum → distension from bacterial gas and neutrophils, micro perforation, abscess, or frank perforation with peritonitis
Diverticulitis
37
What are the Sx of Diverticulitis?
Lower abd pain, nausea, fever. NO diarrhea & NO bleeding!
38
What are the Tx of Diverticulitis?
- Oral/IV abx for uncomplicated diverticulitis - Percutaneous drainage, surgery for complicated diverticulitis (perforation, stricture, recurrent disease) * Not a ER issue, unless there is frank bleeding/perf.
39
What are the Complications of Diverticulitis?
- Perforation: rupture of diverticulum due to multiplication and expansion of bacteria - Obstruction - Abscess formation
40
What is the most common cause of lower GI bleed?
Diverticulosis
41
The following Sx of a lower GI bleed is indicative of what disease? Chronic abdominal pain and diarrhea.
IBD
42
The following Sx of a lower GI bleed is indicative of what disease? Weight loss, new constipation, anemia
Neoplasia
43
The following Sx of a lower GI bleed is indicative of what disease? Painless, heavy bleeding in o/w healthy, elderly patient.
Diverticulosis
44
The following Sx of a lower GI bleed is indicative of what disease? Hematochezia after major surgery or M.
Ischemic colitis
45
The following Sx of a lower GI bleed is indicative of what disease? Acute dysentery, travel, ill contacts, or antibiotic use.
Infectious diarrhea
46
The following Sx of a lower GI bleed is indicative of what disease? Chronic, microcytic anemia.
Neoplasia or AVMs
47
The following Sx of a lower GI bleed is indicative of what disease? Hx of heavy/chronic NSAIDs use.
Drug-induced colitis
48
The following Sx of a lower GI bleed is indicative of what disease? History of pelvic radiation.
Radiation proctitis
49
___________ is commonly associated with lower gastrointestinal bleeding, but may also occur from a brisk upper gastrointestinal bleed.
Haematochezia

DEMS_BTRAN (8 decks)

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