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Pathophysiology II > Week 3 > Flashcards

Week 3 Flashcards

1
Q

what are the 4 IBS subtypes

A

IBS-d (with diarrhea)
IBS-c (with constipation)
IBS-m (mixed with const. and diarrhea)
IBS-u (unsubtyped IBS)

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2
Q

Rome Criteria IV

A
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3
Q

Bristol stool scale

A
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4
Q

Brain-Gut Pathway

A
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5
Q

Gut-Brain Axis

A
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6
Q

Some things that happen with IBS

A
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7
Q

Alarm features for IBS

A
  • Age ≥50 years old
  • Blood in stools
  • Nocturnal symptoms
  • Unintentional weight loss
  • Change in symptoms
  • Recent antibiotic use
  • Family history of organic GI
    disease
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8
Q

Peruse some ways of screening some things

A
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9
Q

Why is colonoscopy not necessary without alarm features?

A

Because low occurrence of abnormal visual structures

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10
Q

Diagnostic flow for IBS

A
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11
Q

safety of some foods

A
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12
Q

What the fuck is FODMAP. You want low FODMAP with IBS, typical diets are considered high FODMAP

A
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13
Q

High FODMAP Foods

A
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14
Q

Low FODMAP BAMMM!!

A
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15
Q

Does just going GF help all people with IBS?

A

nah brah, you gotta test other foods dudes

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16
Q

Use peppermint oil, duh

A
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17
Q

Antidepressants help

A

ok

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18
Q

Treat predominant symptoms. Ab Pain

A
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19
Q

Treat predominant symptoms. Constipation

A
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20
Q

Treat predominant symptoms. Diarrhea

A
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21
Q

Treat predominant symptoms. Bloating

A
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22
Q

Two types of IBD

A

Crohn’s
Ulcerative colitis

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23
Q

3 legs of IBS stool of treatment

A

-motility agents (laxatives, anti-diarrheal)
-Neuromodulators, antidepressants
-Dietary changes

24
Q

Sx of Crohn’s

A

-Skip lesions, skip areas (from mouth to rectum, typically starts at terminal ileum, affects any part of digestive tract.
-cobblestoning
-creeping fat and fistula
-diarrhea
-x-ray-String Sign (bowel wall thickening)
-Histopathology ~ non-reseating granuloma, Th 1 mediated inflammation, transmural inflammation

25
Q

Sx of Ulcerative colitis

A

-Inflammation limited to colon
-continuous information, always involves rectum
-Deep ulcerations and pseudo polyps
-Bleeding diarrhea
-X-ray lead-pipe sign (loss of haustra)
-histopathology -> crypt abcess, th2 mediated inflammation, involves mucosa, submucosa

26
Q

Good to explore what’s going on in intestines

A
27
Q

The ravages of IBD

A
28
Q

Compare risk factors of IBD types (Crohn’s and Ulcerative)

A
29
Q

Review CDAI scoring for Crohn’s

A
30
Q

Mayo clinic scoring

A
31
Q

Therapeutic goals in IBD

A
32
Q

Is IBD increased risk for colon cancer?

A

Yes, 10% at 20 years…

33
Q

Recommended surveillance?

A
34
Q

Red flags in GI: Mid-epigastric pain and vomit blood

A

condition assumed present until proven otherwise
-upper GI hemorrhage from inner lining of ST/esophagus
-possible consequences of misdiagnosis is massive bleeding from upper GI leading to death

35
Q

Signs of Mid-epigastric pain with vomit blood

A

Refer to ER

36
Q

Red flags in GI: Daily heartburn for many years

A

Refer to Doc

37
Q

Red flags in GI: Mid-ab pain followed by vomiting then pain moving to RLQ

A

ACUTE APPENDICITIS, Refer to ER

38
Q

Signs of appendicitis

A
  • Only 50% of case has the above symptoms
  • Absence of appetite
  • Vomit follows onset of pain
  • RLQ tenderness
  • Rebound tenderness, pain on percussion, rigidity, guarding
  • Invariably absence of bowel sounds
  • Low grade fever -> Rupture of appendix
39
Q

what can mimic appendicitis symptoms?

A

ectopic pregnancy

40
Q

Tests for appendicitis?

A
41
Q

Red flags in GI: mid to lower Ab colicky pain, vomit, constipation, ab distension

A

Condition assumed present until proven otherwise: BOWEL OBSTRUCTION

42
Q

Possible consequences of Bowel Obstruction?

A

Death.

Refer to Emergency Department

43
Q

four types of bowel obstruction?

A
44
Q

bowel obstruction key feature?

A

persistent vomit

45
Q

acute small intestine obstruction Sx

A
  • Pain appears first and followed by vomit, distension, constipation
46
Q

large intestine bowel obstruction Sx

A
  • Constipation is followed by distension, pain, vomit
47
Q

sign always present with any bowel obstruction?

A

distended abdomen

48
Q

GI red flags: Acute bloody diarrhea (6-8 stools/day) and fever of over 101.5 F

A

Serious
Enteritis (Gastroenteritis if persistent vomit in addition to diarrhe)

49
Q

possible consequences of serious enteritis?

A

serious disability and/or death from dehydration and electrolyte imbalance

50
Q

2 types of serious enteritis?

A

acute infectious (viruses, bacteria, parasites)
inflammatory autoimmune bowel disease (UC, Crohn’s, etc)

51
Q

What to ask and look for in serious enteritis?

A

Inquire:
* Number of stools daily
* Presence of blood in stool
* Presence of fever
Objective Findings:
* Visible blood
* Temp > 101.5 F
* Hyperactive bowel sound (borborygmi)
* Generalized abdominal tenderness to palpation, esp. if on LLQ

52
Q

Risk factors for infectious enteritis:

A
  • Age < 5 y.o.
  • Exposure to unclean water / food
  • Lack of hand washing
53
Q

risk factors for IBD

A
  • Cigarette smoking
  • Family history
54
Q

Red flags in GI: new onset constipation + unexplained weight loss in person over 40 years old

A

Carcinoma of colon (and rectum)

55
Q

Possible consequences of missing carcinoma

A

metastasis, death

56
Q

what do to if you see new onset constipation + unexplained weight loss in person over 40 years old

A

Refer to doctor

Pathophysiology II (5 decks)

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