Path: GI Disorders 2 Flashcards by Rylee Sybert

What part of the intestine is most often involved in intestinal obstruction?

Small intestine

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What is the most common causes of intestinal obstruction

Hernias
Intestinal adhesions
Intussusception
Volvulus

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What clinical features are present with intestinal obstruction?

Abdominal pain and distention
Vomiting
Constipation

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Twisting of a segment of bowel on its vascular mesentery that leads to obstruction and ischemia

Volvulus

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Most common location of Volvulus in elderly

sigmoid colon

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Most common location of Volvulus in young adults

Cecum

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Telescoping of a proximal bowel segment into the distal one

Intussusception

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Intussusception is most common in what age group?

Infants and children

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Intussusception is most common at what location?

Terminal ileum -> cecum

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What are symptoms of Intussusception?

Vomiting, colicky pain, jelly stools, lethargy
Palpable sausage-shaped mass

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What is the hallmark feature of malabsorption syndromes

Steatorrhea

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steatorrhea

fat in the feces

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Chronic malabsorption can lead to what occurring?

Diarrhea and abdomen pain
Weight loss
Borborygmi

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How is fecal fat screened for?

Sudan stain

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Autoimmune enteropathy triggered by gluten ingestion

Celiac disease

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Celiac disease occurs in genetically predisposed individuals: HLA ______ or HLA _______

HLA-DQ2
HLA-DQ8

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In celiac disease there is hypersensitivity to ______________

Giladin

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Celiac disease primarily affects _____________ and/or ____________

Distal duodenum and/or proximal jejunum

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What is an extra-intestinal manifestation with celiac disease that usually occurs after age 20?

Dermatitis herpetiformis

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Laboratory findings in celiac disease

IgA tTG
Antideamidated gliadin peptide antibodies

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Duodenal biopsy of person with celiac disease

1) Flattened villi
2) hyperplasia of crypts
3) increased intraepithelial lymphocytes

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Acute appendicitis is most common in ___________ and _____________

Adolescents and young adults

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Where does pain localize to in acute appendicitis?

Localizes to the right lower quadrant

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How are WBCs in acute appendicitis?

Elevated

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Chronic condition due to abnormal mucosal immune response to luminal microbiota or mucosa-associated microbes in genetically susceptible hosts

IBD

What are the two major forms of Inflammatory bowel disease?

Crohn's disease and ulcerative colitis

UC involves only the _________ and _________

Colon and rectum

Crohn's disease impacts where?

Any area of the GI tract

Is the rectum spared in Crohn's disease?

Yes

Crohn's disease presents with ________ pain and __________ diarrhea

RLQ pain and non-bloody diarrhea

Ulcerative colitis presents with ________ pain and __________ diarrhea

LLQ pain and bloody diarrhea

What pattern of involvement is shown in Crohn's disease?

Skip lesion that spares the rectum

What pattern of involvement is shown in UC?

Continuous lesions that always shows rectal involvement

Depth of Inflammation in Crohn's Disease

transmural (full thickness)

Depth of inflammation in UC

mucosal and submucosal only

Radiology sign of Crohn's disease

String sign on small bowel

Radiology sign of UC

Lead pipe appearance

Histological appearance of Crohn's disease

Noncaseating granulomas and lymphoid aggregates

Histological appearance in UC

Crypt abscesses with neutrophils

When does IBD onset

Usually teens to early adulthood

Shared features between UC and Crohn's disease

Chronic diarrhea Abdominal pain Weight loss Increased risk of colorectal carcinoma

Characteristic symptoms of UC

Bloody diarrhea and pain that is relieved by defecation

Characteristic symptoms of Crohn's disease

Chronic non-bloody diarrhea RLQ pain

Extra-intestinal eye manifestations of IBD

Episcleritis Iritis Anterior uveitis

Ulcerative colitis morphology

Mucosal and sub-mucosal inflammation with pseudopolyps

Are there structural or biochemical abnormalities with irritable bowel syndrome?

What criteria helps diagnose IBS

Abdominal pain and bloating ≥ 3 days/month for ≥ 3 months, plus ≥2 of Pain related to defecation, Change in stool frequency, or consistency

IBS is most commonly seen in

Women aged 20-40

IBS is a disorder of _______- _______ interaction

Gut-Brain

What seems to be a cause/exacerbate the symptoms of IBS?

Psychological stressors Dietary triggers Altered gut microbiome

Decreased colonic contractions leads to _____________ predominant IBS

Constipation

Increased colonic contractions leads to ______________ predominant IBS

Diarrhea

Mucosal mass or projection that protrudes into the lumen of the intestine

Polyp

Non-neoplastic polyps are __________________

inflammatory

Most common neoplastic polyp type

Adenomatous polyp

Are adenomatous polyps Premalignant?

Yes, precursor to colorectal adenocarcinoma

Autosomal dominant disorder where numerous colorectal adenoma appear as a teenager

Familial Adenomatous Polyposis

Familial Adenomatous Polyposis (FAP) shows a _________% risk of colorectal carcinoma if untreated

100%

In untreated familial adenomatous polyposis, when does cancer develop?

Early, before age 30 often

Hereditary autosomal dominant disorder that presents with non-polyposis colorectal cancer?

Lynch syndrome

When does peak incidence of colorectal cancer occur?

Ages 60-80

Low intake of _______________

High intake of _____________________________

What are two dietary risk factors of colorectal cancer?

Low intake of unabsorbable vegetable fiber High intake of refined carbs and fat, red meat

There should be a suspicion of colonic neoplasm if iron deficiency anemia occurs in males at ____________ and in females after _____________

Males > 50 years old Females post-menopause

Right sided CRC grows as a ________________ mass

Polypoid, exophytic mass

What symptoms/findings may right-sided CRC present with?

Iron deficiency anemia Weight loss

Left sided CRC causes what lesions?

Napkin ring constrictive lesions

What symptoms/findings mat present in left-sided CRC?

Colicky pain Hematochezia

What are the two most important prognostic factors of CRC?

Depth of invasion Presence or absence of lymph node metastases

Where does distant metastasis in CRC most commonly occur?

Liver Can also to the lungs

For those at average risk of CRC, when should screening begin?

Age 45

For those with a first-degree relative with CRC, when should screening begin?

Start at age 40 or 10 years before relatives diagnosis

What is the gold-standard for CRC screening?

colonoscopy

What characteristic lesion on barium enema X-ray is a sign of constricting carcinoma?

Apple-core lesion

What is useful for treatment monitoring and detecting recurrence with CRC?

CEA (Carcinoembryonic antigen) Not used for screening

Path: GI Disorders 2 Flashcards

(75 cards)