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Lower GI/Other Conditions
Terms in this set (61)
What does the Rule of 2's apply to?
What are the rules?
Meckel's (ileal) diverticulum
2 y/o MC age at clinical presentation
2 types of ectopic tissue (gastric or pancreatic)
2 inches in length
2 feet from ileocecal valve
MC complaint in Meckel diverticulum?
Bright red or maroon bleeding
Top 3 MCC SBO
1.) Post-surgical ADHESIONS (60%)
Top 3 MCC LBO
Crampy abd pain, vomiting, obstipation, abd distension. High pitched tinkles on auscultation & visible peristalsis
Intestinal segment invaginates "telescope" into adjoining intestinal lumen causing bowel obstruction.
Infant with vomiting, abdominal pain, and "currant jelly stools" s/p viral infection
Dance's sign = "Sausage-shaped mass" in RUQ and emptiness in RLQ
Twisting of any portion of bowel on itself
MC site for volvulus
Sigmoid, cecal colon
Autoimmune inflammation of small bowel d/t ingestion of gluten-containing foods leading to loss of villi & absorption area --> fat malabsorption
Celiac Disease (Sprue)
What skin condition is Celiac Disease (Sprue) associated with?
MC area of diverticular dz?
Sigmoid Colon (highest intraluminal pressure)
Uninflamed diverticula associated with low fiber diet, constipation, and obesity
MCC acute lower GI bleed
Inflamed diverticula 2ry to obstruction/infection --> distention, fever, LLQ pain
What comes sx comes first in appendicitis?
Anorexia & periumbilical pain, then RLU pain, nausea then vomiting
Chronic, dull abd pain worse after meals. "Intestinal angina" lasting 10-30 min + weight loss
Chronic mesenteric ischemia
Congenital aganglionic colon with neurogenic bowel obstruction
What ares does Ulcerative Colitis effect?
COLON --> Begins in rectum and moves proximally to colon
What area is ALWAYS effected in Ulcerative Colitis
LLQ pain, tenesmus, urgency, bloody diarrhea
What decrease risk of Ulcerative Colitis?
Toxic Megacolon and colon CA is more associated with which irritable bowel disease?
Where does Crohn's Disease effect?
Any segment from mouth to anus
What area is Crohn's Disease MC
Terminal ileum (RLQ pain)
Which IBD is deeper and is transmural?
RLQ pain, weight loss, diarrhea (no blood)
Perianal dx, fistulas, abscesses, malabsorption (b12/iron) is more associated with which irritable bowel disease?
MC colon polyp and lowest CA risk?
Which type of colon polyp is considered cancerous?
MC adenoma polyp
Adenoma polyp with highest risk of becoming CA
Colorectal CA is the ___ leading cause of CA death
3rd (after Lung and Skin)
Small, dark-colored spots on the lips, around and inside the mouth, near the eyes and nostrils, and around the anus. These spots may also occur on the hands and feet. Increased risk for Colon CA
Hernia that follows the inguinal tract d/t persistent patent process vaginalis. Goes in to scrotum. MC young children & young adults. MC RIGHT testicle
Hernia that d/t weakness of Hesselbach plexus. Does NOT reach scrotum
Hepatic vein thrombosis or occlusion --> decreased liver drainage, portal HTN & cirrhosis
Classic triad of Budd-Chiari Syndrome
3.) RUQ pain
Gallstones in gallbladder
Episodic RUQ/epigastric pain begining abruptly , continuous in duration, and resolves slowly lasting 30m- hours, associated with nausea and precipitated by fatty or large meal
Gallstones in biliary tree (common bile duct)
Biliary tract infection 2ry to obstruction by gallstone
Triad/Pentad of Cholangitis
Charcot's Triad Reynold's Pentad
1.) Fever/chills 4.) Shock
2.) RUQ pain 5.) AMS
Gallbladder (cystic duct) obstruction by gallstone causing inflammation/infection of gallbladder
What is + Boas sign?
Referred pain to R subscapular region in acute cholecystitis d/t phrenic nerve irritation
What finding in chronic cholecystitis is a premalignant condition?
Cholecystitis MC occurring in seriously ill pt d/t GB sludge and NOT stone formation?
Acute Acalculous Cholecystitis
Benign hereditary d/o with mildly reduced activity of glucuronosyltransferase (UGT) causing jaundice
Autosomal recessive d/o with NO glucuronosyltransferase (UGT) activity causing jaundice in 1st week of life and kernicterus (increased bilirubin in CNS), and resulting in death is not treated
Crigler Najjar Syndrome
Isolated mild conjugated hyperbilirubinemia d/t inability of hepatocytes to secrete conjugated bilirubin (gene mutaion MRP2)
+ BLACK LIVER
Dubin Johnson Syndrome
When does PHYSIOLOGY neonatal jaundice usually occur and why?
3-5 days after birth (if 1st day PATHOLOGIC) b/c increase in indirect bill (d/t deficiency of UGT and increased breakdown of fetal Hgb)
Only type of hepatitis associated with SPIKING fevers
Hx Ulcerative colitis, progressive jaundice, pruritis, RUQ pain, hepatomegaly, splenomegaly (+) p-ANCA
Primary Sclerosing Cholangitis
Rare autosomal recessive d/o ATB7B mutation, inadequate bile excretion of copper, increase copper absorpiong in SI, and copper deposition in tissue
Scorpion bite and mumps (in children) is associated with what?
Epigastric pain, constant, boring, radiating to the back, relieved with leaning forward or in fetal position
MCC pancreatic exocrine insufficieny/chronic pancreatitis in children
1.) Pancreatic calcifications
MC Pancreatic CA
Adenocarcinoma (DUCTAL) found in the HEAD of pancreas
MCC of massive lower gastrointestinal bleeding?
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