Crohn's Disease Assessment
- Diarrhea
 - 5-6 per day
 - Cramping Abdominal Pain
 - Fever
 - Weight Loss
 - Malabsorption
 - Anemia
 - Obstruction
 - Fistulas
 
Crohn's Disease Characteristics
- Terminal Ileum and Colon
 - Rectal Sparing
 - Transmural Inflammation
 - Granulomas
 - Skip Lesions
 - Cobblestone Mucosa
 - Fissures
 - Fistulas
 - Perianal Disease
 - Creeping Fat
 - Lymphoid Aggregates
 - String Sign on Barium Swallow
 
Crohn's Symptoms and Associations
- Diarrhea
 - Malabsorption
 - Bile-Wasting
 - Pigment Gallstones
 - Oxalate Kidney Stones
 - Ankylosing Spondylitis
 - Erythema Nodosum
 - Uveitis
 - Migratory Polyarthritis
 
Ulcerative Colitis Characteristics
- Autoimmune
 - Mucosal and Submucosal Only
 - Rectal Involvement
 - Stepwise Lesions
 - Friable Pseudopolyp
 - Crypt Abscess
 - Loss of Haustra
 - Lead Pipe Appearance
 - Bloody Diarrhea
 
Ulcerative Colitis Associations
- Toxic Megacolon
 - Colorectal Carcinoma
 - Anterior Uveitis
 - Pyoderma Gangrenosum
 - Ankylosing Spondylitis
 - Primary Sclerosing Cholangitis
 - P-ANCA
 
Diverticulosis and Diverticulitis Assessment
- Outpouching
 - Inflamed Diverticula
 - Abdominal Pain
 - Abdominal Distention
 - Flatulence
 - Fever
 - Rectal Bleeding
 - Alternating Constipation and Diarrhea
 - Peritonitis
 
Diverticulosis and Diverticulitis Interventions
- High Fiber Diet
 - Reduce Intra-abdominal Pressure
 - Stool Softeners
 - Exercise
 - Anticholinergics
 - Antibiotics
 - Bowel Resection
 
Appendicitis
- Fecalith leading to obstruction and infection
 - Most commonly affects teenagers
 - Initial peri-umbilical visceral pain
 - Subsequent somatic right lower quadrant pain
 - Rebound tenderness
 - Positive psoas sign
 - Pain at McBurney's point
 - Leukocytosis
 - Fever
 - Appendectomy
 
Acute Appendicitis Treatment
- CT Scan
 - Immediate Appendectomy
 - NPO
 - IV Fluids
 - Antibiotics
 - Tertiary Intention
 - Antibiotics Until Afebrile
 
Peptic Ulcer Disease Assessment
- Helicobacter Pylori
 - NSAIDs
 - Increased Stomach Acid
 - Abdominal Pain
 - Heartburn (Pyrosis)
 - Melena
 - Weight Changes
 - GI Distress
 - Most Commonly in Duodenum
 - Duodenal: Pain Relieved by Eating
 - Gastric: Pain Caused by Eating
 
Peptic Ulcer Disease Interventions
- Combination Drug Therapy
 - Two Antibiotics
 - Proton Pump Inhibitor (PPI)
 - Decrease Acid Secretion
 - Avoid NSAIDs
 - Diet and Lifestyle Changes
 
Hemochromatosis Signs and Symptoms
- Micronodular Cirrhosis
 - Hepatocellular Carcinoma
 - Diabetes
 - Bronze Skin Coloring
 - CHF
 - Arthropathy
 - Testicular Atrophy
 - Impotence
 
Hemochromatosis Pathophysiology
- Hemosiderin Deposition
 - Autosomal Recessive
 - HLA-A3
 - Secondary to Transfusion Therapy
 - Increase Iron
 - Increase Ferritin
 - Increased Transferrin Saturation
 
Wilson's Disease Pathophysiology
- Autosomal Recessive
 - Mutation in ATP7B gene
 - Chromosome 13
 - Decrease in Ceruloplasmin
 - Inadequate copper excretion
 - Liver
 - Brain
 - Kidney
 - Cornea
 - Joints
 - Treat with Penicillamine
 
Wilson's Disease Symptoms
- Cirrhosis
 - Hepatocellular Carcinoma
 - Basal Ganglia Degeneration
 - Dementia
 - Dyskinesia
 - Asterixis
 - Kayser-Fleischer Rings
 - Slit Lamp Exam
 - Hemolytic Anemia
 
Carcinoid Syndrome
- Neuroendocrine Cells
 - Serotonin
 - Appendix
 - Chromogranin A
 - Neuron Specific Enolase
 - Dense Core Bodies on EM
 - Symptoms When Metastasize to Liver
 - Flushing
 - Wheezing
 - Right Heart Murmur
 - Diarrhea
 
Colorectal Cancer Assessment
- 3rd Most Common Cancer
 - Change in Bowel Habits
 - Bowel Obstruction
 - Rectal Bleeding
 - Anemia
 - Weight Loss
 - Ascites
 - Colonoscopy
 - FOBT and FIT
 
Lynch Syndrome (Hereditary Nonpolyposis Colorectal Cancer)
- Autosomal Dominant
 - Defective DNA Mismatch Repair
 - 80% Risk of Colon Cancer Development
 - Proximal (Right) Colon
 - Type II associated with Endometrial, Ovarian and Skin Cancers
 - 3 Relatives with Colon Cancer
 - Occurs Across 2 Generations
 - 1 Relative Diagnosed < 50 Years Old
 - Frequent Screening
 - Colectomy
 
Types of Hernias
- Hiatal
 - Gastroesophageal Reflux Disease (GERD)
 - Inguinal
 - Men
 - Femoral
 - Women
 - Incisional
 - Umbilical
 - Strangulation
 
Hernia Interventions
- Reduce Intra Abdominal Pressure
 - Avoid Straining and Lifting
 - Open Mouth Sneezing
 - Excision
 - Herniorrhaphy
 - Hernioplasty
 - Scrotal Support
 
Types of Intestinal Obstruction
- Adhesions
 - Hernia
 - Volvulus
 - Intussusception
 - Tumor
 - Mesenteric Artery Occlusion
 - Spinal Injury
 - Paralytic Ileus
 
Intestinal Obstruction
- Severe Abdominal Pain
 - Vomiting
 - High Pitched Bowel Sounds
 - Abdominal Distention
 - Increased Peristalsis
 - Absent Bowel Sounds
 - Paralytic Ileus
 
Meckel's Diverticulum
- True Diverticulum
 - Vitelline Duct
 - Yolk Stalk
 - Contain Ectopic Tissue
 - Pancreatic And Gastric Mucosa
 - Hemorrhage
 - Intussusceptions
 - Volvulus
 - 2 Feet From Ileocecal Valve
 - 2 Inches Long
 - 2% Population
 - First 2 Years Of Life
 - Pertechnetate T99
 
Hirschsprung Disease
- Failure of Neural Crest Cell Migration
 - Involves Rectum
 - Lack of Auerbach and Meissner Plexus
 - Chronic Constipation
 - Failure to Pass Meconium
 - Congenital Megacolon
 - Increased Risk with Down Syndrome
 - RET Mutations
 
Imperforate Anus
- Congenital Anorectal Malformation
 - No Anal Opening
 - Absence of Meconium
 - Gradual Increase in Abdominal Distention
 - Surgical Repair
 - Bowel Management
 
Whipple's Disease
- Tropheryma Whipplei
 - Gram-Positive
 - Middle-aged, Caucasian men and Farmers
 - Malabsorption
 - Mesenteric Nodes
 - Arthralgias
 - Cardiac Symptoms
 - Neurologic Symptoms
 - PAS-positive Foamy Macrophages
 
Celiac Disease Diagnosis and Treatment
- Blunting of Intestinal Villi
 - Lymphocytes in Lamina Propria
 - Anti-gliadin Antibodies (IgA)
 - Anti-endomysial Antibodies (IgA)
 - Anti-tissue Transglutaminase Antibodies (IgA)
 - Gluten-Free Diet
 - Corticosteroids
 - Dapsone
 - Intestinal Lymphoma
 
Celiac Disease Characteristics
- European Descent
 - HLA-DQ2
 - HLA-DQ8
 - Autoimmune-mediated Intolerance of Gliadin
 - Dermatitis Herpetiformis
 - Weight Loss
 - Failure to Thrive
 - Decreased Bone Density
 - Steatorrhea
 - Anemia
 
Fistula Causes
- FRIEND Mnemonic
 - Foreign Body
 - Radiation
 - Inflammation or Infection
 - Epithelialization
 - Neoplasm
 - Distal Obstruction
 
Mesenteric Ischemia
- Severe Abdominal Pain
 - Bloody Diarrhea
 - Metabolic Acidosis
 - Increased WBC
 - Increased Lactate (Lactic Acid)
 - X-ray
 - Air Within Bowel Wall
 - CT Angiography
 - Bowel Wall Edema
 - Antibiotics
 - Emergent Surgical Intervention