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| Chapter 11 Workbook |
LEARNER OBJECTIVES
At the completion of this chapter, the learner will be able to:
Section 2: Physiology of the Colon
2.1 Explain the function of the colon.
2.2 Describe the anatomy of the colon.
2.3 Describe the role of the colon in absorption and secretion.
2.4 Explain colon motility.
2.5 Explain the role of the colon in digestion.
Section 3: Specific Colon Diseases
3.1 Discuss colon polyps and cancer.
3.2 Describe the epidemiology of colon cancer and the predisposing causes.
3.3 Explain the use of CEA in diagnosis and follow-up of patients
with colon
cancer.
3.4 Discuss the polyp-carcinoma sequence as related to colon cancer.
3.5 Explain the pathophysiology of diverticulosis.
3.6 Discuss colonic obstruction, including causes, diagnosis, and
treatment.
3.7 Define irritable bowel syndrome.
3.8 Explain the Manning criteria and how to make a positive
diagnosis of an
irritable bowel.
3.9 Describe the treatment of irritable bowel and the approach to
differential
diagnosis.
3.10 Discuss fecal incontinence, including pathophysiology,
symptoms, and
treatment.
3.11 Define constipation.
3.12 Discuss the differential diagnosis of constipation.
3.13 Explain management of constipation.
3.14 Discuss infections of the colon, including Shigella,
Salmonella, Clostridium
difficile, Entamoeba
histolytica, Balantidium coli, and Blastocystis hominis.
3.15 Discuss intestinal nematode infections, including roundworm,
hookworm,
whipworm, pinworm and
strongyloides stercoralis.
3.16 Define microscopic colitis and eosinophilic colitis.
Section 4: The Anal Canal
4.1 Describe the anatomy of the anal canal and anorectal spaces.
4.2 Explain the symptoms associated with anorectal pathology.
4.3 Describe the examination process of the anorectum.
4.4 Define hemorrhoids, including diagnosis and treatment.
4.5 Describe fistula-abscess disease, including classical signs and
management.
4.6 Discuss sexually transmitted diseases of the anorectum,
including
venereal warts, syphilis, and
Herpes simplex 2.
Section 5: Lower Gastrointestinal Bleeding
5.1 Differentiate major and minor gastrointestinal bleeding,
including diagnosis,
investigation of the source, and
treatment.
LEARNER WORKBOOK
EXERCISE 1
1.1 The colon contributes to three important functions in the body.
What are they?
1.2 Briefly describe the anatomy of the colon.
1.3 Explain the following statement.
The fundamental feature of
colonic transport that enables efficient
water absorption is the ability
of the colonic mucosa to generate a large
osmotic gradient between the
lumen and the intercellular space.
1.4 The regulation of water and electrolyte transport in the colon
involves
the complex interplay between
________________, ________________,
and ___________________
regulatory pathways.
1.5 Several fundamental contractile patterns exist within the colon.
Define six contractile patterns.
1.6 Briefly explain the role of the colon in digestion.
EXERCISE 2
2.1 List five presenting features of colon cancer.
2.2 Explain the Dukes' classification used to stage colon cancer
after
surgical resection.
2.3 What is CEA?
2.4 Three histologic types of adenomatous polyps occur: tubular,
tubulovillous,
and villous. Briefly explain
each.
2.5 Particular conditions have been associated with an increased
risk of
colon cancer. List three.
2.6 What is diverticulitis?
2.7 List three complications of diverticulitis.
2.8 Describe the presenting symptoms of patients with colonic
obstruction.
2.9 List eight causes of colonic obstruction.
2.10 What is the irritable bowel syndrome?
2.11 Briefly explain the Manning criteria for making a positive
diagnosis
of irritable bowel.
2.12 Fill in the following table:
| Drug therapy in
irritable bowel syndrome: |
| Symptom |
Drug |
Dosage |
| Abdominal pain |
| Constipation |
| Diarrhea |
| Abdominal bloating,"gas" |
2.13 Explain the physiology of defecation.
2.14 Define fecal incontinence and discuss its pathophysiology,
diagnosis,
and treatment.
2.15 Define constipation and discuss its causes, symptoms,
diagnosis, and treatment.
2.16 Match the following:
Infections
of the Colon
1. Salmonella
2. Shigella
3. Clostridium difficile
4. Entamoeba histolytica
5. Balantidium coli
|
Causative
Organism
a. A parasite causing amebiasis
infection
b. Spore-forming gram-positive
bacterium
c. A ciliated protozoan
d. Gram-negative bacterium
e. Invasive bacterium causing
septicemia
f. A yeast |
2.17 Explain the differences between roundworm, hookworm, whipworm,
and pinworm.
EXERCISE 3
3.1 Explain the anatomy of the anal canal.
3.2 List three common lesions that cause anorectal pain.
3.3 Explain the difference between spontaneous prolapse and complete
rectal prolapse.
3.4 Outline the examination process for patients undergoing
examination of
the anorectum.
3.5 Briefly describe each of the following anorectal problems,
including
diagnosis and treatment:
hemorrhoids, fissure in ano, fistula-abscess
disease, pilonidal disease.
3.6 Explain three sexually transmitted diseases of the anorectum.
EXERCISE 4
4.1 What are the two most common causes of major lower GI bleeding?
4.2 Explain the process for investigating a lower GI bleed.
4.3 List eight common causes of minor GI bleeding.
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