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Flashcards in 28. Cases Deck (28):
1

What are the main sx of celiac disease?
Main extraintestinal manifestation?

FTT, fatigue, diarrhea, flatulence, weight loss
Dermatitis herpetiformis

2

Diagnosis of celiac disease?

Anti-deaminated gliadin, tissue trans-glutaminase, endomysial IgA (also IgG for deam gliadin)
Confirmatory biopsy

3

Celiac disease increases the risk for what malignancy?

T cell lymphoma

4

What HLA is associtated with celiac disease?

HLA DQ2
HLA DQ8

5

What marker identifies T cell specificity in celiac disease?

NKG2D

6

Definitive dx of celiac sprue must include:

1. Clinical documentation of malabsorption
2. Small bowel biopsy
3. Improvement in sx in and histology with GFD

7

What is the drug that is most commonly used for IBD?

Infliximab (anti-TNFalpha)

8

Who more commonly gets crohn's disease?
Association with smoking

Caucasians and women
Smoking is a risk factor

9

What is the gross morphology of an intestine with Crohn disease?

Creeping fat
Wall thickening and narrowed lumen
Linear ulcers
Cobblestone mucosa

10

What are the microscopic features seen in Crohns

Skip lesions
Crypt acscess
Architectural distortion
Transmural inflammation
Granulomas (50%)

11

What are the main complications of Crohn's disease?

Fibrosing strictures
Fistulas
Protein losing enteropathy
Malabsoprtion and pernicious anemia
Steatorrhea
Increased risk for GI cancer

12

What are the extraintestinal manifestations of Crohn's

Migratory polyarthritis
Sacroilitis
Ankylosing spondylatitis
Erythema nodosum
Uveitis
Systemic amyloidosis

13

UC is limited to the colon with __% having backwash ileitis in severe pancolitis

10%

14

Gross morphology of UC

Reg, granular, friable mucosa
Ulceration
Pseudopolyps
Non-thickened wall **

15

Microscopic features of UC

Cryptitis and crypt abscesses
No granulomas
Inflammation limited to mucosa and submucosa
Architectural distortion

16

What are the main complications of UC?

Toxic megacolon
Bowel perforation
Uncontrollable C. diff infection
GI carcinoma

17

What does inflammation in UC progress through to carcinoma?

Dysplasia

18

What are the extraintestinal manifestations of UC?

Migratory polyarthritis
Sacroilitis
Ankylosing spondylitis
Uveitis
Pericholangitis
Primary sclerosing cholangitis **

19

Does Crohn's or UC have skip lesions?

Crohns

20

Does Crohn's or UC have the potential for toxic megacolon?

UC

21

Does Crohn's or UC have the potential for perianal fistula?

Crohns

22

Does Crohn's or UC have the potential for fat/vitamin malabsorption?

Crohns

23

Does Crohn's or UC have recurrence after surgery?

Crohns

24

Does Crohn's or UC have inflammation limited to the mucosa?

UC

25

Does Crohn's or UC have wall thickening?

Crohns

26

Does Crohn's or UC have strictures?

Crohns

27

What is a pseudomembrane?

Plaque-like adhesion of fibrinopurulent necrotic debris overlying sites of mucosal injury

28

How is the diagnosis of pseudomembranous colitis made?

Detection of the toxin in the stool