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Gastrointestinal > Inflammatory Bowel Disease > Flashcards

Inflammatory Bowel Disease Flashcards

1
Q

What is inflammatory bowel disease?

A

A dysregulated, inappropriate response of the intestinal immune system, to an otherwise innocuous luminal antigens, in a genetically susceptible host

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2
Q

What are the three types of crohn’s disease?

A

ileitis
colitis
ileocolitis

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3
Q

UC or CD: diffuse mucosal inflammation limited to the colon

A

UC

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4
Q

UC or CD: affects rectum

A

UC

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5
Q

UC or CD: patchy, transmural inflammation

A

CD

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6
Q

UC or CD: may affect any part of the GI tract

A

CD

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7
Q

UC or CD: may involve all or part of the colon, but no further

A

UC

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8
Q

Who usually has UC?

A

Young people 20-30s

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9
Q

What is the effect of smoking on UC? CD?

A

Lowers UC, increases CD

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10
Q

What is the effect of an appy on UC? CD?

A

Lowers CD, no effect on CD

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11
Q

What is the effect of high sanitation in childhood on UC? CD?

A

No effect on UC

Increases CD

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12
Q

What is the effect of high carb intake on UC? CD?

A

UC no effect

Increases CD

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13
Q

What is the effect of perinatal infection on UC? CD?

A 
UC = ?
CD = increases
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14
Q

What is the dysbiosis theory of IBD?

A

Decrease protective bacteria, increased aggressive bacteria

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15
Q

What are the effect of dysregulated immune response on IBD?

A

Loss of tolerance

Defective apoptosis

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16
Q

What is the cytokine that causes Th0 cells to turn into Th1 cells?

A

IL-12

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17
Q

What is the cytokine that causes Th0 cells to turn into Th3 cells?

A

IL-10

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18
Q

What is the role of Th1 cells in IBD?

A

cell mediated granulomas

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19
Q

What is the role of TH2 cells in IBD?

A

Hypersensitivity

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20
Q

Which has a higher genetic influence: CD or UC?

A

CD

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21
Q

What is the gene that transmits IBD susceptibility?

A

Polygenic

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22
Q

What are the three factors that lead to the development of IBD?

A

Luminal antigen
Genetic susceptibility
Environmental triggers

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23
Q

What is the usual presentation of UC?

A

Bloody diarrhea
Rectal discomfort
Fecal urgency
Abd cramping

24
Q

Is UC transmural?

A

no

25
Q

What is proctitis? Proctosigmoiditis?

Pancolitis?

A

UC at the various flexures

26
Q

What are the four presentations of CD?

A

Inflammation
Obstructuion
Fistualization
Microperforation

27
Q

What is the most common site of CD?

A

ileum and cecum

28
Q

Which has perianal diseases: CD or UC?

A

CD

29
Q

Obstruction usually occurs in CD or UC? Why?

A

CD d/t fibrosis of the wall

30
Q

What are the signs of a retroperitoneal fistualization with CD?

A

Psoas abscess sign

31
Q

Skips lesions = ?

A

CD

32
Q

Cobblestoning appearance =?

A

CD

33
Q

Granulomas is found in CD or UC?

A

CD

34
Q

True or false: the rectum is usually spared in CD

A

True, but it can involve

35
Q

What are the mouth symptoms of IBD?

A

APthous stomatitis

36
Q

What are the eye symptoms of IBD?

A

Episcleritis and uveitis

37
Q

What are the joint symptoms of IBD?

A

Arthritis

38
Q

What affects the risk of osteopenia with IBD?

A 
cytokines
IBD meds (corticosteroids)
39
Q

WHich joints are usually affected in IBD?

A

Wrist, knee, ankle

40
Q

What are the skin manifestations of IBD?

A

P. Gangrenosum
vascular complications
E. Nodosum

41
Q

What are the goals of IBD treatment?

A

Obtain remission

Avoid long term toxicity

42
Q

What are the drugs used to obtains remission induction in UC?

A

aminosalicylates
Corticosteroids
6MP

43
Q

What are the drugs that are used to maintain remission in UC?

A

6MP

Aminosalicylates

44
Q

What are the drugs used to obtains remission induction in CD?

A

Aminosalicylates
Abx
Corticosteroids

45
Q

What are the drugs that are used to maintain remission in CD?

A

Abx
Immunomodulators
Aminosalicylates

46
Q

What are the indications for metronidazole use in IBD?

A

Active DC

Perianal disease

47
Q

What are topical corticosteroids indicated for IBS? Systemic?

A

Proctitis and left-sided colitis

moderate to severe CD

48
Q

What is the MOA of azathioprine?

A

Purine analogue (HGPRT)

49
Q

What is the MOA of 6 mercaptopurine

A

Purine analogue (HGPRT)

50
Q

What are the adverse effects of 6MP?

A

Fever, rash
Pancreatitis
Hepatitis

51
Q

What is the MOA of methotrexate?

A

inhibits dihydrofolate reductase

52
Q

What are the antibody drugs used in IBD? What is this particularly useful for?

A

Infliximab

Fistulas

53
Q

What are the indications for surgery in UC? (4)

A
  • Exsanguinating hemorrhage
  • Perforation
  • CA
  • Unresponsive acute disease
54
Q

What is the most common surgery for UC?

A

Ileal pouch-anal anastomosis

55
Q

What are the indications for surgery in CD?

A
  • Free perforatio
  • Massive hemorrhage
  • CA
  • Chronic obstructions
56
Q

What is strictureplasty?

A

Maintain the bowel, but push it together and sew it up vertically (see slide) This saves intestines

57
Q

What is the antibody that is effective for CD?

A

anti-TNF

Gastrointestinal (42 decks)

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