OnlineMedEd: Gastroenterology - "IBD" Flashcards
1
Q
Review the following for ulcerative colitis: • Population •Endoscopy •Biopsy •Patient presentation •Cancer •Extraintestinal manifestations •Surgery
A
- Population: 20-30 yo
- Endoscopy: continuous inflammation starting in the rectum
- Biopsy: superficial inflammation with crypt abscesses
- Patient presentation: bloody diarrhea
- Cancer: hugely increased risk of colorectal cancer –start screening 8 years after symptom onset
- Extraintestinal manifestations: PSC and pANCA
- Surgery: colectomy curative
2
Q
Review the following for Crohn's: • Population •Endoscopy •Biopsy •Patient presentation •Cancer •Extraintestinal manifestations •Surgery
A
- Population: young people 20-30 and older people 50-75
- Endoscopy: skip lesions anywhere in the GI tract
- Biopsy: transmural inflammation with granulomas
- Patient presentation: watery diarrhea
- Cancer: no increased risk of cancer!
- Extraintestinal manifestations: fistulas, strictures, B12 deficiency and fat malabsorption (due to inflammation in the terminal ileum), osteopenia and iron deficiency due to duodenal inflammation
- Surgery: for fistulas
3
Q
Review the treatment tiers for IBD.
A
•Mild:
- 5-ASA compounds (like sulfasalazine), which is a topical intraluminal agent for UC
• Moderate:
- Immune modulators (6-MP, azathioprine, methotrexate)
• Severe:
- Infliximab (for Crohn’s)
- Colectomy (for UC)
4
Q
Steroids should only be used for _____________.
A
flares –never chronically
5
Q
In IBD flare-ups, you need to rule out ______________.
A
infection
In fact, all IBD flare-ups should be treated with steroids and antibiotics.
6
Q
What antibiotics should you use for IBD flare-ups?
A
Ciprofloxacin and metronidazole
