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GIR Test 2 > B5-044 Inflammatory Bowel Disease > Flashcards

B5-044 Inflammatory Bowel Disease Flashcards

(81 cards)

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1
Q

deep and linear ulcerations in the terminal ileum and ascending colon with normal islands of tissue inbetween on colonoscopy

A

Crohn’s

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2
Q

transmural inflammation with primarily lymphoid aggregates on histology

A

Crohn’s

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3
Q

feeling of need to evacuate bowels urgently or painfully

A

tenesmus

signals rectal disorder

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4
Q

shallow ulcers in the rectum and descending colon on colonoscopy

none is transverse or ascending colon

A

UC

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5
Q

mucosal and submucosal inflammation with evidence of crypt abscesses on histology

A

UC

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6
Q

blood diarrhea
nocturnal diarrhea
weight loss
+/- improved with defecation

A

inflammatory bowel disease

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7
Q

improves with defecation
emotional triggers
non-bloody diarrhea
daytime only

A

irritable bowel syndrome

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8
Q

IBD is diagnosed clinically with

additional test necessary, 3

A
  • colonoscopy
  • radiography
  • histology
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9
Q

[…] with biopsy should be performed in suspected Crohn’s and UC, and neoplastic pathology

A

ileocolonoscopy

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10
Q

useful for distinguising IBD from IBS

A

fecal calprotectin

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11
Q
  • lesions may occur anywhere from mouth to anus
  • skip lesions
A

Crohn’s

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12
Q

Crohn’s has a higher indicidence in […]

females/male

A

females

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13
Q
  • weight loss
  • abdominal pain
  • nocturnal diarrhea
  • no rectal urgency
A

Crohn’s

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14
Q
  • glossitis
  • cobblestoning of oral mucose
  • perianal disease
  • fistulas
A

Crohn’s

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15
Q
  • non-caseating granulomas
  • full thickness inflammation
A

Crohn’s

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16
Q

extraintestinal manifestations of Crohn’s

lots, but i only listed the 4 she focused on

A
  • aphthous stomatitis
  • anterior uveitis with hypopion
  • erythema nodosum
  • pyoderma gangrenosum
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17
Q

indurated, erythematous nodules in the pre-tibial region

A

eythema nodosum

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18
Q
  • rapidly enlarging hemorrhagic non follicular pustule, surrounded by an erythematous halo
  • very painful
  • quickly ulcerates
A

pyoderma gangrenosum

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19
Q

complications of Crohn’s

4

A
  • strictures
  • fistula
  • abscesses
  • anal fissure

due to transmural inflammation

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20
Q

medication for symptom control in mild-moderate Crohn’s

A

5-ASA products

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21
Q

aim of treatment in Crohn’s

3

A
  • get the inflammatory process into remission
  • minimize negative health impacts of diagnosis and treatment
  • nutrition
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22
Q
  • medication used for symptom management/flairs of Crohn’s
  • start a moderate-high dose and taper
A

corticosteroids

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23
Q

medications used as adjuct Crohn’s treatment with biologics like TNF-a

A
  • thiopurine, azathiopurine
  • methotrexate
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24
Q

anti TNF medications used in achieving remission in Crohn’s

A

adalimumab
infliximab

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25
ant-integrin medications used in achieving Crohn's remission
natalizumab vedolizumab
26
anti-interleukin-12/23p40 mediation used in achieving Crohn's remission
ustekinumab | second line agent after failed treatment
27
test for [...] prior to starting the patient on anti-TNF therapy
TB
28
indications for surgery in Crohn's disease
strictures or fistulas
29
if terminal ileum is resected, what cannot be reabsorbed?
bile acids also issues with B12 absorption | causes steatorrhea and kiney stones
30
immunosuppressed Crohn's patients should be screened for | 2
cervical cancer pneumococcal vaccines
31
Crohn's patients on thiopurines should be screened for
skin/urinary tract cancer
32
Crohn's patients on corticosteroids should be screened for
osteoporosis
33
CRP and ESR are less likely to be elevated in
UC
34
UC patients are [...] likely to have systemic features than Crohn's patients | less, more, equally
less
35
* hematochezia * diarrhea * abdominal pain
UC
36
contigous disease
UC
37
extraintestinal manifestations of UC
primary sclerosing cholangitis
38
* "onion skin" bile duct * beads on a string bile duct
primary sclerosing cholangitis
39
primary sclerosing cholangitis increases the risk of what cancers? | 2
cholangiocarcinoma gallbladder | **start colon cancer screening early**
40
course treatment of UC depends on
current and previous severity presence of poor prognostic factors
41
first goal of UC therapy
remission
42
progression of treatment options for UC | where you'd start to where you'd go
1. 5-asa oral/rectal 1. rectal steroids 1. oral steroids 1. thiopurines 1. biologics
43
poor prognostic factors for UC
* over 40 at dx * extensive colitis * previous hospitalization for colitis * elevated CRP * low serum albumin
44
indications for surgery in UC
* toxic megacolon * hemorrhage * medical intractability * malignant degeneration
45
risks of colectomy
* increases risk of infertility * alters absorption
46
* shallow ulcerations * friable mucosa * may loose haustra
UC
47
* deep ulcerations * cobblestone mucosa * creeping fat * bowel wall thickening * linear ulcers * fissures
crohn's
48
* transmural inflammation * non-caseating granulomas * lymphoid aggregates
crohn's
49
Th1 mediated
Crohn's
50
* mucosal and sumucosal inflammation * crypt abscesses * neutrophilic infiltration * ulcers
UC
51
Th2 mediated
UC
52
skip lesions usually rectal sparing
crohns
53
contigous from rectum proximally
UC
54
most commonly terminal ileum and ascending colon
crohn's
55
# complications include * fistulas * phlegmon/abscess * strictures * perianal disease
crohns
56
# complications include fulminant colitis toxic megacolon perforation
UC
57
kidney stones gallstones
crohn's
58
primary sclerosing cholangitis
UC
59
MPO-ANCA P-ANCA
UC
60
* smoking may make symptoms better * patients present after cessation
UC
61
* smoking is a risk factor for developing * worsens course
crohns
62
anti-saccaromyces cervissiae antibodies
crohns
63
smoking cessation is associated with worsening of
UC
64
intracellular gram-negative cocci on proctitis swab
gonorrhea
65
proctitis with pustular discharge, rectal pain, and tenesmus
gonorrhea
66
remember to include [...] on the differential of proctitis
STIs
67
mesalamine is used for treatment of
UC
68
pustular proctitis + gram negative cocci =
gonorrhea
69
iron is absorbed in the
proximal small bowel
70
loss of the ileocecal valve can cause | 3
* bacterial overgrowth -> steatorrhea * B12 deficiency * decreased bile acid absorption
71
choleretic diarrhea occurs secondary to
decreased bile acid absorption | terminal ileum resection
72
once a patient has less than [...] cm of small bowel, sequelae of short gut syndrome may be seen
200
73
painful skin ulceration with irregular, raised borders and necrotic bed
pyoderma gangrenosum
74
pyoderma gangrenosum is associated with
IBD (both UC and crohns)
75
beads on a string
primary sclerosing cholangitis | UC
76
primary sclerosing cholangitis is associated with
UC
77
risk factors for the developmental of colorectal cancer in a patient with UC | 4
* extent of disease (pancolitis > left sided) * hx of colon cancer * primary sclerosing cholangitis * duration of disease (>after 8-10 years)
78
surgical option for UC with the least risk of infertility
subtotal colectomy
79
IBD medication safe to use in pregnancy
mesalamine
80
medication widely used for UC but not used for Crohns
mesalamine
81
medications that can be used to induce remission in IBD | 2
* infliximab * prednisone

GIR Test 2 (18 decks)

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