EXAM #1: INFLAMMATORY BOWEL DISEASE Flashcards Preview

Gastrointestinal System > EXAM #1: INFLAMMATORY BOWEL DISEASE > Flashcards

Flashcards in EXAM #1: INFLAMMATORY BOWEL DISEASE Deck (44):
1

What is IBD?

Dysregulated response of the intestinal mucosa to otherwise innocuous luminal antigens

2

What are the two major diseases that make-up IBD?

1) Ulcerative Colitis
2) Crohn's Disease

3

What are the "other" minor diseases associated with IBD?

1) Microscopic colitis
2) Diversion colitis
3) Diverticular colitis
4) Pouchitis

4

What are the characteristic features of UC?

- Diffuse mucosal inflammation
- Limited to colon

5

What are the characteristic features of CD?

- Patchy transmural inflammation
- May affect any part of the GI tract, but most commonly ileum

6

What are the alternate causes of colitis other than UC and CD?

1) Radiation
2) Ischemia
3) Medications

7

What environmental factor is protective in UC and a risk factor for CD?

Smoking
- Protective in UC
- Risk factor for CD

8

What surgical procedure is protective against UC?

Appendectomy

9

What are the different processes that lead to the development of IBD?

1) Persistent infection
2) Defective mucosal integrity
3) Dysbiosis (imbalance between protective and aggressive flora)
4) Dysregulated immune response

10

What lymphocyte system plays the biggest role in the development of IBD?

T-lymphocytes

11

Which type of T-cell response is associated with CD?

Th1

12

Which type of T-cell response is associated with UC?

Th2

13

What is the genetic influence on IBD?

Familial occurrence that is POLYGENIC

14

Describe the typical clinical presentation of UC.

- Bloody diarrhea= most common symptom
- Recal discomfort
- Fecal urgency
- Abdominal cramping

15

Where does UC start?

Begins in the rectum and extends proximally

16

What is Proctitis?

UC involving rectum only

17

What is Proctosigmoiditis?

UC involving rectum and sigmoid colon

18

What is Extensive disease in UC?

UC extending into transverse colon

19

What is pancolitis?

UC involving the entire colon/

20

What is a "lead pipe sign" pathogmnemonic for?

UC

21

Are obstruction and fistulization associated with CD or UC?

CD

22

Small bowel involvement of IBD leads to what diagnosis?

CD

23

Describe the typical clinical presentation of CD.

- Abdominal pain (RLQ)
- Diarrhea
- Low grade fever
- Anorexia

24

What are clinical signs of obstruction seen in CD?

- Post-parandial cramps
- Abdominal distention
- Borborygmi
- Vomiting
- Weight loss from food avoidance

25

What are clinical signs of an enterovesical fistula?

1) Recurrent UTI
2) Pneumaturia (air w/ urination)

26

Describe the gross appearance of CD.

"Cobblestone mucosa"

27

What are the distinguishing features of CD?

1) Granuloma formation
2) Skip lesions
3) Fistulization
3) Small bowel involvement
4) Perianal disease

28

What are the extraintestinal manifestation of IBD?

- Aphthous stomatitis (CD)
- Episcleritis and uveitis
- Arthritis
- Vascular complications
- Erythema nodosum
- P. gangrenosum

29

Why are patients with IBD at risk for osteopenia?

1) Inflammation/ cytokines
2) IBD medications i.e. corticosteroids

30

What is primary sclerosing cholangitis?

Disease of bile ducts that causes inflammation and obliterative fibrosis

*Seen most often with UC*

31

What are the major categories of medications that are used to manage IBD?

1) Aminosalicylates
2) Corticosteroids
3) Immunomodulators
4) Antibiotics
5) Supportive agents

32

How is remission induced in UC?

1) Aminosalicylates
2) Corticosteroids
3) 6MP/ Azathioprine
4) Cyclosporine

33

How is remission maintained in UC?

1) Aminosalicylates
2) 6MP/ Azathioprine

34

How does the management of CD significantly differ from UC?

Addition of Antibiotics

35

What are the indications for Metronidazole?

1) Active Crohn's
2) Perineal disease
3) Post-op Crohn's
4) Pouchitis

36

What are the adverse effects of Metronidazole?

Nausea
Metallic taste
Furry tongue
Candidiasis
Peripheral neuropathy

37

What are the indications for topical corticosteroids?

Proctitis
Left-sided colitis

38

What are the indications for systemic corticosteroids?

Moderate to severe UC or CD

39

What are the indications for parenteral corticosteroids?

Severe/ toxic UC or CD

40

What are the adverse effects of 6MP/ Azathioprine?

1) Hypersensitivity
2) Bone marrow suppression
3) Opportunistic infection
4) Lymphoma risk

41

What are the indications for surgery in UC?

1) Severe bleeding
2) Perforation
3) Cancer/ dysplasia
4) Unresponsive acute disease

42

What are the surgical option is the standard of care for UC today?

Ileal pouch-anal anastamosis (most common)

43

What are the indications for surgery in CD?

1) Perforation
2) Hemorrhage
3) Cancer/ dysplasia
4) High grade obstruction risk

44

What is the preferred surgical procedure for a stricture in CD?

Strictureplasty