Firecracker Review 11/15 Flashcards Preview

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Flashcards in Firecracker Review 11/15 Deck (28):
1

C diff exotoxin a

enterotoxin)—chemoattracts neutrophils which release cytokines → mucosal inflammation and GI fluid loss

2

C diff exotoxin b

cytotoxin)—disrupts cytoskeleton by depolymerizing actin filaments → GI mucosal cell death → pseudomembranous colitis

3

death in copd

1) resp acidosis + hypercapnic resp failure
2) cor pulmonale
3) massive spontaneous pneumo

4

cyclosporine causes

hyperkalemia and renal failure

5

C diff diagnosis

cytotoxin assy --> most sensitive, gold standard
EIA
PCR

6

Entamoeba complications

toxic megalon, perforation
liver abscess
pericarditis

7

Shigella organisms

S. sonnei (most common in U.S.), S. flexneri (most common in developing countries), S. dysenteriae, and S. boydii

8

AKI - hypervolemia/hypovolemia

hypervolemia due to decreased GFR, activate RAS
hypovolemia due to increase in vascular permeability, causes salt/water wasting

9

UC etiology

genetic
immune system - ANCA
environmental
NSAID use

10

UC age at diagnosis

15-25
55-65

11

UC extraintestinal manifestations

Uveitis (inflammation of the middle layer of eye)
Pyoderma gangrenosum (necrotic ulcerations of legs)
Ankylosing spondylitis (chronic inflammation of the spine)
Primary sclerosing cholangitis (sclerosis of both intrahepatic and extrahepatic bile ducts)

12

UC colonoscopy/biopsy

friable erythematous mucosa
pseudopolyps
inflamm limited to submucosa and crypt abscesses

13

UC labs

anemia
increased CRP, ESR

14

X rays in UC

toxic megacolon
colonic perforation

15

UC Barium Enema

avoid if acute flair --> perforation
Microulcerations
Pseudopolyps
Narrowing of luminal wall

16

UC complications

severe bleeding
colorectal cancer
strictures, colonic perforation, toxic megacolon

17

UC treatment

topical, oral 5-ASA

18

CD mechanism

dysregulated proinflammatory response to the bacteria lining the walls of the GI tract, which ultimately results in the release of inflammatory substances that cause direct mucosal injury

19

CD age

15-30
60-70

20

CD in children

growth failure specifically refers to a vertical growth rate below the appropriate velocity for age.

21

CD in children - location

1) colon + ileum
2) ileum only
3) colon only

22

CD extraintestinal manifestations

same as UC + erythema nodosum

23

CD colonoscopy biopsy

skipped areas of inflammation, cobblestoning of the mucosa, strictures, and even pseudopolyps
transmural inflammation and granulomas

24

imaging study in CD

barium contrast, small bowel follow through

25

CD complication

intestinal strictures, perforation
fistulas, sinus tags
cancer

26

mild to moderate CD rx

mesalamine

27

severe CD rx

azothiopurine, 6mercapturine, MTX
infliximab, adalimuab

28

CD surgical interventions

obstruction, abscess, fistula or stricture formation, bowel perforation, toxic megacolon, and cance