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Clinical Medicine III > GI: IBD & Celiac > Flashcards

GI: IBD & Celiac Flashcards

1
Q

This disease is chronic, relapsing-remitting GI inflammatory disorder.

A

IBD

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2
Q

Describe the bimodal peaks of age related to IBD

A

15-35 and 50-80

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3
Q

What three factors are hypothesized to cause IBD?

A

autoimmune
genetic
environment

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4
Q

5 red flag sxs for IBD…

A 
severe bleeding
severe pain
dysphagia
dehydration
obstruction
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5
Q

Crohn or UC?

Mouth to Anus
(+) Skip lesions
Full-thickness, transmural inflammation

A

Crohn

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6
Q

Crohn or UC?

Colon + Rectum
Extends proximally
(-) skip lesions, continuous
Mucosal layer only

A

UC

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7
Q

Crohn manifestations in oral cavity…

A

apthous ulcers

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8
Q

MC Crohn manifestation in ileum…

A

ileitis

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9
Q

Crohn manifestation in terminal ileum & proximal asc. colon?

A

ileocolitis

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10
Q

Crohn manifestation in the colon…

A

crohn colitis

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11
Q

Crohn manifestation in anus/rectum

A

perianal disease (abscess/fistula)

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12
Q

Crohn is known as a penetrating disease… this means what four complications can occur?

A

ulcer
stricture
fistula
abscess

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13
Q

Describe the onset of sxs of Crohn disease…

A

insidious onset, intermittent/relapsing-remitting sxs

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14
Q

Mild/Mod/Severe Crohn:

inflammation + stricture

A

moderate

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15
Q

Mild/Mod/Severe Crohn:

Inflammation + stricture + fistula

A

Severe

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16
Q

What is the MC extra-intestinal manifestation of Crohn Disease?

A

arthralgia

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17
Q

What are three Crohn/UC manifestations that can occur in the eyes?

A

episcleritis, iritis, uveitis

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18
Q

What are two Crohn/UC manifestations that can occur on the skin?

A

erythema nodosum, pyoderma gangrenosum

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19
Q

Pt. p/w abd. pain, diarrhea, +/- NV, perianal disease and anemia.

What is this presentation concerning for?

A

Crohn Disease

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20
Q

What is the best way to Dx crohn disease?

A

colonoscopy + bx

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21
Q

What would you expect to see on colonoscopy + Bx with Crohn disease?

A

Colonoscopy: ulcerations/cobblestoning

Bx: granulomas

22
Q

Describe the effectiveness of 5-ASA on crohn disease?

A

minimally effective

23
Q

what can corticosteroids be used for in crohn disease?

A

acute flares

24
Q

What two drugs can be used alone or in combo for moderate/severe crohn disease?

A

immunomodulators +/- biologics

25
Q

When can Abx (cipro, metronidazole) be used for crohn disease?

A

if abscess/fistula

26
Q

The below are complications of crohn or UC?

abscess
strictures
fistula
obstruction
colon CA
malabsorption
A

crohn

27
Q

A pt. p/w the below, concerning for…

lower abd. pain
bloody diarrhea
fecal urgency + tenesmus
+/- anemia/hypovolemia

A

UC

28
Q

How can you diagnose UC?

A

sigmoidoscopy/colonoscopy + bx

29
Q

the below, found on colonoscopy is concerning for…

diffuse friability
erosions
bleeding

A

UC

also seen on sigmoidoscopy

30
Q

Crypt abscesses seen on Bx are suggestive of…

A

UC

31
Q

What are two complications of UC?

A

toxic megacolon

colon CA

32
Q

What can worsen the sxs of both UC and Crohn Disease and should therefore be avoided?

A

NSAIDs

33
Q

What labs can be helpful in dx of UC/Crohn?

A

CBC, CMP, CRP/ESR

34
Q

if an IBD patient is developing diarrhea/change in baseline stool habit, what should be ordered?

A

stool studies

35
Q

The below are indications for what IBD tx?

severe hemorrhage
perf
CA
refractory disease

A

surgery

36
Q

taking Anti-TNF (biologics) drugs can leave patients susceptible to what two diseases, so they must be screened before tx begins?

A

TB and HBV

37
Q

imaging is not required for CD dx, but which imaging studies can be ordered/may be helpful?

A

CT/MR enterography

UGI + SBFT

Capsule endoscopy (C/I if stricture)

38
Q

(+) String Sign on UGI w. SBFT indicates…

A

Crohn Disease

39
Q

What category of UC? Mild/Mod/Sev…

> 4 stools daily + anemia + low grade fever

A

moderate

40
Q

What category of UC? Mild/Mod/Sev…

> 6 stools daily, systemic toxicity

A

severe

41
Q

What imaging may be helpful in the evaluation of UC?

A

CT A/P

42
Q

5-ASA is primarily used for…

A

mild/mod UC

43
Q

Thiopurines can take how long to begin working?

A

3-6 mo

44
Q

What two genes may genetically predispose somebody for celiac disease?

A

HLA DQ2 and DQ8

45
Q

A patient presents with:

diarrhea, steatorrhea, flatulence/bloating and wt. loss

This is concerning for…

A

malabsorption, celiac disease

46
Q

What are three atypical sxs of celiac?

A

abd. pain, constipation, dyspepsia

47
Q

These are burning, pruritic lesions that are erythematous and papular +/- vesicles. They are assoc. w. celiac disease

A

dermatitis herpetiformis

48
Q

What are three main extra-intestinal sxs of celiac disease?

A

dermatitis herpetiformis
IDA
Osteoporosis

49
Q

Celiac disease is identified via ________ and confirmed via ________

A

ID: serology (elevated tTG IgA)

Confirm: duodenal biopsy w. villous atrophy

50
Q

testing for celiac is done on a gluten free or gluten containing diet?

A

gluten containing

51
Q

How is celiac treated?

A

gluten free diet

52
Q

What are two main complications of celiac disease?

A

nutrient deficiency

lymphoma

Clinical Medicine III (21 decks)

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