Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clin Med III > IBD > Flashcards

IBD Flashcards

1
Q

Pathophysiology of IBD

A

immunologic

genetic

environmental

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

IBD age group affected

A

15-35 y/o

bimodal second peak at 50-80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

men are more likely to get UC or CD

A

UC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

female are more likely to get UC or CD

A

CD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

smoking increases or decreases risk of CD

smoking increases or decreases risk of UC

A

increases

decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

with IBD, what impacts clinical presentation, dx eval, mgmt, and complications

A

extent and severity of involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

mouth to anus

patchy/skip lesions

transmural inflammation

A

crohn’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

limited to colon, involves rectum

extends proximally with continuous circumferential involvement

mucosal layer inflammation

A

UC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

most common form of crohn’s disease

A

ileitis (affects ileum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

if crohns impacts the colon, what is it called

A

Crohn colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

is perianal disease possible in crohn’s disease

A

yes - abscess, fistula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

which is a penetrating disease - ulcers, strictures, fistulas, abscesses?

A

CD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

clinical presentation of MILD crohns

A

inflammation

insidious onset, intermittent usually (alternates between exacerbations and relative remission)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

clinical presentation of MODERATE crohns

A

inflammation + strictures

insidious onset, intermittent usually (alternates between exacerbations and relative remission)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

clinical presentation of SEVERE crohns

A

inflammation + strictures + fistula

insidious onset, intermittent usually (alternates between exacerbations and relative remission)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

abdominal pain in RLQ pain and tenderness

tender, palpable RLQ mass if abscess

what dx?

A

Crohn’s

RLQ - due to terminal ileal involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

if terminal ileal involvement with CD, what vit def will you see

A

b12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

most common extra-intestinal manifestation of crohn’s disease

A

arthralgias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

other extra-intestinal manifestations of crohn’s

A

oral aphthous ulcers

episcleritis, iritis, uveitis

ecythema nodosum

pyoderma gangrenosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

dx of CD

A

colonoscopy with TI intubation

+/- EGD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

imaging of CD (if needed)

A

+/- CT or MR enterography

+/- UGI with SBFT

+/- capsule endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

when do you not use capsule endoscopy with crohn’s

A

suspected intestinal stricture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What do you find on colonoscopy for Crohns

A

skip lesions

ulcerations

cobblestoning

granulomas

rectal SPARING in most pts

MAYBE fistulas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

3 complications of crohn’s disease

A

colon cancer

intestinal strictures, abdominal and perianal fistulas, abscess which can lead to small bowel obstruction and perforation

malabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
when is a colonoscopy recommended with crohns
every 1-2 years beginning 8 years after disease/symptom onset
26
with crohn's disease what can intestinal strictures, abdominal and perianal fistulas and abscess lead to
small bowel obstruction and perforation
27
UC affects what part of the GI tract
colon ONLY
28
continuous, circumferential pattern - CD or UC
UC
29
mucosal surface of colon only that causes friability, erosions, and bleeding - UC or CD
UC
30
mild UC clinical presentation disease course
less than 4 stools daily, no systemic toxicity
31
moderate UC clinical presentation disease course
more than 4 stools/day, anemia, low grade fever
32
severe UC clinical presentation disease course
more than 6 stools daily, systemic toxicity
33
onset of UC
insidious with intermittent exacerbations and remission
34
UC or CD: periumbilical/LLQ pain bloody diarrhea fecal urgency, tenesmus, rectal bleeding constipation (if proctitis)
UC
35
extra-intestinal manifestations of UC
episcleritis, iritis, uveitis erythema nodosum pyoderma gagrenosum sclerosing cholangitis arthralgias
36
most common extra manifestational symptom of UC
arthralgias
37
UC dx eval (one in red)
flex sigmoidoscopy colonoscopy **preferred over flex to see extent of disease
38
what will you see with flex sig or colonoscopy with UC
begins distally and spreads proximally continuous circumferential pattern WITHOUT skip lesions superficial inflammation: erythematous, exudate, friability/erosions
39
what does a biopsy show from flex sig or colonoscopy for UC
crypt abscesses
40
UC complications
colon cancer hemorrhage toxic megacolon
41
colonoscopy recommended when with UC
every 1-2 years beginning 8 years after disease/symptom onset
42
descrive toxic megacolon (complication of UC)
high mortality rate rare colonic dilation of greater than 6 cm with signs of toxicity
43
CD and UC mgmt goals
achieve remission maintain remission improve quality of life
44
antibiotics used in CD or UC
CD
45
4 medical tx for both CD and UC 1 for CD
salicylates (5-ASA) corticosteroids immunomodulators biologics antibiotics (CD)
46
when do you use step-up tx management for tx of IBD
low risk pts with mild disease
47
when do you use step-down tx to tx IBD
high risk pts with moderate to severe disease
48
side effects of 5-ASA
diarrhea kidney injury pancreatitis
49
anti-inflammatory meds for IBD. what class
5-ASA
50
anti-inflammatory meds with immune system suppression - what class
corticosteroids
51
when do you do corticosteroids in IBD
flares in UC and CD
52
what three things should you remember about corticosteroids
SLOW TAPER have an exit strategy to avoid steroid dependence short-term use ONLY
53
what should you be cautious of with oral prednisone
systemic side effects
54
when do you recommend DEXA scan with oral prednisone
if pt with IBD has had a lifetime use of steroids for 3+ mos
55
what should be given with oral prednisone
calcium and vit D
56
modifies immune system activity and decreases inflammatory response what med class
immunomodulators
57
what should you consider with 6MP and Azathioprine (imuran)
optimal response takes 3-6 months so may need to bridge them with another med be aware of systemic risks
58
what should you be aware of with methotrexate
folate supplementation tetraogenic (M and F need to be off meds for 6 mos before conceiving)
59
three immunomodulators
methotrexate 6-MP imuran
60
with immunomodulators what needs to be monitored
CBC and liver tests
61
biologics AKA
Anti-TNF
62
when do you use biologics
moderate to severe IBD modulates immune response, prevents inflammation, improves mucosal healing
63
what is something a provider should be aware of when tx with biologics
decreased or lost response to med
64
what should you consider before anti-TNFs are given
PPD test CXR for TB Hep B assessment + vaccine if needed
65
clinical monitoring of TNFs
regular CBC + CMP annual dermatologic exams
66
when do you give antibiotics and why
CD for perianal disease, fistulas, abscesses!!!
67
what two antibiotics can you give with CD
cipro and metro
68
cipro adverse effects
tendinitis photosensitivity prolongation of QT interval - arrhythmia
69
metro adverse effects
periph neuropathy metallic taste disulfram rx
70
IBD red flags
severe bleeding - sig anemia severe abdominal pain - peritoneal signs (guarding, rigidity, rebound tenderness) inability to tolerate PO signs of dehydation - increased creatinine, tachy, hypotension signs of obstruction
71
IBD indications for surgery
severe hemorrhage perforation dysplasia/cancer refractory disease not responding to medicine
72
risk factors assoc with aggressive IBD
high risk anatomic locations like perianal region, extensive disease penetrating/fistualizing disease steroid resistance/dependence severe disease activity - maplabsorption as evid by weight loss, nutrient def, hypoalbuminemia) young age
73
IBD primary care considerations: what should you always check if someone has a change in baseline stool habits
stool samples - want to make sure it is not bacterial/viral/etc
74
IBD: what can exacerbate disease
NSAIDS
75
health maintenance things primary care should be aware of
immunizations cancer screenings DEXA anxiety/depression smoking cessation routine lab monitoring of CBC and CMP
76
celiac age presentation
10-40 y/o
77
gluten toxicity to small intestines results in what
mucosal inflammation --> crypt hyperplasia --> abnormal villous architecture villous atrophy which results in loss of absorptive surface capacity and small bowel malabsorption
78
3 assoc with celiac disease
genetics: HLA DQ2, HLA DQ8 autoimmune: thyroid, DM downs
79
classic celiacs
diarrhea, steatorrhea, flatulence/bloating, weight loss
80
atypical celiac
pain, constipation, dyspepsia
81
silent celiac
extra intestinal manifestations (like anemia)
82
derm symptom found in celiac disease
dermatitis herpetiformis - chronic inflammatory disease that produces lesions that burn and itch. erythematous and slightly papular or pustular; sometimes vesicles
83
3 ways to establish celiac dx
serologic testing clinical suspicion endoscopic findings
84
what must be done on a gluten containing diet for accurate dx of celiac
serology and biopsy of small intestine will find positive serologic antibody testing = igA tissue transglutaminase
85
what antibody is primarily assoc with celiac disease
IgA tissue transglutaminase tTG Ab
86
Gold standard for dx of celiac disease
EGD with duodenal biopsy find villous atrophy
87
CELIAC: mgmt acronym
Consultation with dietitian Education about disease Lifelong adherence Identification and tx of nutritional def Access to advocacy group/resources Continuous follow-up
88
complications with celiac disease
malabsoprtion - Fe, B vit, osteoporosis malignancy - non-Hodgkin, GI malig

Clin Med III (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions