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Flashcards in IBD popcorn Deck (23)
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1
Q

Smoking ↑ risk

A

Crohn’s Disease

2
Q

Smoking ↓ risk

A

Ulcerative Colitis

3
Q

Condition?

  • Mouth –> Anus
  • Transmural
  • Causes fistulas
  • MC site : Distal Ileum
  • 1/3 w/ perianal dz (fistula/fissure/abscess)
  • Aphthous ulcer
A

Crohn’s

4
Q

Condition?

  • Chronic, int, NOCTURNAL NON-bloody diarrhea
  • “Colicky” RLQ pain / mass
A

Crohn’s

5
Q

Condition?

  • Skip lesions
  • Rectal sparing!!
  • “string sign” on small bowel follow thru

1st line Tx?

A

Crohn’s

1st line Tx:

  • Step up (5-ASA- Salicylates) = Mesalamine or Sulfalazine
  • Immunomodulator= Azathioprine
  • Bio/TNF blockers = Infliximab, Adalimumab
6
Q

Tx for Flares of Crohn’s?

A

Corticosteroids

  • Budesonide (less systemic effects)
  • Prednisone (oral = systemic effects)
  • SLOW taper!! Avoid dependence

Antibiotics

  • Cipro + Metro
  • Cipro: tendinitis, photosens, QT prolong
  • Metro: Disulfuram rxn (avoid ETOH), metallic taste
7
Q

Condition?

  • Colon only
  • Rectum almost always
  • Mucosal surface of colon
  • Proctitis (rectum) is MC site!
A

UC

8
Q

Condition?

  • Rectal bleeding
  • BLOODY/MUCOUS NOCTURNAL diarrhea
  • “crampy” abd pain
  • Tenesmus (rectal urgency)
  • Anemia if dz is severe
A

UC

9
Q

Condition?

  • ↑ ESR & CRP if dz active
  • Colonoscopy (choice dx study)
  • Complications:
    • Pyoderma Gangrenosum
    • Nutrient deficiency (Fe, B12)
A

Crohn’s

10
Q

Condition?

  • On flex sig / colonoscopy
    • inflammation distal –> proximal
    • Continous involvement
    • Loss of haustral folds
    • Petechia, exudate, friability
A

UC

11
Q

Complications of which dz?

  • Hemorrhage
  • TOXIC MEGACOLON (very serious)
    • colonic dilation >6cm
A

UC

12
Q

Tx for UC?

A

Step up therapy

  • 1st line: 5-ASA-Salicylate (Mesalamine/Sulfalazine)
  • Immunomodulators (6MP, Azathioprine)
  • TNF blocker (Remicade)
13
Q

Tx for flares of UC?

A

Corticosteroids

  • Budesonide: less systemic SE. Used for ileal or Right sided colonic dz
  • Prednisone: oral. Systemic SE (osteoporosis, insomnia, weight gain, psychosis)
  • (SLOW taper!!) & avoid dependence
14
Q

What is the surgery for UC?

What are 3 indications for this surgery?

A

Complete Proctolectomy

  • Perforation / Severe hemorrhage
  • Dysplasia / Cancer
  • Refractory dz to medical management
15
Q

What are the 6 RED FLAGS of IBD (Crohn’s & UC)

A
  1. Anemia from severe bleeding
  2. Peritoneal signs (Severe abd pain)
  3. Weight loss d/t not tolerating POs
  4. Dehydration (↑ creatinine, tachycardia, hypotension)
  5. Obstruction
  6. Failure of therapy

PAWD-OF

16
Q

Condition?

  • Gluten toxic to small intestine
  • Exposure –> mucosal inflammation, crypt hyperplasia, villous atrophy
  • White Northern Europeans
A

Celiac

17
Q

Complications of Celiac?

A
  • Fe deficiency anemia
  • B vitamin deficiency
  • Osteoporosis
  • Slight incr. risk of malignancy (Non-hodgkin’s lymphoma or GI)
18
Q

Celiac associated with what 4 things?

Previously dz of infants, now what age group?

A
  • Autoimmune
  • DM 1
  • Thyroid dz
  • Trisomy 21/Down’s
  • 10 - 40 yrs
19
Q

Condition?

  • Diarrhea, bloating, flatulance
  • Dermatitis herpetiformis
  • Lactose intolerant
  • Neuro disorders from B vit deficiency
  • FTT (children)

Tx?

A

Celiac

Tx: avoid gluten, supplement PRN

20
Q

GOLD STANDARD dx for Celiac?

A

Small bowel biopsy (via EGD) –> will show villous atrophy

MUST be done while pt eating gluten

21
Q

Serologic Blood Testing for Celiac

  • What level must be NORMAL for test to be valid?
  • 3 other diagnostic findings?
A

IgA must be normal

  • Fe deficiency anemia
  • Osteopenia
  • Elevated LFTs
22
Q
A
23
Q

What is seen on PE of Celiac dz?

A

Dermatitis Herpetiformis

Close-up of dermatitis herpetiformis lesions. Dermatitis herpetiformis is a chronic inflammatory disease that produces lesions that burn and itch intensely. The lesions are erythematous and may be slightly papular, form small pustules, or there may be vesicles.