IBS

Question 1

Chronic state of physiologic inflammation ready to be activated, and dampened by tissue repair and immune modulation

Answer 1

Inflammatory bowel disease

Question 2

Inflammatory response id activated by?

Answer 2

T-cell activation

Question 3

Diarrhea, rectal bleeding, tenesmus, passage of mucus, fever

Answer 3

Ulcerative colitis

Question 4

Collar-button ulcers

Answer 4

Ulcerative colitis

Question 5

Most feared complication of ulcerative colitis

Answer 5

Perforation / Toxic megacolon

Question 6

Transverse colon >5 - 6cm

Answer 6

Toxic megacolon

Question 7

Mucosal disease that usually involves the RECTUM and extends to ALL or PART of colon

Answer 7

Ulcerative colitis

Question 8

Rectal sparing

Answer 8

Crohn’s disease

Question 9

Major symptoms of ulcerative colitis

Answer 9

Diarrhea, rectal bleeding, tenesmus, passage of mucus, crampy abdominal pain

Question 10

Physical signs of proctitis

Answer 10

DRE: tender anal canal and blood

Abdominal exam: direct tenderness on palpation over colon; hepatic tympany with magacolon; signs of peritonitis

Question 11

Long-standing disease

Answer 11

Presence of inflammatory polyps (pseudopolyps)

Question 12

Atrophic featureless mucosa with narrowed and shortened colon

Answer 12

Remission

Question 13

Fulminant disease

Answer 13

Toxic colitis or megacolon perforation

Question 14

Two major histologic features suggesting chronicity

Answer 14

Distortion of colon crypt architecture

Basal plasma cells and multiple basal lymphoid aggregates

Question 15

Villous atrophy and crypt regeneration with increase inflammation

Answer 15

Backwash ileitis

Question 16

Any part of the mouth to colon, rectum is spared and segmental; stricture and fibrosis

Answer 16

Crohn’s disease

Question 17

Granulomas, transmural inflammation, subserosal and submucosal lymphoid aggregates

Cobblestoning

Answer 17

Crohn’s disease

Question 18

Crypt abscess

Answer 18

Ulcerative colitis

Question 19

Dermatologic extraintestinal manifestations of IBD

Answer 19

Erythema nodosum
Pyoderma gangrenosum
Pyoderma vegetans
Pyostomatitis vegetans
Sweet’s syndrome

Question 20

Rheumatologic

Answer 20

Arthritis
Ankylosing spondylitis
Sacroiliitis

Question 21

Ocular

Answer 21

Conjuntivitis

Uveitis

Question 22

Conjunctivitis
Uveitis
Arthritis
Urethritis
Sacroiliitis

Answer 22

Reiter’s syndrome

Question 23

Gross blood and mucus

ANCA +

Answer 23

Ulcerative colitis

Question 24

Sysytemic symptoms, painful, fistula
ASCA +
Recurrence after surgery

Answer 24

Crohn’s disease

Question 25

Highly sensitive and specific marker for intestinal inflammation

Answer 25

Fecal lactoferrin

Question 26

Histologic inflammation Predict relapses Detect pouchitis

Answer 26

Fecal calprotectin

Question 27

Used to assess disease activity and is performed before treatment

Answer 27

Sigmoidoscopy

Question 28

Assess disease extent and activity

Answer 28

Colonoscopy

Question 29

Earliest radiologic change of ulcerative colitis seen on single-contrast barium enema

Answer 29

Fine mucusal granularity

Question 30

Deep ulcerations which indicate ulceration has penetrated mucosa

Answer 30

Collar button lesions

Question 31

Massive hemorrhage

Answer 31

Treat disease or do colectomy if pt requires 6-8 units of blood within 24-48 H

Question 32

Transverse or right colon with diameter of >6 cm with loss of haustration

Answer 32

Toxic megacolon

Question 33

Most dangerous complication

Answer 33

Perforation

Question 34

Presumed malignant until proven otherwise when impassable with colonoscope

Answer 34

Strictures

Question 35

Mainstay tx mild-mod UC and Crohn’s

Answer 35

Sulfasalazine