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Flashcards in Inflammatory Bowel Diseases and IBS Deck (34):
1

Name the two inflammatory bowel diseases

Crohn's and ulcerative colitis

2

What is the major difference between Crohn's and ulcerative colitis?

ulcerative colitis involves mucosal ulceration in the colon whereas Crohn's involves transmural inflammation (ileitis, ileocolitis, and colitis)

3

Ethinic group with increased incidence of inflammatory bowel disease

Jewish

4

Age group most commonly affected by inflammatory bowel disease

2nd and 3rd decades

5

Defect in the function of the intestinal lumen. Breakdown of the defense barrier of the gut. Exposure of mucosa to microorganisms or their products. Results in chronic inflammatory process mediated by T cells

pathophysiology of inflammatory bowel disease

6

Systemic complications include: apthous stomatitis, episcleritis and uveitis, arthritis, vascular complications, E. nodosum, P. gangrenosum

inflammatory bowel disease

7

complications of inflammatory bowel disease related to small bowel pathophysiology

gallstones, malabsorption, renal stones

8

Involves the mucosal surface of colon with the formation of crypt abscesses. Always includes the rectum, spreads proximally

ulcerative colitis

9

Clinical course is marked by flare-ups and remissions. More common in nonsmokers. Higher risk for development of cancer

ulcerative colitis

10

Hallmark of ulcerative colitis

bloody diarrhea

11

Symptoms include: rectal bleeding, LLQ cramps, severe diarrhea, fever, anemia, hypoalbuminemia, and hypovolemia

severe ulcerative colitis

12

disease of bile ducts that causes inflammation and obstruction, 80% have UC, liver transplant

sclerosing cholangitis

13

Systemic associations include: peripheral and central arthritis, uveitis, sclerosing cholangitis

ulcerative colitis

14

What is needed for the diagnosis of ulcerative colitis?

sigmoidoscopic demonstration of inflammation and the exclusion of bacterial and parasitic infection.

15

What are dietary recommendations for treatment of ulcerative colitis?

reduce dietary fiber during exacerbation, folic acid supplements w/sulfasalazine.

16

What are pharmacological options for ulcerative colitis?

oral Fe w/rectal bleeding or anemia. Loperamide for troublesome diarrhea. Prednisone for inflammation.

17

What do the following have in common in relation to ulcerative colitis: exsanguinating hemorrhage, toxicity/perforation, suspected cancer, dysplasia, systemic complications, growth retardation, and intractibility

indications for surgery

18

Transmural involvement with formation of fistulas, narrowing of lumen, obstruction. Can involve any segment of the G.I. tract, but usually rectal sparing.

Crohn's Disease

19

Name of predominant segment of GI tract when it's involved with Crohn's disease

ileocolitis (45%)

20

strongly associated with the development of Crohn’s Disease, resistance to medical therapy and early disease relapse

cigarettes (not e-cigs though)

21

Insidious onset. Intermittent bouts of low-grade fever, diarrhea and RLQ pain. Postprandial pain common. RLQ mass. Perianal disease (abscess, fistula)

Crohn's disease

22

Often nocturnal B.M.’s, night sweats, weight loss.
Skin lesions, primarily erythema nodosum, may precede intestinal symptoms.

Crohn's disease

23

Common presentation of physical exam includes: abdominal distention, abnormal bowel sounds, tenderness in area of involvement.

Crohn's disease

24

Associated with abscesses, fistulas, skin tags in the perianal region as well as anal strictures.

Crohn's disease

25

Serum test that can be used for Crohn's disease that is highly specific, but has low sensitivity

ASCA (anti-saccharomyces cerevisiae antibody)

26

Radiography that is better for finding complications of Crohn's disease including strictures and fistulas

Barium contrast studies

27

“cobble stoning”, “skip lesions”, pseudodiverticula, dilated bowel, fistulas communicating to adjacent bowel/mesentery/bladder/vagina

Crohn's Disease

28

Serum test that can be used for detection of ulcerative colitis but is not useful as the sole diagnostic test due to low sensitivity.

Perinuclear antineutrophil cytoplasmic antibodies (pANCA)

29

Common radiologic finding of Crohn's disease due to narrowing and stricturing of terminal ileum

String sign

30

A functional gastrointestinal disorder that is a variable combination of chronic or recurrent gastrointestinal symptoms not explained by structural or biochemical abnormalities

irritable bowel syndrome

31

How long must a patient have abdominal pain or discomfort, pain relieved by defecation, and pain with a change in frequency or form of stools to be classified as having irritable bowel syndrome?

3 months

32

Associated symptoms in order of prevalence includes: fatigue, back ache, early satiety, nausea, HA, irritable bladder, functional dyspepsia

irritable bowel syndrome

33

How do we make a positive diagnosis of irritable bowel syndrome without costing the patient tons of money

Rome and Manning Guidelines

34

positive diagnosis is usually made from h/o that includes onset during late teens/early twenties, intermittent, crampy pain that doesn't occur at night

irritable bowel syndrome