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P&T Block 3 Pulm & GI > L81 > Flashcards

Flashcards in L81 Deck (42):
1

2 IBD diseases

Crohn's
Ulcerative colitis

2

What part of the bowel does UC always involve?

Rectum - can move backwards into the colon from there

3

UC: continuous or skip lesions

Continuous inflammation

4

Describe UC diarrhea

Bloody

5

Describe UC on colonoscopy

Red and pissed
Friable = white areas, mucous areas of repair
Pseudopolyps = look like holes

6

How deep does UC go into the bowel wall?

Shallow: mucosa and submucosa
Deeper is a sign of Crohn's

7

What part of the GI is effected by Crohn's

Anywhere! Most commonly SI
Skip lesions - jumps around

8

3 clinical patterns of Crohn's

Inflammation
Obstruction - chronic inflammation caused narrowing
Inflam through entire bowel wall -> fistula

9

UC or Crohns: granuloma

Crohn's

10

Describe Crohn's diarrhea

Can or cannot be bloody

11

Describe Crohn's on colonoscopy

War zone - super bumpy
"Cobblestone"

12

What are manifestations of UC outside the GI

Pyoderma grangrenosum = ulcerative rash
Erythema nodosum = papular + painful
PSC

13

What are extra-GI manifestations of Crohn's

Pyoderma, erythema
Perianal disease

14

UC increases your risk for what kind of cancer

Colo-rectal

15

Best treatment for UC

Surgery is curative!
Ileal pouch-anal anastomosis

16

Do you do surgery for Crohn's

You can - yes/no depends on case/if emergency

17

What is microscopic colitis

Endoscopy clear
Biopsy shows microscopic inflam
Common problem is can't reabsorb water in colon -> diarrhea

18

2 types of microscopic colitis

Collagenous
Lymphocytic

19

How does collagenous colitis present? Pt pop. What is abnormal on histo?

Water diarrhea - no pain
Older women
See abnormal collagen layer

20

How does lymphocytic colitis present? What is abnormal on histo?

Water diarrhea
High lymphocytes

21

Treat microscopic colitis

1. Anti-diarrheals
2. Mild steroid = budesonide
3. Bismuth salts, bile acid binders

22

What does C.Diff cause?

Pseudomembranous colitis

23

C.Diff: why type of bacteria, what are the bacteria's products

GP bacillus
Toxins A + B

24

Risk factors for developing C.Diff

Hospital
Antibiotics in non-hosp pts
PPI use

25

C.Diff presentation

Watery diarrhea - really bad smell
High wt ct

26

Dx C.Diff infection

PCR stool for the bug
See pseudomembranes on endoscopy = white milky patches of infection

27

Treat C.diff

Metronidazole
Vanco
Relapses: fecal transplant

28

Describe how polyps progress in colon cancer

Small adenoma -> large -> colon carcinoma

29

Have what other cancers puts you at increased risk for colo-rectal cancer

Endometrial or ovarian

30

3 ways to screen for colo-rectal cancer

Colonoscopy
Flexible sigmoidoscopy
Stool occult blood

31

What 2 inherited conditions put you at highest risk for developing colo-rectal cancer

Familial adenomatous polyposis
Hereditary non-polyposis colorectal cancer syndrome

32

Describe HNPCC
- Age onset
- Where in colon
- Polyps?
- Associated with what other cancer

Younger pts
R colon dominance
Presents as multiple primary cancers - FEW/NO polyps
Associated with endometrial cancer

33

What is the Rome criteria?

How dx IBS
3+ days per month
For at least last 3mo
Ab pain + 2 of the following:
1. Pain improves when you poop
2. Change in freq of stool
3. Change in appearance of stool

34

Pathophys of IBS

No structural abnormality
Some combo of:
- More gut motor activity
- SI + LI involvement
- CNS-ENS dysreg

35

Most common IBS symptom

Bloating

36

What is a diverticulum

Outpouching from the gut that doesn't go anywhere
May have varying amts of gut layers assocaited

37

What is diverticulosis

Many false diverticula of the colon
Often asymptomatic

38

Risk factors for diverticulosis

Obesity
Diet low in fiber

39

What is diverticulitis

A diverticulum gets inflam
LLQ pain
Fever
Maybe feel a mass

40

Treat diverticulitis

Antibiotics + supportive

41

How will ischemic colitis present?

Hematochezia
Acute ab pain

42

Treat ischemic colitis

Treat underlying cause: clot, etc
Might need surg if has progressed (gangrene)