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Clin med A 2 > trigger colon and rectrum > Flashcards

trigger colon and rectrum Flashcards

1
Q

chronic RLQ pain w intermittent non-bloody diarrhea

A

crohns

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1
Q

arthralgia, arthritis, apthour ulcers

A

extraintestinal manifestations crohns

also include:
pyoderma gangrenosum
erythema nodosum
fistulas
iritis, uveitis
kidney stones
arthralgia
arthritis
apthous ulcers

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2
Q

pyoderma gangrenosum, erythema nodosum

A

extraintestinal manifestations crohns

also include:
pyoderma gangrenosum
erythema nodosum
fistulas
iritis, uveitis
kidney stones
arthralgia
arthritis
apthous ulcers

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3
Q

fistulas, iritis, uveitis, kidney stones

A

extraintestinal manifestations crohns

also include:
pyoderma gangrenosum
erythema nodosum
fistulas
iritis, uveitis
kidney stones
arthralgia
arthritis
apthous ulcers

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4
Q

hot red tender nodules 1-5cm in diameteer on surface of lower legs, ankles and calves

A

erythema nodosum as extraintestinal manifestation of crohns

these correlate w bowel symptoms (happens after bowel symptoms appear)

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5
Q

pustule lesions that can become ulcers with necrotic tissues. usually on dorsal feet and legs but can occur on arms and chest

A

pyoderma gangrenosum

extraintestinal manifestation of crohns. assocaited with SEVERE disease

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6
Q

cobblestoning appearance on colonoscopy

A

crohns disease

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7
Q

what labs can you order in crohns

A

CBC
Serum albumin
CMP
ESR
CRP
Iron
Vit D
B12
stool studies

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8
Q

goal of disease is minimize symptoms and complications NOT curative

A

crohns

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9
Q

smoking crazy assocaited with this dx

A

crohns

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10
Q

inflammation of only the colon

A

ulcerative colitis

mostly rectal and sigmoid colon

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11
Q

Step UP therapy with enteric coated budesonide (corticosteroid)

A

ileum/cecum low risk crohns treatment.

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12
Q

Mass in RLQ

A

crohns affecting terminal ileum

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13
Q

MC in female caucasions with western diet

A

crohns

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14
Q

MC in male caucasions with western diet

A

ulcerative colitis

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15
Q

oral prednisone for one week then taper off. can use 5 ASA as alternatice

A

mild to mod crohns (diffuse colitis or Left colonic involvement)

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16
Q

what is used for relapse of mild to moderate crohns

A

second course of glucocorticoid, Immunomodulator (azathioprine), biologic (infliximab)

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17
Q

infection, hygeien issues, abscess, malnutrition and diarrhea

A

complications of ulcers in crohns

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18
Q

start therapy with biologics (infliximab) + immunomodulators (azathioprine)

A

treatment to induce and maintain remission of high risk (mod-severe) crohns

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19
Q

hallmark sign is bloody diarrhea

A

ulcerative colitis

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20
Q

presents with fecal urgency, crampy lower abd pain that relieves with urgency, and anemia.

A

ulcerative colitis

also hallmark of bloody diarrhea

fever, fatigue, pus in diarrha

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21
Q

presents with fever, fatigue, pus in diarrhea

A

ulcerative colitis

also presents with bloody diarrhea, fecal urgency, crampy lower abd pain that relieves with urgency, and anemia.

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22
Q

complication including toxic megacolon and fulminant colitis.

A

ulcerative colitis

also see: perforation and severe bleed

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23
Q

ankylosing spondylitis

A

ulcerative colitis extraintestinal manifestation

also see: arthritis

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24
smoking makes this better actually
ulcerative colitis
25
UC w a hematocrit of 26% and an albumin of 2.8 mild, mod or severe?
severe
26
sigmoidoscopy showing continuous friable mucosa with pus, erosions, bleeding and erythema
ulcerative colitis gold standard
27
DO NOT do a colonoscpy w/ this
severe/fulminant colitis
28
colonic epithelial dysplasia and carcinoma are higher risk w what
ulcerative colitis
29
decrease caffeine
ulcerative colitis
30
what is the typical signs/symptoms and labs for toxic magacolon
31
topical mesalamine (5-ASA) or hydrocortisone suppository
treatment for mild/mod UC limited to the distal colon (not past sigmoid)
32
oral mesalamine + topical mesalamine. add on corticosteroids if unresponsive after 4-8 weeks
tx for mild - mod UC that extends past the sigmoid colon
33
prednisone +/- immunomodulators (azathioprine or cyclosporine) / TNF blocker (infliximab) only + the last 2 if unresponsive to corticosteroids or if flares occurs while tapering off corticosteroids
tx for mod-severe UC
34
proctocolectomy with placement of ileostomy
curative tx for ulcerative colitis
35
what is indicated if a UC patient has more than one relapse in a year
maintenance therapy with mesalamine. also indicatd if pt has ulcerative proctosigmoiditis (rectum, sigmoid or anus involved) or if they have proximal/sigmoid (left sided colitis)
36
inhibits prostaglandin production
5 -ASA/ aminosalicylates (mesalamine or sulfasalazine)
37
inhibits DNA/RNA synthesis of lymphocytes
immunomodulators/immunosuppresents azothioprine and purinethol
38
SE leukemia, thrombopenia, anemia
immunomodulators/immunosuppresents azothioprine and purinethol also: NVD, infection, malaise
39
BBW for rapid growing malignancy/lymphoma
immunomodulators/immunosuppresents azothioprine and purinethol
40
what immunomodulator is used if azothioprine fails
methotrexate. not effective in UC
41
MOA of interfering with cytokine driven inflammatory processes
ATN biologics imab's
42
BBW of serious infections
ATN biologics (imab's)
43
SE are fever, urticaria, hypotension
ATN biologics (imab's) also: NV, myalgia, rigors could also see sepsis and malignancy
44
TOC for CD fistula
anti TNF (imab's)
45
used for fistula and abscess in CD
abx metonidazole or cipro TOC for fistula only is anti TNF tho
46
ileocolonoscopy in 6-12months
follow up treatment after asymptomatic
47
caused by DNA changes in lining of colon
adenomatous polyps
48
risk factors include being a dude, genetics, high fat diet, >50 yo, and obesity
adenomatous polyps this is also the same risks for colon cancer (except the dude one)
49
flat or sessile or pedunculated and slow growing
adenomatous polyps flat = cancer sessile and pedunculated = less likely cancer
50
anemia, melena, weight loss, weakness, fatigue
proximal colon cancer (also positive FOBT)
51
obstruction, hematochezia, urgency/tenezmus
distal colon cancer (also change in bowel habits)
52
CEA is used for what
assessing colon cancer PROGNOSIS NOT FOR SCREENING
53
proctocolectomy with ileoanal anastomosis or ileorectal anastomosis
FAP, reccomended before 20
54
autosomal dominant condition
lynch syndrome
55
CRC inevitable by age 50 unless removed
FAP
56
inherited APC gene mutation
FAP
57
caused by mutations in a gene that detects and repairs DNA base pairs
Lynch syndrome
58
few adenomas that are flat and more villous
Lynch syndrome
59
1. 1st degree relative w polyps prior to 50 2. pt having polyps prior to 50 3. 3+ relative w colon cancer
tool of "three" for lynch syndrome
60
peophylactic hysterectomy and oopherectomy reccomended
lynch syndrome for women who are 40 or done having kids.
61
increase venous pressure such as during straining, pregnancy, constipation and obesity
hemorrhoids
62
right anterior, right posterior, left lateral
places for internal hemorroids
63
below dentate line
external hemorroids
64
hemorroids of the squamous epithelim
external
65
nonpainful bleeding, mucoid discharge that is not painful. can present with prolapse
internal hemorroids only becomes painful when its stage 4 and protruding outside the anus.
66
proper toileting, high fiber, drink water, take laxatives
tx for stage 1-2 hemorroids
67
rubber band ligation (preferred) injection sclerotherapy
stage 1-2 with recurrent bleeding or failure of conservative tx. stage 3-4
68
hemorroidectomy
tx for severe stage 3 or stage 4.
69
painful bluish nodule
external hemorroid
70
warm sitz bath, topical ointment, evacuation of clots
external hemorroid tx.
71
MC in posterior midline
anal fissures (linear ulcerations or tears around anus) IF THEY ARE OFF MIDLINE suggests HIV/AIDS, crohn, TB, anal carcinoma
72
tearing pain with defecation
anal fissures
73
caused by fistulas
1/2 of all perianal abscesses
74
throbbing, erythema, and swelling
perianal abscesses
75
assocaited with purulent discharge that may lead to itching tenderness and pain
perianal fistula

Clin med A 2 (30 decks)

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