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Flashcards in Wk 5 Deck (20)
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1

path characteristics of Crohn's

transmural inflamm (involves all layers of intestinal wall), skip lesions, cobblestoning, fissures, sinuses, fistulas

2

path characteristics of UC

continuous, inflammatory dz of colon or rectal mucosal layer
starts in rectum, moves proximally
thinning of wall
pseudopolyps, loss of goblet cells, distortion of crypts, loss of haustra

3

What is indeterminate colitis

within venn diagram, it’s where UC and Crohn’s overalp. therefore no difinitive dx

4

What are the two forms of microscopic colitis and why are they called microscopic?

lymphocytic (MC) and collagenous (rare)
-can only see via microscope (dx by biopsy) of the large intestine

5

what's the difference between ulcerative proctitis, pancolitis and left sided colitis?

proctitis- just the rectum (most common)
pancolitis- entire large intestine (2nd most common)
left sided colitis- descending colon and rectum

6

which type of ulcerative colitis is associated with increased risk for colon CA?

pancolitis

7

UC can be seen on what exam?

anoscopic exam

8

sequelae of UC?

-toxic megacolon (massive dilation) because of tenuation and thinning of wall. can lead to perforation
-hemorrhage

9

systemic effects of IBD?

Eyes: Episcleritis, Uveitis
Kidneys: nephrolithiasis, hydronephrosis, fistulae, urinary tract infection
Skin: erythema nodosum, pyoderma gangrenosum
Mouth: stomatitis, apthous ulcers
Liver: steatosis
Billiary tract: gallstones, sclerosing cholangitis
Joints: spondylitis, sacrolitis, peripheral arthritis
Circulation: phlebitis

10

Location of Crohn disease?

R colon (35%)
colon alone (20%)
distal ileum (35%)
SI alone (5%)
gastroduodenal (5%)

11

Sequelae for Crohn's?

-transmural thinking leading to obstruction of terminal ileum
-fistulas, abscesses, fissures, stenosis (of ileocecal valve), inflammation

12

anatomical limits of colonoscopy?

can go through ICV to terminal ileum (cannot rule out Crohn's unless it goes through terminal ileum)

13

which type of endoscopy is used to biopsy for Celiac disease?

upper endoscopy

14

which type of endoscopy is used to dx IBD?

colonoscopy

15

Common ssx of UC?

cramping pain in lower abdomen
relieved by BM
bloody stool

16

Common ssx of Crohn's?

constant pain in RLQ
NOT relieved by BM
abdominal mass in RLQ

17

Is IBS or IBD considered AI?

IBD

18

lab tests for IBD?

-fecal calprotectin- screening test that tells you level of inflammation and whether they are in acute flare or not
250 indicates impending relapse or active dz
-CBC (mild anemia in IBD)
-low serum iron, low B12 in Crohns
-ESR & CRP (elevated)

19

dietary treatments for IBD?

Specific carbohydrate diet
Elimination diet
Exclusive enteral nutrition
GAPS

20

supplements and botanicals for IBD?

-Folic acid, DHEA or Ashwagandha (dec. side effect of IBD meds)
-LDN
-Turmeric and Boswelia
-Aloe vera (UC only)
-Salmon, fish oil
-rPC (retarded release phosphatidylcholine)
-VSL #3 probiotic
-Fecal transplant