Appendix and IBD

Question 1

Acute appendicitis etiologies
children
adults

Answer 1

children: lymphoid hyperplasia 2˚ to viral illness
adults: fecalith

Question 2

Pain in appendicitis

Answer 2

periumbilical, localizes over McBurney point

Question 3

IBD Sx

Answer 3

recurrent bouts of blood diarrhea and pain

Question 4

UC associations

Answer 4

PSC (primary sclerosing cholangitis)

pANCA +

Question 5

CD associations

Answer 5

calcium oxalate nephrolithiasis
(fat malabsorption, Ca2+ caught up in fat, Ca2+ normally binds oxalate, when upbound oxalate gets absorbed and forms stones)
fistula and stricture formation

Question 6

Lesion locations in UC and CD

Answer 6

UC: begins in rectum –> moves prox only in colon
CD: skip lesions may involve small bowel

Question 7

Sx in UC and CD

Answer 7

UC: bloody diarrhea and LLQ pain
CD: RLQ pain and non-bloody diarrhea

Question 8

Radiological findings of UC and CD

Answer 8

UC: lead pipe X-ray, loss of haustra
CD: string sign, barium cannot get through stricture

Question 9

Complications of UC and CD

Answer 9

UC: toxic megacolon
CD: strictures, fistulas, malabsorption –> calcium oxalate nephrolithiasis

Question 10

Smoking in UC and CD

Answer 10

UC: protective
CD: more risk for CD