Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI- Week 6 > Bernadino: IBD > Flashcards

Bernadino: IBD Flashcards

1
Q

What is IBD?

A

Idiopathic and chronic intestinal inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is UC?

A

MUCOSAL disease
involves the rectum and extends proximally to involve part of the entire colon

Chronic and relapsing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is CD?

A

Effects ANY portion of the luminal GI tract

*more aggressive b/c has ability to generate TRANSMURAL inflammation and BEYOND

Presents in two patterns:

  1. obstructive/fibrostenotic (inflammatory> hard woody strictures)
  2. Penetrating/fistulilzing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Who is IBD most commonly seen in?

A

15-25 yrs but SECOND peak 60-70 (more aggressive)

Men= women
Jews>non jews

*usually chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

A pt presents w/ bloody mucoid diarrhea and tenesmus.

Dx?

A

UC (mucosal involvement> blood)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A pt presents w/ nonbloody diarrhea, abdominal pain, weight loss/anorexia, perianal abscess, and growth failure.

Dx?

A

Crohns (mores systemic, penetration> fistulas)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What infections can mimic IBD/cause bloody diarrhea/have a RIGHT pref.?

A

Bacteria: c. diff
Parasites: e. histolytica, trichinella
Viruses: CMV (punched out ulcers and bloody diarrhea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are complications of UC?

A

Mucosal shedding> bloddy diarrhea

Starts in the rectum and moves UP> chronic/relapsing

30% will undergo colectomy over 30 years

Colon cancer: 18% over 30 years (1 in 5 people)*

Primary Sclerosing Cholangitis 4%** (almost never seen w/ crohns)

*cryptitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Crohn’s Disease?

A

A pan-enteric transmural inflammatory disease
(Mouth to sigmoid, usually spares rectum)

Usually (70%) involves the terminal ileum

Skip lesions (patchy distribution)

Perianal involvement (fistulas/fissures/red boil around anus)

80% require surgery by 15 yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What complications are associated w/ CD?

A

fistulae
abscess
strictures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A pt presents w/ painful diarrhea, anemia and less bleeding than seen in UC.

Dx?

A

CD

*biopsy> granuloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the microscopic morphology of IBD?

A

noncaseating granulomas and lymphoid aggregates (Th1 medaited)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What serologies can be useful in diagnosing CD?

A

*ASCA (anti-saccharomyces cerevisiase Abs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What serologies can be useful in diagnosing UC?

A

*pANCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are Extraintestinal manifestations of IBD?

A

Pancreatitis

Thyroiditis
Bronchiolitis

Erythema Nodosum

Pyoderma Gangrenosum

Oral/Opthalmmalogic: APTHOUS ulcers, uveitis, iritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are common complications of UC?

A

Toxic megacolon

17
Q

What are common complications of CD?

A

Fistulae

Obstruction

18
Q

How does IBD increase the risk of CRC?

A

Happens more w/ duration and extent of disease

Increased risk with:
Disease proximal to splenic flexure
> 8 years duration; young age at diagnosis
Primary sclerosing cholangitis 
Family history of CRC
Pseudopolyps at colonoscopy

Flat or depressed adenomas–fields of dysplasia> CRC

19
Q

What is a protective treatment against CRC used to tx pts w/ IBD?

A

5-ASA

20
Q

How does CRC present in IBD?

A

Doesn’t follow adenoma-carcinoma sequence:

Dysplasia/ DALM (dysplasia associated lesion or mass)–> colon comes out

Dysplasia–> colectomy

21
Q

What type of surveillance for CRC occurs in a pt who has had IBD for more than 7 yrs?

A

colonoscopy and biopsies every 1-2 years

22
Q

IBD induction therapy?

A
  1. 5-ASA (mild disease):
    Sulfasalazine, mesalamine
  2. Steroids:
    Prednisone, budesonide
  3. Biologics – Infliximab
  4. Cyclosporine (pt not getting better w/ anything, transition to surgery)
  5. Surgery:
    UC – cure
    Crohn’s – to treat complications
23
Q

What is maintenance therapy for IBD?

A

5-ASA:
Sulfasalazine, mesalamine

Immunomodulators:
Azathioprine
6 Mercaptopurine
Methotrexate

Biologics – Infliximab

*NO ONE WILL BE ON MAINTENANCE STEROIDS

24
Q

What medications are used to specifically treat the sml bowel and R colon?

A

Pentasa (mesalmine)

Budesonisde (steroid)

25
Q

What medications are used to specifically tx the left colon?

A

asacol (mesalmine)

prednisonse (prednisone)

26
Q

What are complications from ileal disease/resection?

A

bile salt diarrhea
galstones
vit B12 def
oxylate stones

27
Q

What do biologics do (infliximab)?

A

Most are Abs to TNFa or to where it binds

28
Q

What are toxicities of TNF-a inhibitors (infliximab)?

A 
renal toxicity
bone disease
neurologic injury
liver injury
infection
malignancy- lymphomas, leukemias
29
Q

Infliximab

A

Make sure they dont have latent TB or HBV. Make sure they don’t have an active infection.

30
Q

What are indications for surgery in UC?

A

unresponsive acute disease

cancer or dysplasia

31
Q

What is the MC surgical option for UC?

A

ileal pouch anal anastamosis

32
Q

What are indications for surgery w/ crohns disease?

A

perforation
hemorrhage
dysplasia
unhappy w/ medical therapy

33
Q

In ppl w/ active crohns disease, what percent will have a recurrent surgery?

A

55%

*surgery is usually hte beginning of multiple surgeries

GI- Week 6 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions