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Kumar > BII > Flashcards

BII Flashcards

1
Q

Cofactorii din etiologia BII

A
  1. Susceptibilitate genetik
  2. Factori de mediu
  3. Microbiota intestinala
  4. Rsp imun al gazdei
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2
Q

Cel mai mare factor de risc independent pt BII

A

Istoricul familial pozitiv

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3
Q

Factorii genetici majori pt BC

A
  1. Gena NOD2
  2. Genele autofage
  3. Calea Th17
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4
Q

Unde este exprimata NOD2

A
  1. Cel epiteliale
  2. Macrofage
  3. Cel endoteliale
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5
Q

Factorii de mediu si alti factori de risc

A
  1. Fumatul
  2. AINS
    3 Igiena
  3. Factori nutritionali
  4. Factori psihologici
  5. Apendicectomia (pt BC)
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6
Q

Receptorii Toll-like

A

Prin intermediul lor actioneaza liganzii bacterieni cu sist imun innascut si dobandit

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7
Q

Inflamazomul

A

Senzor de alerta intracelular al sist imun innascut - declanseaza activarea mediatorilor inflamatiei

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8
Q

BC are o tendinta particulara de a afecta …

A

Ileonul terminal si colonul ascendent

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9
Q

Tipuri de CU

A
  1. Proctita (rect)
  2. Colita stg (sigmoid + descendent)
  3. Colita extensiva (tot)
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10
Q

Semn precoce in BC

A

Ulceratia aftoida la niv colonului

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11
Q

CU macroscopic

A

Mucoasa eritematoasa, inflam, sageranda (friabila).
Ulcere extensive
Aspect de polipi post-inflamator

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12
Q

Unde apare ileita de reflux

A

CU

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13
Q

BC microscopic

A
  1. Cel inflam cronice
  2. Hiperplazie limfoida
  3. Granuloame
  4. Cel caliciforme +
  5. Abcese criptice +
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14
Q

CU microscopic

A
  1. Cel inflam cronice
  2. Granuloame rare
  3. Depletia cel caliciforme
  4. Abcese criptice ++
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15
Q

Anticorpii

A

ANCA - CU

ASCA - BC

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16
Q

Tipurile de artropatii

A 
Tip 1 (pauci) - acute / auto-limitate (<10 sapt) -> recaderi BII + asociate cu alte manif extraint
Tip 2 (poli) - luni / ani -> independent de BII + ascociere cu uveita
17
Q

Simptome majore in BC

A
  1. Diaree
  2. Durere abd
  3. Pierdere in greutate
18
Q

Manifestari tegumentare in BII

A
  1. Eritem nodos

2. Pyoderma gangrenosum

19
Q

Teste sangvine in BC

A
  1. Anemie
  2. PCR, VSH, leucocite, trombocite
  3. Hipoalbuminemie
  4. Biochimie hepatik
  5. Hemoculturi
  6. ASCA
20
Q

Teste de scaun in BC

A
  1. Coprocultura -> C. difficile
  2. Microscopia -> paraziti
  3. Calprotectina fecala, lactoferina
21
Q

Tratament pt inductia remisiei in BC

A
  1. Glucocorticoizi
  2. Nutritie enterala
  3. Atc anti-TNF
  4. Atb (ciprofloxacin, metronidazol)
22
Q

Glucocorticoizii in BC

A

In forme moderat severe
Prednisolon oral 30-60 mg/zi

Budesonid - boala ileocecala usoara moderata

23
Q

Contraindicatii glucocorticoizi in BC

A
  1. Boala penetranta intestinala

2. Sepsis perianal

24
Q

Mentinerea remisiei in BC

A

Azatioprina, Mercaptopurina, MTX

Anti-TNF

25
Q

Agentii anti-TNF in BC

A

Infliximab
Adalimumab
Certolizumab pegol

26
Q

Terapii biologice noi

A

Vedolizumab

Ustekinumab

27
Q

Simptomul major in CU

A

Diaree cu sange si mucus

28
Q

Megacolonul toxic

A

Colon dilatat > 6cm, pereti subtiri, cu gaze si psuedopolipi

29
Q

Teste sangvine in CU

A 
Anemie feripriva
VSH, PCR, leucocite, trombocite
Hipoalbuminemie
Biochimie hepatica
ANCA
30
Q

Standardul de aur in CU

A

Endoscopia cu biopsii

31
Q

5-ASA

A

Sulfasalazina
Balsalazida
Olsalazina

32
Q

Tratamentul in proctita

A

Supozitoare 5-ASA -> prima linie
Steroizi topici ««< ASA
5-ASA oral +++++
5-ASA no work => prednisolon oral

33
Q

Tratament in colita stanga

A

5-ASA topice -> prima linie
5-ASA oral +++++
5-ASA no work => prednisolon oral

34
Q

Tratament in pancolita

A

5-ASA oral
5-ASA clisma +++++
5-ASA no work => prednisolon oral

35
Q

Tratament colita refractara

A

Terapie biologica

  • anti-TNF: Infliximab, Adalimumab, Golimumab
  • anti-integrina: Vedolizumab
  • Tofacitinib (inhib Janus-kinaza 1-3)
36
Q

Terapia initiala in colita severa

A

Hidrocortizon 100 mg iv 6h

Heparina cu greutate molec mica

37
Q

Terapia de salvare in CU

A

PCR >45 / > 8 scaune / zi dupa 3 zile de hidrocortizon iv =>

Ciclosporina 2mg/kg iv, Infliximab

38
Q

Interventia chir de electie in CU acuta

A

Colectomie subtotala cu ileostoma finala

Kumar (8 decks)

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