Clinical- IBD Flashcards
Overall, what is the result of irritable bowel disease
Increased permeability of the epithelium of the gut
What is the immunogenetics component to IBD
HLA-DR2
What is the gene association with IBD
CARD15/NOD2
Which antibody is commonly associated with Ulcerative colitis
ANCA (antineutrophil cytoplasmic antibodies)
*Notice the relation to PSC
What antibody is commonly associated with Crohn disease
ASCA (anti Saccharomyces cerevisiae)
What are the main therapies for IBD
-5-aminosalicylic acid, corticosteroids, immunomodulating agents
What are the common other conditions seen with IBD
Peripheral arthritis
Erythema nodosum, pyoderma gangrenosum (especially with UC)
Thrombolytic effects (DVT)
Renal stones with urate or calcium oxalate (especially with crohns)
Which IBD condition has non-caseating granulomas
Crohns
What condition is characterized by the “cobblestone”appearance
Crohns
Which condition commonly has “creeping fat”
Crohns
What other condition commonly has non caseating granulomas
Sarcoidosis
Which of the IBD commonly has pseudopolyps
UC
Which IBD commonly has granulomas
Crohn disease
Which of the IBD will commonly have bloody diarrhea
UC
Which IBD is commonly seen to have fulminant colitis
UC
What is fulminant colitis
Severe disease characterized by rapidly worsening symptoms with signs of toxicity
Which IBD is commonly seen to have defects on growth
Crohns
Which IBD is commonly seen to have acute ileitis mimicking appendicitis
Crohns
Which IBD is commonly seen to have anorectal fissures, fistula, abscesses
Crohns
Which IBD is commonly seen to have toxic megacolon
UC
Which IBD is commonly seen to have intestinal obstruction
Crohns
Which IBD is commonly seen to have a reduced risk after having a appendectomy before age 20
UC
Which IBD commonly presents following cessation of smoking
UC
What is the key to diagnosis for UC
Sigmoidoscopy
What is the key to diagnosis in Crohns
Sigmoidoscopy, curium edema, Upper GI and small bowel series
UC is commonly seen to have what lab findings
Increased sedimentation rate/CRP
Increased fecal calprotectin levels
Anemia
Crohns is commonly found to hav which lab findings
Hypoalbuminemia
Anemia
Which IBD is commonly seen to have edema, friability, mucous, and erosions
UC
Which IBD is commonly seen to have lead pipe on barium swallows
UC
Which diagnostic test should not be run on UC and what is the reasoning
Colonoscopy due to the risk of perforation
What is te diagnostic test order for Crohns
Colonoscopy and a biopsy
What are the biopsy findings in Crohn’s disease
Skip lesions with stellate ulcers, stricture, and segmental involvement of healthy tissue followed by unhealthy
Granulomas on biopsy is indicative of which IBD
Crohns
In the complication of Crohns with an abcess, what is the process
- Usualy presents with a fever and leukocytosis
- Emergent CT
- Broadspectum antibiotics
- Percutaneous drainage or surgery
What is the indication or finding in an intestinal obstruction in crohns
Intravenous fluids with nasogastric suction
What is the diet given for patients with obstructive due to crohns
-Low roughage diet (aka no raw fruits, veggies, popcorn, nuts)
What is the presentation of retroperitonieal phlegmon or abcess
Fevers, chills, tender ab mass, leukocytosis
What is the fistula between the small intestine and colon called
Enterocolonic
What is the presention of a entercolonic fistula
Usually asymptomatic, but can have diarrhea, weight loss, bacterial overgrowth
What is the names of the fistulas that form with the bladder
Colovesical (colon to bladder)
Enterovesical (Small intestine to bladder)
What is the symptom associated with fistulas connecting to the bladder
Recurrent urinary infection
What is the symptom of a fistula with the vagina
Malodorous drainage and problems with hygiene
What is the cause of cutaneous fistulas
Surgical scars
Which IBD is commonly seen to have perianal disease
Crohn
What is perianal disease characterized by
Skin tags, anal fissures, perianal abscesses, fistulas
What is the best way to treat perianal disease
With a colorectal surgeon and using an MRI
Which IBD is commonly seen to have severe hemorrhage
Crohns
When there is the resection of the terminal ileum, what can occur
Reduced resorption of the bile acids, leading to secretory diarrhea
Patients with extensive ideal disease should not be given which compounds and what are commonly associated with it
Should not be given bile salt binding agents, as it can cause diarrhea, as well as kidney stones
What are the side effects of administering glucocorticoids for IBD
-mood changes, insomnia, buffalo hump, weight gain (striae), moon faces
What are the side effects of 5-ASA
Aka aspirin
-Acute interstial nephritis
What should always be administered with AZO components
-Folate
What should always be tested for before administration of azathioprine or 6-MP
-TPMT or thiopurine methyltransferase
