Brainscape's Knowledge GenomeTM

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


See full index

Bloc E - GI & Metabolism > Feb21 M1-IBD and Celiac > Flashcards

Feb21 M1-IBD and Celiac Flashcards

1
Q

**ulcerative colitis vs crohn’s: depth

A 
UC = mucosal
crohn's = transmural
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

**UC vs crohn’s pattern

A 
UC = contiguous
Crohn's = skips areas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

**UC vs Crohn’s location

A

UC: rectum

Crohn’s: mouth to anus (rectum spared)

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

**UC vs Crohn’s rectum involvement

A

UC: rectum involved

Crohn’s: rectum spared

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

**UC vs Crohn’s ileum involvement

A

UC: none (or rarely backwash)

Crohn’s: common

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

**UC vs Crohn’s: presence of fistula or abcess

A

UC: no

Crohn’s: yes, can have fistula or abcess

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

**UC vs Crohn’s: granulomas

A

UC: NO granuloma

Crohn’s: granuloma in 10-30% cases

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

**UC vs Crohn’s: role of tobacco

A

UC: tobacco may prevent it?

Crohn’s: tobacco causes harm

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

**mnemonic for extraintestinal manifestations of IBD + meaning

A

C: cholangitis (PSC)
H: hematologic (anemia, amyloid)
E: eye
A: arthrisis (peripheral or axial)
T: thromboembolism
S: skin (nodosum, pyoderma gangrenosum, etc.)
(+ kidney stones, gallstones, osteomalacia, pericarditis)

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

(EXAM) granulomas in crohn’s or in UC

A

in crohn’s (10-30% of patients)

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

etiology of IBD

A

genetic predisposition (160 genes) + environmental triggers + immune system

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

cells of innate immune response

A

macrophages, neutrophils, natural killer cells

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

cells of adaptive immunity

A

B and T lymphocytes, dendritic cells

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

important gene in Crohn’s disease and epi

A

NOD2 (cytosolic R for pathogenic bacterial signals). increases risk of CD by 20-40%

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

main factors influencing microbiome composition

A

**diet, sanitation, hygiene, climate, vitamin D

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

how microbiome composition affects IBD

A

get diff type of IBD with diff microbiome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

pathogenesis of IBD

A
  1. dendritic cells (APCs) sample luminal BACTERIA****
  2. APC present antigens to lymphocytes
  3. lymphocytes release proinflam cytokines (TNF alpha, ILs): IMBALANCE of proinflam molecules
  4. increase in adhesion molecules and vascular permeability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

2 factors increasing risk of CD and IBD

A
  1. smoking (CD)

2. lifestyle like developed countries (IBD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

main symptom of IBD + important note

A

diarrhea. **primary etiology of diarrhea is infectious disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

tests for IBD

A
  • CRP, calprotectin (inflam marker in stool), B12, anemia.

- endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

CD is where

A

(upper gut rare)
small bowel alone
small bowel + colon
colon alone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what causes diarrhea in CD

A

inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

fibrostenotic lesion def in CD

A

inflamm caused scar tissues: areas of narrowing (distension, nausea, vomiting)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

fistulas in CD what and why

A

link between bowel and other bowel or bladder, vagina, etc. bc CD is transmural

25
Q

abscesses in what IBD

A

CD

26
Q

CD features

A

diarrhea, abd pain, bleeding (no bleeding in IBS), strictures, fistulas, malabsorption

27
Q

(IMPORTANT) 7 features of CD (MSNDBEE)

A
  1. mucosal erythema (edema)
  2. superficial ulcers
  3. nodularity from skip areas (cobblestoning)
  4. deep linear ulcers on axis
  5. bowel wall thickening (string sign)
  6. edematous mesentery (fat)
  7. extension of fissuring (fistula, abscesses, adhesions, etc.)
28
Q

(IMPORTANT) histo feature of CD

A

mucosal inflam (crypt abscesses) and chronic mucosal damage, granulomas, ulceration, metaplasia

29
Q

UC 3 stages

A

-proctitis: few bleeding
-less stools
-mucous
-constipation
left-sided colitis
pancolitis

30
Q

most severe complication of UC

A

toxic megacolon (also called Crohn’s colitis): toxic damage to muscularis propria (tunica muscularis). dilated and gangrenous colon

31
Q

UC 4 charact on endoscopy

A
  1. mucosal erythema
  2. broad ulceration
  3. pseudopolyps (regen mucosa)
  4. mucosal atrophy
32
Q

meds for induction in IBD

A

ASA, CS, immunomodulator methotrexate, biologic meds (Abs, anti-TNF)

33
Q

meds for maintenance in IBD

A

ASA, immunomodulators methotrexate and thiopurines, biological meds

34
Q

only induction meds in IBD

A

CS

35
Q

only maintenance meds IBD

A

thiopurines

36
Q

IBD meds induction + maintenance

A

ASA, methotrexate, biological meds

37
Q

(IMPORTANT) best meds in Crohn’s disease

A

biological meds (Ab, anti-TNF, etc.)

38
Q

meds combo used in IBD + general plan

A

biological + immunosuppressant

usually: CS + maintenance

39
Q

celiac disease other names

A

gluten sensitive enteropathy and nontropical sprue

40
Q

celiac pathogenesis

A

T cell mediated immune disease triggered by gliadin (gluten protein)

41
Q

2 important genetic factors in celiac

A

HLA DQ2, DQ8 gene loci on chroosome 6

42
Q

how body rx with gliadin

A

TTG (tissue transglutaminase) modifies gliadin and it rxs with immune system

43
Q

celiac on histo

A

CD8+ (cytotoxic) T cells infiltration, mucosal inflam, crypt hyperplasia, villous atrophy

44
Q

3 types of celiac

A
  • classic or typical
  • atypica celiac sprue
  • asymptomatic celiac
45
Q

charact of typical celiac

A

steatorrhea, malabsorption, villous atrophy, mucosal lesions

46
Q

atypical celiac charact

A

minor GI symptoms but many symptoms out of GI (osteoporosis, arthritis, anemia, neuro, ..)

47
Q

asymptomatic silent celiac charact

A

gluten-sensitive enteropathy found after serology

48
Q

latent celiac def

A

normal villous structure but positive marker for celiac (TTG positive)

49
Q

refractory celiac def

A

very bad villous atrophy and not responding to 6 months gluten free diet

50
Q

celiac diseases in order

A

healthy-latent-silent (asymptomatic)-atypical-typical

51
Q

(IMPORTANT) celiac main symptom

A

nocturnal and early morning diarrhea (and also steatorrhea)

52
Q

(IMPORTANT) skin condition associated with celiac

A

dermatitis herpetiformis (pruritic papules) (IgA deposits)

53
Q

(IMPORTANT) gold standard for celiac dx

A
  • IgA tTG (tissue transglutaminase) + order IgA

- if IgA deficient, order IgG TTG

54
Q

celiac endoscopy features

A

scalloping, absent folds, fissures, mosaicism

55
Q

(IMPORTANT) REAL way to dx celiac (bc IgA TTG not perfect)

A

biopsy

56
Q

biopsy stages (done in D2) for celiac

A

0: preinfiltrative mucosa (can’t dx)
1: lymphocytes in LP
2. crypt hyperplasia
3. villous atrophy
4. total atrophy

57
Q

(IMPORTANT) celiac treatment

A

gluten free diet

58
Q

(IMPORTANT) celiac complications

A

increased risk of:

  • lymphoma
  • upper gut and SI malignancy
  • ulcerative jejunoileitis
59
Q

celiac vs gluten sensitivity

A 
celiac = inflammatory
sensitivity = allergy to gluten, no enteropathy

Bloc E - GI & Metabolism (58 decks)

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