Firecracker Review 11/15 Flashcards
C diff exotoxin a
enterotoxin)—chemoattracts neutrophils which release cytokines → mucosal inflammation and GI fluid loss
C diff exotoxin b
cytotoxin)—disrupts cytoskeleton by depolymerizing actin filaments → GI mucosal cell death → pseudomembranous colitis
death in copd
1) resp acidosis + hypercapnic resp failure
2) cor pulmonale
3) massive spontaneous pneumo
cyclosporine causes
hyperkalemia and renal failure
C diff diagnosis
cytotoxin assy –> most sensitive, gold standard
EIA
PCR
Entamoeba complications
toxic megalon, perforation
liver abscess
pericarditis
Shigella organisms
S. sonnei (most common in U.S.), S. flexneri (most common in developing countries), S. dysenteriae, and S. boydii
AKI - hypervolemia/hypovolemia
hypervolemia due to decreased GFR, activate RAS
hypovolemia due to increase in vascular permeability, causes salt/water wasting
UC etiology
genetic
immune system - ANCA
environmental
NSAID use
UC age at diagnosis
15-25
55-65
UC extraintestinal manifestations
Uveitis (inflammation of the middle layer of eye) Pyoderma gangrenosum (necrotic ulcerations of legs) Ankylosing spondylitis (chronic inflammation of the spine) Primary sclerosing cholangitis (sclerosis of both intrahepatic and extrahepatic bile ducts)
UC colonoscopy/biopsy
friable erythematous mucosa
pseudopolyps
inflamm limited to submucosa and crypt abscesses
UC labs
anemia
increased CRP, ESR
X rays in UC
toxic megacolon
colonic perforation
UC Barium Enema
avoid if acute flair –> perforation
Microulcerations
Pseudopolyps
Narrowing of luminal wall
UC complications
severe bleeding
colorectal cancer
strictures, colonic perforation, toxic megacolon
UC treatment
topical, oral 5-ASA
CD mechanism
dysregulated proinflammatory response to the bacteria lining the walls of the GI tract, which ultimately results in the release of inflammatory substances that cause direct mucosal injury
CD age
15-30
60-70
CD in children
growth failure specifically refers to a vertical growth rate below the appropriate velocity for age.
CD in children - location
1) colon + ileum
2) ileum only
3) colon only
CD extraintestinal manifestations
same as UC + erythema nodosum
CD colonoscopy biopsy
skipped areas of inflammation, cobblestoning of the mucosa, strictures, and even pseudopolyps
transmural inflammation and granulomas
imaging study in CD
barium contrast, small bowel follow through
CD complication
intestinal strictures, perforation
fistulas, sinus tags
cancer
mild to moderate CD rx
mesalamine
severe CD rx
azothiopurine, 6mercapturine, MTX
infliximab, adalimuab
CD surgical interventions
obstruction, abscess, fistula or stricture formation, bowel perforation, toxic megacolon, and cance
