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PMCOL 344 > GI - Crohn's and Colitis > Flashcards

GI - Crohn's and Colitis Flashcards

1
Q

what does IBS stand for

A

irritable bowel syndrome

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2
Q

what IBS disorder

A

a functional disorder

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3
Q

does IBS come with inflammation

A

no

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4
Q

does IBD come with inflammation

A

yes

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5
Q

what does IBD stand for

A

inflammatory bowel disease

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6
Q

what are 2 types of IBD

A

ulcerative colitis and crohns disease

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7
Q

what category of bowel issue contains

ulcerative colitis and crohns disease

A

IBD

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8
Q

what is the major difference with IBD and IBS

A

IBD has inflammation, IBS does not

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9
Q

what is

ulcerative colitis and crohns disease (general, 4 things)

A

autoimmune, inflammatory, severe, progressive

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10
Q

what characterizes IBS

A

bouts of cramping, abdominal pain, bloating, constipation, diarrhea

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11
Q

what are the long term effects on bowel of IBS

A

none

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12
Q

what are the structural effects on bowel of IBS

A

none

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13
Q

what kind of disorder is IBS

A

functional

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14
Q

how do IBS bowel look in colonoscopy

A

normal

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15
Q

how do IBS epithelial cells function appear

A

to be normal

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16
Q

what % of population has IBS symptoms

A

20%

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17
Q

which subset of population gets more IBS

A

women before 35

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18
Q

is IBS chronic

A

yes

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19
Q

what are 5 possible causes of IBS

A

food sensitivities, stress, bacterial infection, hormones, alteration of 5-HT reuptake into neurons

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20
Q

what does increased GI motility lead to

A

diarrhea

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21
Q

what does decreased GI motility lead to

A

constipation

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22
Q

how do you generally try to treat IBS

A

symptomatically

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23
Q

what are 3 symptom treatments for IBS

A

diet, stress, laxatives/antidiarrheals

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24
Q

what drug do you use for constipation dominant IBS

A

lubiprostone

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25
what is lubiprostone used for
drug for constipation dominant IBS
26
what is the mechanism of lubiprostone
binds to EP4 receptors, increase cAMP, activate CFTR (Cl-), stimulates fluid secretion
27
what is the structure of lubiprostone
analogue of PGE1
28
what does lubiprostone do to transit of gut contents
speeds up
29
how does lubiprostone speed up gut (physically, not like receptor stuff)
increases fluid in stool to stretch gut and speed it up
30
what happens when lubiprostone activates EP4 receptors
increase cAMP and activate epithelial Cl- channels (CFTR) to stimulate fluid secretion
31
how does Cl- channel activation stimulate water secretion
Cl- movement creates an osmotic gradient, H2O and other electrolytes flow passively from the ECF into the lumen through channels
32
why is lubiprostone selective for the gut
because it is poorly absorbed
33
what is ulcerative colitis
inflammatory disorder causing ulcers in the lining of rectum and colon
34
where do ulcers form in ulcerative colitis
where inflammation leads to cell death (cells die in mucosa)
35
what is the main symptom in ulcerative colitis and why
diarrhea because colon inflammation in colon causes frequent emptying
36
which layer gets cell death in ulcerative colitis
in mucosa (closest to lumen)
37
what is the diff with ulcerative colitis and crohns disease
in crohns, inflammation is deeper in intestinal wall and occurs in other parts of GI tract (SI, mouth, esophagus, stomach)
38
does ulcerative colitis associate with increase cancer risk
yes
39
does crohns associate with increase cancer risk
yes
40
how do you treat UC and crohns
long term anti-inflammatories and immunosuppressant drugs | anti-diarrheals for symptoms
41
why do you use anti-diarrheals for UC and crohns
for symptomatic relief, but it does not affect etiology of the disease (doesnt cure)
42
what are glucocorticoids
potent anti inflammatory and immunosuppressant agents
43
how does prednisolone work
binds to members of nuclear receptor superfamily, modifties gene transcription
44
what stages of inflammation does prednisolone inhibit
all of them
45
what is an example glucocorticoids
prednisolone
46
how do you use prednisolone for mild UC
rectal enemas (local inflammation, systemic steroids is not ideal)
47
how do you use prednisolone for severe UC and crohns
it is given orally
48
what is the pro and con for using prednisolone
it can induce remission but long term use is nad
49
what are aminosalicylates used for
maintenance of remission of both UC and crohns disease
50
what is an example of aminosalicylates
sulfasalazine
51
is sulfasalazine absorbed well in the drug
no
52
what happens once sulfasalazine is in the colon and why
5-ASA is released in the colon by bacteria
53
what are the 2 things that sulfasalazine breaks into
5-ASA and sulfapyridine
54
what is a type of person that shouldnt take sulfasalazine + why
antibiotic allergies (cause sulfapyridine)
55
what are 3 things that sulfasalazine does that is good
- localized anti-inflammation - scavenges free radicals - inhibits prostaglandin synthesis
56
what does sulfasalazine do to prostaglandin synthesis + why important
inhibit cause that can cause inflammation
57
what is the mechanism of action of sulfasalazine
localized anti-inflammatory actions including scavenging of free radicals and inhibition of prostaglandin synthesis
58
sulfasalazine cannot be used by persons with allergies to what?
sulphonamides, class of antibiotics
59
what is mesalazine
just 5-ASA on its own
60
what are biologicals
humanized antibodies targeting components of the inflammatory pathway
61
what are 3 main targets for biologicals
- TNF-alpha - anti-alpha4beta7 integrin on T-helper lymphocytes - anti-protein subunit of IL-12 and IL-23
62
what is IL
interleukin
63
what is TNF-alpha
anti-tumor necrosis factor-alpha

PMCOL 344 (27 decks)

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