GI (IBD) Flashcards
all the hard diseases
UC location and layers affected
colon, rectum
mucosa, submucosa
minor complications of UC
haemorrhoids, anal fissures, perirrectal abcesses
major complication of UC and symptoms
toxic megacolon
high fever, tachycardia, distended abdomen, elevated wbc, dilated colon
clinically, which is common in crohn’s vs uc?
1. fever, malaise
2. rectal bleeding
3. abdominal tenderness
4. abdominal mass
- crohn’s
- both
- crohn’s, but uc possible
- crohn’s
clinically, which is common in crohn’s vs uc?
1. abdo pain
2. abdo wall and internal fistula
3. distribution
4. aphthous or linear ulcers (mouth)
all crohn’s
what is most affected for crohn’s.
terminal ileum, but can occur in any part of GI tract.
crohn’s vs uc which is continuous
CD discontinuous uc continuous
mild, moderate UC and what is the marker of inflamx
mild - less than 4 stools, no systemic disturbance (ESR normal)
mod - 4-6 stools, minimal systemic disturbance
what are systemic manifestations of severe UC and ESR level?
fever, tachycardia, anemia. more than 6 stools a day
ESR > 30
ileufulminant UC? and symptoms
> 10 bowel movements a day
continuous bleeding, toxicity, abdominal tenderness, transfusion, colonic dilation
CD presentation
periods of remission and exacerbation
diarrhoea, abdominal pain, perirectal, perianal lesion
nonpharm for UC and CD
- exclusion diets are not endorsed
- enteral nutrition
- probiotics (VSL3, e coli nissle 1917)
major classes of therapies in IBD
- 5 ASA
- corticosteroids
- immunomodulators (azathioprine)
- immunosuppressive (cyclosporine)
- antimicrobials (metronidazole)
- anti tnf), interlukin, jk inhibitors (tofactinib)
use of corticosteroids in IBD
40-60mg prednisone for refractory IBD or require more rapid control
or budesonide
cyclosporine benefit in UC vs CD
short term benefit in UC if patients fail corticosteroids
little benefit in CD
what is infliximab vs adalimumab and their role in therapy
anti TNF alpha antibody for both UC and CD
for both induction and maintenance therapy
adalimumab is used when infliximab has lost response
first line for UC mild to moderate
TOP ASA > PO ASA > corticosteroids
how does smoking affect UC and CD
UC: If suddenly stop smoking, can trigger a flare up
CD: if stop smoking, is beneficial for pt
systemic complications of IBD
eye inflamx
lower bone density
growth failure rate in children
liver and bile duct inflammation
ASYMMETRICAL arthritis and join pains
skin lesions
kidney stones
IBD patients are usually..
underweight, malnutrition
what can be used for remission induction but not maintenance therapy
steroid, cyclosporine
which has more side effects, sulfasalazine or mesalazine
sulfasalazine. due to the sulfapyridine side group
dose related side effects of sulfasalazine (3)
GI. headache, mild hematologic toxicities
side effects rendering immediate stop of sulfasalazine
agranulocytosis, aplastic anemia
