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GI Exam 3 > IBD > Flashcards

IBD Flashcards

1
Q

Define IBD

A

Inflammatory Bowel Disease
Group of chronic disorders characterized by inflammation and/or ulceration of the small and large intestine
- Typically remain silent for a while and the require acute therapeutic intervention

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2
Q

Types of IBD

A

Crohn’s disease or Ulcerative colitis

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3
Q

Typical Clinical Presentation of IBD

A 
15-40 years old
Diarrhea 
Abdominal pain
Complications of blood loss/malabsorption (dehydrate, loss or protein, weight loos, hypovitaminosis (B12), iron deficiency, fatigue
Extraintestinal complications
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4
Q

Extraintestinal complications =

A

Inflammation of the eyes, skin lesions, joint pain

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5
Q

Lab Findings with IBD

A

Inflammation (leukocytosis, CRP)

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6
Q

***Colitis Presentation

A

Mostly the colon/large intestine
ALWAYS THE RECTUM
CONTINUOUS

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7
Q

***Crohn’s Presentation

A 
Any part of the GI tract
DO NOT AFFECT RECTUM!!!!
Inflammation leads to stricture
Non-continuous!
Abscess formation due to inflammation
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8
Q

Crohn’s Disease General

A

Genetic
Deep ulceration (obvious, sharp-edged, large ulcers)
Non-rectum, non-continuous
40% small bowel alone, 40% small bowel and colon
Commonly have: perianal fistuals, fissues, strictures, abscesses
Danger of perforation and ileus obstruction

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9
Q

Define Stricture

A

Narrowing of the GI tract (reduces motility)

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10
Q

Define Fissure

A

Splitting of the skin in te anus

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11
Q

Define Fistuala

A

Abnormal connections

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12
Q

Define Ileus

A

Accumulation of the waste

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13
Q

Pathology of Crohn’s Disease

A
  • Ileum is the most common site of involvement
  • Ulcers extend through bowel wall and allow bacteria into the mesentery to form abscesses
  • Different types of ulcers and fistulas
  • Fibrous reparative responses can cause marked thickening of the bowel wall
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14
Q

Types of Ulcers in Crohn’s Disease

A

Apthous ulcers (canker sores)
Fissures
Furrows (surrounded by mucosa)
Fistulas (abnormal connections

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15
Q

Stricturing Crohn’s Disease

A

Narrowing of bowel resulting in bowel obstruction or changes in the caliber of feces (change in size and shape)

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16
Q

Penetrating Crohn’s Disease

A

Creates fistulas between the bowel and skin

17
Q

Inflammatory Crohn’s Disease

A

Causes inflammation without causing strictures or fistulas

18
Q

Ulcerative Colitis General

A 
More frequent
Genetic
Primarily LARGE intestine
RECTUM involved
CONTINUOUS
Shallow small bloody ulcers covered in exsudate (dead cells and pus)
Friability of intestinal lining
19
Q

Ulcerative Colitis + Other Risk

A

Gastrointestinal carcinoma

Total colostomy

20
Q

Ulcerative Proctitis UC

A

Only rectum

21
Q

Pancolitis UC

A

Entire colon

22
Q

Distal Colitis UC

A

Left side of the colon

23
Q

***Crohn’s Disease + Extraintestinal Manifestations

A

Joints (arthritis)
Skin (erhthema nodosum)
Eyes
Depression

24
Q

Sclerosing Cholangitis Leads to

A

Obstruction of the bile ducts causing cholestatis and cirrhosis

25
Ulcerative Colitis Pathology
Begins as a pinpoint hemorrhagic Depletion of the goblet cells (mucus producing cells), increased mitoses Intense chronic inflammation and mucosal atrophy All this leads to small islands of viable mucosa
26
Define Toxic Megacolon
Severe complication of UC characterized by a marked dilation of the colon, high body temperature and severe abdominal pain - Related to gut motility with accumulation of bacterial endotoxins (paralytic ileus)
27
Outcome of Toxic Megacolon
Inflammation and pressure of accumulated gas cause atony and necrosis and surgery is needed to prevent perforation, sepsis and death
28
Drugs that can precipitate Toxic Megacolon
Anticholinergic and opiates!!
29
Etiology of IBD
Genetically linked | Autoimmune responses with triggers such as bacteria or protein or viral infections
30
Known causes of colitis included:
Radiation therapy | Chronic bacterial infections
31
Crohn's Autoimmune CD4 T-lymphocyte
TH1
32
Colitis Autoimmune CD4 T-lymphocyte
TH2
33
IBD as an autoimmune disease:
Lots of interleukins (TNF alpha) such as PGs | Genetic risk factors are NOD2, CARD15, IBD1 (mutations favor CD)
34
Define Probiotics
"good bacteria" Helps fighting external bacteria and helps the immune system When these are depleted, then it results in more infection
35
Define Prebiotics
Sugars for food for gut bacteria | They are not broken down so they feed the good bacteria
36
Pharmacology of IBD
NOT curative | Goal: achieve remission and stabilize
37
Crohn's Disease is characterized by
Increased CRP in plasma Arthritis as an extraintestinal complication Deep transmural ulcerations Non-continuous lesions with no rectal involvement
38
Ulcerative Colitis is characterized by:
Diarrhea and abdominal pain Increased risk of carcinoma Shallow ulcer covered with exsudate Involves the RECTUM

GI Exam 3 (9 decks)

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