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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
Q

Ulcerative Colitis Pathology

A

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
Q

Define Toxic Megacolon

A

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
Q

Outcome of Toxic Megacolon

A

Inflammation and pressure of accumulated gas cause atony and necrosis and surgery is needed to prevent perforation, sepsis and death

28
Q

Drugs that can precipitate Toxic Megacolon

A

Anticholinergic and opiates!!

29
Q

Etiology of IBD

A

Genetically linked

Autoimmune responses with triggers such as bacteria or protein or viral infections

30
Q

Known causes of colitis included:

A

Radiation therapy

Chronic bacterial infections

31
Q

Crohn’s Autoimmune CD4 T-lymphocyte

A

TH1

32
Q

Colitis Autoimmune CD4 T-lymphocyte

A

TH2

33
Q

IBD as an autoimmune disease:

A

Lots of interleukins (TNF alpha) such as PGs

Genetic risk factors are NOD2, CARD15, IBD1 (mutations favor CD)

34
Q

Define Probiotics

A

“good bacteria”
Helps fighting external bacteria and helps the immune system
When these are depleted, then it results in more infection

35
Q

Define Prebiotics

A

Sugars for food for gut bacteria

They are not broken down so they feed the good bacteria

36
Q

Pharmacology of IBD

A

NOT curative

Goal: achieve remission and stabilize

37
Q

Crohn’s Disease is characterized by

A

Increased CRP in plasma
Arthritis as an extraintestinal complication
Deep transmural ulcerations
Non-continuous lesions with no rectal involvement

38
Q

Ulcerative Colitis is characterized by:

A

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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