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Foundations III GI (Cholley) > IBD & Celiac disease > Flashcards

IBD & Celiac disease Flashcards

1
Q

What are the possible causes of IBD?

A

Multifactoral:
Genetic
Environmental
Immunologic

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2
Q

What is the effect of smoking on crohn’s vs UC?

A

Increases risk of Crohns

Decreases risk of UC

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3
Q

Which is more common? UC or Crohn’s?

A

UC

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4
Q

What are characteristics of Crohn’s?

A

Can affect entire GI tract: Mouth –> anus

Transmural (affects entire thickness of mucosa)

Can cause fistula

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5
Q

Crohn’s: What is the MC site of involvement?

A

Distal ileum

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6
Q

How does Crohn’s present?

A

Gradual onset

Colicky RLQ pain

Chronic, intermittent diarrhea
(often nocturnal)

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7
Q

What extra-intestinal manifestations are seen in both Crohn’s & UC?

A

Arthralgias, arthritis (MC!)
Erythema nodosum
Episcleritis, iritis, uveitis
Sclerosing cholangitis

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8
Q

What is the procedure of choice for crohn’s?

A

Colonoscopy: Skip lesions

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9
Q

What will biopsy show in crohn’s?

A

Granulomas

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10
Q

What other tests can you use to dx crohn’s?

A

CT of abd/pelvis w/ contrast

Small bowel follow-through: String sign

ESR, CRP: elevated in active disease

IBD specific antibodies

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11
Q

What are complications of crohn’s?

A

Fistula, abscess
Obstruction
Perforation
Nutrient deficiencies (Fe, B12)**

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12
Q

What class of medication can worsen sx of both Crohn’s & UC?

A

NSAIDs!

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13
Q

Both Crohn’s & UC increase the risk of what?

A

Colon CA

Perform colonoscopy every 1-2yrs

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14
Q

How do you treat Crohn’s disease?

A 
Salicylates 
Abx (fistulas/abscess)*cipro+flagyl
Corticosteroids (flares)
Immunosuppressants 
TNF blockers 
Surgery 
Nutrition*
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15
Q

UC affects what organ in the body?

A

Mucosal surface of colon only

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16
Q

What term is used to describe a disease that extends into the cecum?

A

Pancolitis

17
Q

What term is used to describe a disease that extends to (but not beyond) splenic flexure?

A

Left-sided colitis

18
Q

How does UC present?

A

Diarrhea (often bloody)

Tenesmus

19
Q

What extra-intestinal manifestations are only seen in crohn’s?

A

Aphthous ulcers

Gallstones

20
Q

How do you make the definitive dx of UC?

A

Flex Sig or colonoscopy

21
Q

What other tests are used to dx UC?

A

CT abd/pelvis w/ contrast

ESR, CRP

IBD specific antibodies

22
Q

What are complications of UC?

A

Hemorrhage

Toxic megacolon

23
Q

How do you treat UC?

A

Step up therapy

  1. Salicylates 1st line**
  2. Corticosteroids (flares)**
  3. Immunomodulators (6-MP/Azathioprine)
  4. TNF blockers (Remicade)
  5. Surgery
24
Q

What are indications that surgery is needed for UC?

A

Perforation
Severe hemorrhage
Dysplasia/CA
Refractory to med tx

25
Q

What are the ADEs of cipro?

A

Tendinitis
Photosensitivity
QT prolongation

26
Q

What are ADEs of flagyl?

A

Peripheral neuropathy
Metallic taste
Disulfuram rxn

27
Q

What are red flags in IBD?

A 
Severe bleeding
Severe abd pain
Wt loss
Dehydration 
Obstruction
Failure to respond to med tx
28
Q

What causes celiac disease?

A

Immune d/o triggered by environmental exposure

29
Q

Exposure to gluten can cause ______, _______, & _____ in the small intestine

A

inflammation, crypt hyperplasia, & villous atrophy

30
Q

Celiac disease is associated w/ what conditions?

A

Autoimmune disease
DM I
Thyroid disease
Down’s

31
Q

How does celiac disease present?

A

Diarrhea w/ foul smelling stools

Bloating & flatulence

Fe deficiency anemia

Vit B deficiency –> neuro d/o

Osteopenia

Dermatitis herpetiformis

32
Q

How do you dx celiac disease? What is gold standard?

A

Serologic: IgA, celiac panel

Small bowel biopsy via EGD = GOLD

33
Q

Is there an increased risk of malignancy in celiac disease?

A

Slightly!

Non-hodgkins
GI malignancy

34
Q

What does “AEIOU” stand for in celiac disease per Coplan?

A 
Anemia 
Elevated LFTs
Iron deficiency 
Osteopenia 
Uncomfortable digestion

Foundations III GI (Cholley) (10 decks)

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