IBD CIS Flashcards

1
Q

Does diet affect the course of IBD?

A

No… at least for this class anyways

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2
Q

Is there a cure for Crone’s

A

No

  • it’s chronic and lifelong
  • exacerbations and remissions
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3
Q

what commonly happens to people with Crohn’s

A

Extensive terminal ileum resection

  • parenteral Vitamin B12
  • that is where B12 is absorbed
  • Non-caseating granulomas
  • there can be many different kinds of FISTULAS
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4
Q

What other diseases have non caseating granuomas?

A

Sarcoid was the bolded one

  • PBC
  • histoplasmosis
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5
Q

Ulcerative Colitis?

A
  • idiopathic inflammatory condition
  • involves mucosal surface of colon only
  • diffuse friability and erosions with bleeding
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6
Q

What would UC look like clinically?

A

bloody diarrhea with low abd cramping

  • tenesmus
  • starts at rectum and progresses continuously to cecum
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7
Q

What is interesting about UC and smoking?

A

-more common in non-smokers

… or smokers that just quit

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8
Q

What is associated with reduced risk of UC?

A

appendectomy before age 20

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9
Q

What do lab studies look like with UC?

A
  • P-ANCA
  • ASCA
  • HLA-B27
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10
Q

What is UC associated with?

A
  • Uveitis
  • Pyoderma gangrenosum
  • pleuritis
  • erythema nodosum
  • ankylosing spondylitis
  • spondyarthropathies
  • PSC
  • HLA-B27
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11
Q

What are some indications for surgery in UC?

A
  • severe hemorrhage
  • perforation
  • carcinoma
  • fulminant colitis
  • Toxic megacolon
  • Invisible flat dysplasia
  • Non-endoscopically resectable dysplastic lesions
  • refractory disease requiring long-term coticosteroids
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12
Q

What is the cure for UC sometimes?

A

Surgery

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13
Q

Ulcerative colitis as opposed to Crohn’s

A
  • Mucosal
  • Colon only
  • continuous lesions
  • bloody diarrhea
  • crypt abscess on histology
  • toxic megacolon (no fistulas or fissures)
  • Ulcerated pseudopolyps
  • smoking protective*
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14
Q

Crohns as opposed to UC?

A
  • transmural
  • anywhere along GI tract (most common is Terminal ileum)
  • Skip lesions
  • often without blood
  • Non-caseating granuloma on histology
  • Strictures (string sign), obstruction, abscesses, fistulas, and fissures
  • apthous ulcers intervening with normal mucosa, linear fissure, “Cobble-stoning”, thickened bowel wall, “creeping fat”
  • Smoking worsens the disease
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15
Q

What lab thing does Crohn’s have?

A

ASCA

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16
Q

What lab thing does UC have?

A

pANCA

17
Q

Which one is seen with a perianal fistula?

A

Crohn’s disease

18
Q

what are some IBD extraintestinal manifestions?

A
  • pyoderma gangrenosum
  • oral apthous ulcer
  • iritis
  • anterior uveitis
  • toxic megacolon
  • ankylosing spondylitis aka bambook spine
  • eyrethema nodosum
19
Q

What are the treatment options for IBD?

A
  • 5-ASA derivatives
  • Corticosteroids
  • Immuno-modulating agents
  • Biologic agents
20
Q

adverse effect of 5-ASA ?

A

Acute interstital nephritis

21
Q

adverse effect of Corticosteroids?

A

Acute: mood changes, insomnia, dyspepsia, weight gain, edema…. mmon facies
-Long term: osteoporosis, osteonecrosis of the gemoral head, myopathy, cataracts, susceptibily to infection

22
Q

What do we need to do if we give someone corticosteroids?

A

give them calcium and vitamin D supplements

-Monitor bone densitometry