IBD CIS Flashcards
Does diet affect the course of IBD?
No… at least for this class anyways
Is there a cure for Crone’s
No
- it’s chronic and lifelong
- exacerbations and remissions
what commonly happens to people with Crohn’s
Extensive terminal ileum resection
- parenteral Vitamin B12
- that is where B12 is absorbed
- Non-caseating granulomas
- there can be many different kinds of FISTULAS
What other diseases have non caseating granuomas?
Sarcoid was the bolded one
- PBC
- histoplasmosis
Ulcerative Colitis?
- idiopathic inflammatory condition
- involves mucosal surface of colon only
- diffuse friability and erosions with bleeding
What would UC look like clinically?
bloody diarrhea with low abd cramping
- tenesmus
- starts at rectum and progresses continuously to cecum
What is interesting about UC and smoking?
-more common in non-smokers
… or smokers that just quit
What is associated with reduced risk of UC?
appendectomy before age 20
What do lab studies look like with UC?
- P-ANCA
- ASCA
- HLA-B27
What is UC associated with?
- Uveitis
- Pyoderma gangrenosum
- pleuritis
- erythema nodosum
- ankylosing spondylitis
- spondyarthropathies
- PSC
- HLA-B27
What are some indications for surgery in UC?
- severe hemorrhage
- perforation
- carcinoma
- fulminant colitis
- Toxic megacolon
- Invisible flat dysplasia
- Non-endoscopically resectable dysplastic lesions
- refractory disease requiring long-term coticosteroids
What is the cure for UC sometimes?
Surgery
Ulcerative colitis as opposed to Crohn’s
- Mucosal
- Colon only
- continuous lesions
- bloody diarrhea
- crypt abscess on histology
- toxic megacolon (no fistulas or fissures)
- Ulcerated pseudopolyps
- smoking protective*
Crohns as opposed to UC?
- 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
What lab thing does Crohn’s have?
ASCA
What lab thing does UC have?
pANCA
Which one is seen with a perianal fistula?
Crohn’s disease
what are some IBD extraintestinal manifestions?
- pyoderma gangrenosum
- oral apthous ulcer
- iritis
- anterior uveitis
- toxic megacolon
- ankylosing spondylitis aka bambook spine
- eyrethema nodosum
What are the treatment options for IBD?
- 5-ASA derivatives
- Corticosteroids
- Immuno-modulating agents
- Biologic agents
adverse effect of 5-ASA ?
Acute interstital nephritis
adverse effect of Corticosteroids?
Acute: mood changes, insomnia, dyspepsia, weight gain, edema…. mmon facies
-Long term: osteoporosis, osteonecrosis of the gemoral head, myopathy, cataracts, susceptibily to infection
What do we need to do if we give someone corticosteroids?
give them calcium and vitamin D supplements
-Monitor bone densitometry
