IBD Clinical Lecture Flashcards
Basic
UC vs CD
UC: confluent mucosal lesion (only in colon)
CD: transmural skip lesions (can be in sm intestine)
Colectomy in UC vs CD
UC: curative
CD: helps with Sx, further Tx required
When does fistula formation occur
UC/CD
CD more often
Serum tests
Crohn’s
Ulcerative Colitis
Chrohn’s: ASCA +
UC: pANCA +
pANCA +
Ulcerative Colitis
ASCA +
Crohn’s
Erythema nodosum
appearance
association
looks like mild bruising an anterior surface of leg
UC and CD
Pyoderma nodosum
appearance
association
central ulcer w/ ring of erythema
UC and CD
Galbladder manifestation of UC
primary sclerosing cholangitis
Primary sclerosing cholangitis association
UC
Gallstones in IBD
pathology
loss of functional ileum
decreased mile salt reuptake
Renal stones in IBD
pathology
extra fat lost in stool
Ca2+ lost with fat in stool
Ca2+ normally binds oxalate and keeps in lumen
excess oxalate absorbed in gut
oxalate excreted in kidney
excess oxalate in kidney creates calcium oxalate stones
Ocular manifestation of IBD
uveitis
MS manifestation of IBD in young people
akylosing spondylitis
Complications of UC
toxic megacolon
hypercoagulability
1˚ sclerosing cholangitis
Complications of CD
abscess
obstruction
hypercoagulability
Random colon Bx during routine colonoscopy in IBD
why do they do that?
looking for dysplasia
adenocarcinoma of colon does not follow
adenoma -> adenocarcinoma sequence in IBD
if dysplasia found, colectomy is warranted
Ideal IBD Tx in pregnancy
keep using Tx that has been working
avoid steroids if possible in 3rd trimester
Complications of biologic therapy
TNF-α inhibitors
infections (mycobacteria)
malignancy (also re-emergence of previous)
demyelinating disease
Dysplasia or cancer on screening colonoscopy
Refusing medical treatment
indications of colectomy
Prednisone is not
maintenance therapy
