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NEC 3 > Inflammatory Bowel Disease > Flashcards

Inflammatory Bowel Disease Flashcards

1
Q

An autoimmune disease

A

Inflammatory Bowel Disease

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2
Q

Characterized by chronic inflammation of the gastrointestinal tract

A

Inflammatory Bowel Disease

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3
Q

What happens if there is a prolonged inflammation?

A

It can cause damage

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4
Q

What are the two disorders of inflammatory bowel disease?

A
  1. Ulcerative Colitis
  2. Chron’s Disease
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5
Q

A chronic and idiopathic characterized by inflammation and ulceration of the rectum and colon

A

Ulcerative Colitis

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6
Q

Ulcerative colitis occurs at what age?

A

Occurs at any age but peaks between ages of 15 and 45 years years

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7
Q

What is the etiology or causes of Ulcerative Colitis

A
  1. Genetic
  2. Altered dysregulated immune response
  3. Proinflammatory cytokines (TNF-a) (Tumor Necrosis Factor- Alpha
  4. Altered response to gut microorganisms
  5. Smoking
  6. Diet high in animal protein
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8
Q

What is the pathophysiology of Ulcerative Colitis?

A
  1. inflammation is diffuse; involves the mucosa and submucosa
  2. Begins in the rectum
  3. Spreads proximally along the descending colon in a continuous fashion.
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9
Q

What is the clinical manifestations of ulcerative colitis?

A

Abdominal pain

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10
Q

Clinical manifestations of ulcerative colitis (MILD)

A

one or two semiformed stools, containing small amounts of blood per day

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11
Q

Clinical manifestations of ulcerative colitis (MODERATE)

A
  1. Increased stool output (four or five times per day)
  2. Increased bleeding
  3. Systemic symptoms
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12
Q

What are the systemic symptoms?

A

-Fever
-Malaise
-Anorexia

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13
Q

Clinical Manifestations of ulcerative colitis (SEVERE)

A
  1. bloody diarrhea with mucus (occurs 10 to 20 times per day)
  2. fever
  3. weight loss greater than 10% of the total body weight
  4. anemia
  5. tachycardia
  6. dehydration
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14
Q

Complications of ulcerative colitis are divided into two, what are those?

A
  1. Intestinal
  2. Extraintestinal
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15
Q

What are the complications of intestinal?

A
  1. hemorrhage
  2. perforation
  3. toxic megacolon
  4. colonic dilation
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16
Q

this is due to inflamed and ulcerated mucosa

A

hemorrhage

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17
Q

this is due to megacolon

A

perforation

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18
Q

extensive dilation and paralysis of the colon

A

toxic megacolon

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19
Q

this is due to severe acute inflammation of the entire colon wall

A

colonic dilation

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20
Q

Extraintestinal

A

Associated with active inflammation

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21
Q

What are the active inflammation in extraintestinal?

A
  1. skin lesion
  2. anemia
  3. leukocytosis
  4. thrombocytosis
  5. uveitis
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22
Q

called as the inflammation inside the eye

A

uveitis

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23
Q

What are the diagnosis of ulcerative colitis?

A
  1. Double-contrast
  2. Sigmoidoscopy
  3. Colonoscopy
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24
Q

A process in which x-rays of the rectum and colon are taken after a liquid containing barium given

A

Double-contrast

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25
Q

What diet should be instilled before performing double-contrast?

A

Low-residue diet is advised days before the procedure

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26
Q

Other important to do in double-contrast

A

-Low residue diet is advised days before the procedure
- Consume only clear liquids during 24 hours before the procedure, including the evening before the test.

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27
Q

What is sigmoidoscopy?

A

Visualization of the rectum, sigmoid and distal descending colon

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28
Q

What needs to be done before doing the sigmoidoscopy procedure?

A

Bowel preparation before the procedure
-First enema is given 2 hours before the procedure
-Second enema is given 1 hour before the procedure

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29
Q

Allows examination of the entire large intestine

A

Colonoscopy

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30
Q

Colonoscopy helps to identify?

A

Identifies the extent of inflammation, ulceration, pseudopolyps, strictures, and lesions

31
Q

What needs to watch out for in colonoscopy?

A

Watch out for any signs of bowel perforation such as (severe abdominal pain, nausea, vomiting, fever and chills)

32
Q

What are the goals for ulcerative colitis?

A
  1. Rest the bowel
  2. Control the inflammation
  3. Monitor fluids and nutrition
  4. Monitor patient stress
  5. Provide education about the disease and treatment
  6. Provide symptomatic relief
33
Q

What are the medical management of Ulcerative Colitis?

A
  1. Sulphasalazine
  2. Corticosteroids
  3. Cyclosporine
  4. Proctocolectomy
34
Q

The drug of choice for Ulcerative Colitis

A

Sulphasalazine

35
Q

What is the mechanism of action of the drug sulphasalazine?

A

Reduces inflammation

36
Q

What discoloration is brought by sulphasalazine?

A

Causes yellowish-orange discoloration of the skin and urine

37
Q

What needs to be avoided when taking a sulphasalazine?

A

Patients should avoid exposure to sunlight and UV rays

38
Q

Why patients need to avoid exposure to sunlight and UV rays when taking sulphasalazine?

A

It can cause photosensitivity

39
Q

This is proven to benefit the management of active UC

A

Corticosteroids

40
Q

When taking a corticosteroid what needs to be monitored for common adverse effects?

A

-Cushing’s syndrome
-Hypertension
-Hirsutism
-Mood Swings

41
Q

An immunosuppressive

A

Cyclosporine

42
Q

This is given to patient with severe UC

A

Cyclosporine

43
Q

What needs to be watch out for when taking a cyclosporine?

A

Watch out for renal dysfunction, hypertension, headache and muscle cramps

44
Q

Cyclosporine is given in what?

A

Given via IVTT

45
Q

A surgical procedure to remove the colon and rectum

A

Proctocolectomy

46
Q

The diet for Ulcerative Colitis

A

-High calorie, high-protein, low-residue/fiber diet with vitamin and iron supplements

47
Q

What foods needs to be avoided in Ulcerative Colitis?

A

Avoid cold foods, high-residue food and smoking

48
Q

Give me an example of high-residue food

A
  1. Whole wheat bread
  2. Cereal with bran
  3. nuts
  4. raw fruit
49
Q

Why do cold foods, high residue diet and smoking need to be avoided?

A

It can increase GI motility

50
Q

Foods that are okay in Ulcerative Colitis

A
  1. White bread
  2. White rice or noodles
  3. Plain crackers and potato rolls
  4. Skinless cooked potato
  5. Eggs
51
Q

Foods that are not okay in Ulcerative Colitis

A
  1. Whole wheat bread and pasta
  2. Brown rice or wild rice
  3. Wheat crackers and rolls
  4. Milk and milk products
  5. Cereal
52
Q

An autoimmune disease that can affect any part of the GI tract from the mouth to the anus

A

Chron’s Disease

53
Q

Chron’s disease occurs most often in what ages?

A

It occurs most often between the ages of 15 and 30 years

54
Q

What is the etiology of Chron’s Disease?

A
  1. Genetic predisposition/defect NOD2 gene
  2. Intestinal microorganisms
  3. Immune dysregulation
  4. Granulomas
55
Q

What is the first gene associated with Chron’s disease?

A

Genetic predisposition/defect NOD2 gene

56
Q

Also known as chronic inflammatory lesions

A

Granulomas

57
Q

Clinical manifestations of Chron’s disease

A
  1. Diarrhea
  2. Abdominal Pain
  3. Fatigue
  4. Weight loss
  5. Fever
58
Q

What is the complication of Chron’s Disease?

A

-Gastrointestinal fistulas
-Urinary Tract Infection
- Perforation
- Intra-abdominal abscess

59
Q

What is the diagnosis of Chron’s Disease?

A

-History & Physical Examination
-CBC, ESR
-Hemoccult
- Radiological studies with barium contrast
- Sigmoidoscopy & colonoscopy with biopsy

60
Q

Medical Management of Chron’s Disease

A
  1. Sulphasalazine
  2. Corticosteroids
  3. Azathioprine
  4. Metronidazole
61
Q

This drug is more effective if large intestines are affected

A

Sulphasalazine

62
Q

This drug reduces inflammation

A

Corticosteroids

63
Q

This drug is immunosuppressant

A

Azathioprine

64
Q

Metronidazole is in what classification of drug?

A

Antibiotic

65
Q

This drug is chron’s in the perianal area

A

Metronidazole

66
Q

What is the nutritional management of Chron’s Disease?

A
  1. Parenteral Nutrition
  2. Elemental diet
  3. Low residue diet
  4. High calorie and CHON
  5. No milk
  6. Vitamins B12 monthly injections
67
Q

For with severe disease, small bowel fistulas, or short bowel syndrome

A

Parenteral nutrition

68
Q

A liquid meal replacement diet that offers a complete nutritional profile

A

Elemental diet

69
Q

This may not be digested properly due to inflamed intestinal mucosa

A

No milk

70
Q

Surgical Management of Chron’s Disease (Indications)

A

-Drainage of abdominal abscess
- Failure to respond to conservative therapy
-Massive Hemorrhage
- Perforation

71
Q

Removal of the damaged or diseased portion of the intestine (small intestine. large intestine, and rectum)

A

Intestinal Resection

72
Q

A surgical connection between two loops of intestine

A

Intestinal Anastomosis

73
Q

Surgical Management for Chron’s Disease

A

-Intestinal Resection
-Intestinal Anastomosis

NEC 3 (16 decks)

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