Inflammatory bowel disease Flashcards
definition: IBD
dysregulated, inappropriate response of the intestinal mucosal immune system to otherwise innocuous luminal antigens in a genetically susceptible host
what is the inflammation pattern in UC? what about CD?
UC - diffuse mucosal inflammation limited to colon
CD - patchy transmural inflammation in any part of GI tract
does UC affect the rectum? CD?
UC - yes
CD - usually rectum sparing
how does smoking affect risk of UC? CD?
UC - decrease / no effect
CD - significant increase
how does appendectomy affect UC risk?
decreases risk
how does high sanitation level in childhood affect CD risk?
increases
what are the etiological hypotheses for IBD?
persistent infection
defective mucosal integrity
dysbiosis
dysregulated immune response
the pathogenesis of IBD involves what three main factors?
luminal antigens
genetic susceptibility
environmental triggers
what is the presentation for UC?
bloody diarrhea
rectal discomfort
fecal urgency
cramping / distention
extensive UC involves what areas?
left and transverse
what are the four presentations of CD?
inflammation
fistulization
obstruction
microperforation
psoas abscess signs would indicate what possible condition?
retroperitoneal fistulization in CD
strictures, fistulizations, skip lesions, and granulomas are indicative of what IBD disease?
CD
what are the most common extraintestinal manifestations related to IBD?
aphthous stomatitis episcleritis arthritis vascular complications e. nodosum p. gangrenosum
what are the IBD related osteopenia risk factors?
inflammation (CD more than UC) IBD medication (corticosteroids)
what are the goals of therapy for IBD?
induce clinical remission
maintain remission
enhance quality of life
avoid long term toxicity
which agents are used for remission induction in UC?
aminosalicylates
corticosteroids
6MP / azathioprine
cyclosporine
which agents are used for remission maintenance in UC?
aminosalicylates
6MP / azathioprine
which agents are used for remission induction in CD?
aminosalicylates antibiotics corticosteroids immunomodulators defined diets
which agents are used for remission maintenance in CD?
immunomodulators
aminosalicylates
antibiotics
what are the indications for metronidazole?
active crohns colitis and ileocolitis
perineal disease
post-op CD prevention
pouchitis
what are the adverse effects of metronidazole?
nausea, anorexia metallic taste furry tongue candidiasis peripheral neuropathy
what are the indications for topical corticosteroids?
proctitis and left sided colitis
what are the indications for oral systemic corticosteroids?
moderate to severe UC or CD
