Inflammatory Bowel Disease- Bernadino Flashcards
Describe two major differences btw UC and CD
UC:
- Involves only mucosa/submucosa
- Involves rectum and is continuous
CD:
- Transmural
- Involves skip lesions through out GI tract (70% involve terminal ileum)
Which IBD has creeping fat, mucosal thickening, and potential for Vit. B12 deficiency?
Crohn’s
Which IBD is associated with granulomas?
Crohn’s
Which IBD has potential for fistulas, abscesses, and strictures?
Crohn’s
Which IBD presents with hematochezia?
UC
The ulcers are what is producing the bleeding!
What is tenesmus? Associated with which IBD?
Tenesmus = pain and urgency to move bowels, very frequently (20 x a day to produce bloody mucosy diarrhea)
Associated with UC
Which IBD is associated with sclerosing cholangitis?
Ulcerative Colitis
Abdominal pain
FTT
Maybe some diarrhea
Crohn Disease
What two skin manifestations are associated with both UC and CD?
pyoderma gangrenosum (looks like nasty ulcer on legs)
Erythema nodosum (bruise on anterior shin, normally patient doesn’t know where it came from)
If pathology report responds with “indeterminant colitis” what can you do to further your evaluation?
Serology!
ASCA- Crohn
pANCA- UC
ASCA associated with…
Crohn
pANCA associated with..
Ulcerative colitis
What is role of surgery in ulcerative colitis?
It is curative
What is the role of surgery in Crohn Disease?
NOT CURATIVE!
Just decreases risk for complications
Why do you see kidney stones with Crohn disease?
Ca+ complexes with creeping fat
Less Ca+ is bound to Oxylate
More oxylate is absorbed leading to stones
Toxic megacolon is associated with?
Profoundly dilated colon associated with ulcerative colitis
Why do you see gallstones with Crohn Disease?
Bile acids are not able to reabsorbed in the terminal ileum
What should you do to treat IBD during pregnancy?
Maintain what has been working!
Except METHOTREXATE, DO NOT USE IT!
Are steroids considered a maintenance therapy?
No!
They are an induction therapy
Which IBD therapy should you NOT give during pregnancy?
Methotrexate!
Big indications for surgery?
Hemorrhage
Perforation
DYSPLASIA
Unresponsive to acute disease therapy (stuff just doesn’t work!)
What drug is protective for colorectal cancer in IBD?
Aspirin
Do pseudopolyps become cancerous?
NOOOO
Jaundice is more likely in UC or CD?
UC!
