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Clinical medicine > Inflammatory Bowel diseases > Flashcards

Inflammatory Bowel diseases Flashcards

1
Q

Inflammatory bowel disease includes

A

ulcerative colitis and crohn’s

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2
Q

differences of ulcerative colitis and crohn’s onset

A

C-gradual, UC- sudden or gradual

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3
Q

differences of ulcerative colitis and crohn’s distribution

A

C-mouth to anus, skip areas, UC- distal to proximal, no skip

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4
Q

differences of ulcerative colitis and crohn’s depth of lesion

A

C- trasmural, UC- mucosal

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5
Q

differences of ulcerative colitis and crohn’s symptoms

A

C- diarrhea/pain, UC- bloody, pus, diarrhea, tenesmus

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6
Q

differences of ulcerative colitis and crohn’s complications

A

C-fistulas, toxic megacolon, colon CA, UC: toxic megacolon and colon cancer

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7
Q

Ulcerative cholitis

A

chronic recurrent disease, starts at rectum and moves proximally, contained within colon, toxic megacolon and malignancy are more likely in UC than C, smoking is protective

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8
Q

Symptoms of UC

A

inflammatory diarrhea, tenesmus, pain in LLQ (rare), weight loss, malaise, fever

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9
Q

Diagnosis of UC

A

CBC: anemia, ESR: increased, Albumin: decreased, Xray will show colonic dilatation, diagnostic is colonoscopy (avoid in severe) or sigmoidoscopy

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10
Q

Treatment of UC

A

topical or oral aminosalicylates, corticosteroids, immunomodulators, surgery can be curative

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11
Q

Crohn’s disease

A

cause is unknown, genetic predispostion, involves: s/l colon, mouth, esophagus, stomach, but mostly terminal ileum and r colon, not usually rectum, has skip areas

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12
Q

Symptoms of Crohn’s

A

abdominal cramps, chronic diarrhea,

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13
Q

Diagnosis of crohn’s

A

anemia, increased ESR, electrolyte imbalances colonoscopy, biopsy, granuloma common

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14
Q

Treatment of Crohn’s

A

acute: oral corticosteroids, Maintenance: mesalamine, MTX, smoking cessation, B12, folate, Vit D, surgery is not curative

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15
Q

Toxic megacolon

A

Emergency, extreme dilatation and immobility of colon, Hirschsprung’s disease, ulcerative colitis, Crohn’s. and infectious causes

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16
Q

Symptoms of toxic megacolon

A

fever, prostration, severe cramps, abd distention

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17
Q

Diagnosis of Toxic megacolon

A

rigid abd, rebound tenderness, xray shows colon dilatation

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18
Q

Treatment of Toxic megacolon

A

Decompression of the colon, fluid and electrolyte balances

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19
Q

Ischemic bowel disease

A

Acute or chronic, >50 yo, intestinal infarction is more common in the small bowel than large, shock is common

20
Q

Acute mesenteric ischemia

A

emergency, high mortality, arterial embolus/thrombus, venous thrombosis, sudden onset of severe abd pain

21
Q

Chronic mesenteric ischemia

A

blood supply is present but insufficient, abd angina and pain 10-30 min after eating, relieved by squatting or lying down

22
Q

Diagnosis of ischemic bowel

A

Ct to rule out other abd causes, diagnostic is colonoscopy

23
Q

Treatment of ischemic bowel disease

A

surgery to revascularize intestine, hydration

24
Q

Intussusception

A

invagination of proximal segment of bowel into portion distal to it, most common in children

25
Q

Symptoms of intussusception

A

children: colick, stoll will contain blood and mucus (jelly stool), abd pain, sausage like mass adults: crampy, no blood, abd pain, mass is rare

26
Q

Diagnosing intussusception

A

children:barium or air filled most diagnostic, adult: barium enema should not be used, Xray is not specific, CT best, usually found in surgery

27
Q

Treatment of intussusception

A

hospitalized, air or barium enema may be curative, surgery or resection

28
Q

Common small bowel obstruction

A

adhesions, hernias, neoplasm, inflammatory bowel disease, volvulus

29
Q

Common large bowel obstruction

A

neoplasm, strictures, hernias, volvulus, intussusception, fecal impaction

30
Q

Symptoms of small bowel obstruction

A

abd pain, distention, vomiting of partially digested food, opstipation, high pitched bowel sounds, later bowel is silent

31
Q

Symptoms of large bowel obstruction

A

distention and pain, may be febrile, tachy, shock

32
Q

Diagnosing bowel obstruction

A

CMP: decreased electrolytes, upright CT shows air fluid levels

33
Q

Treatment of bowel obstruction

A

NPO, NG, IV fluids, monitoring, surgery likely with large intestine

34
Q

Volvulus

A

emergency, twisting of bowel on self, sigmoid or cecal area, ischemia can lead to gnagrene, peritonitis and sepsis

35
Q

Symptoms of bowel volvulus

A

Cramping abd pain and distention, tachy, nausea, vomiting, obstipation, fever, severe pain

36
Q

Diagnosing Volvulus

A

xray shows colonic distension

37
Q

Treatment of volvulus

A

immediate decompression to avoid ischemia, endoscopic depression with surgeon stand by

38
Q

Diverticular disease

A

Diverticulosis are pocket formations, diferticulitis is infection, >60% >60 have, 20% are asymptomatic, 20% have acute

39
Q

Symptoms of diverticular disease

A

sudden onset in LLQ, fever, nausea, diarrhea, blood

40
Q

Diagnosing diverticular disease

A

occult blood, elevated WBC, X ray to rule out free air, CT if pt does not respond to therapy, barium enema avoided

41
Q

Treatment diverticular disease

A

antibiotic treatment (Cipro, flagyl), pt education on diet, and meds

42
Q

Treatment of severe diverticulitis

A

hospitalization, IV antibiotics, NPO, NG tube, surgical management

43
Q

Appendicitis

A

obstruction of appendix leads to inflammation and infection, commonest cause of fecalith and ER surgery, 10-30 yo, 10% of pop, 20% of pt develop peritonitis and perforation

44
Q

Symptoms of appendicitis

A

progressive, intermittent periumbical pain, than RLQ localization, nausea and anorexia, vomiting/diarrhea, low grade temp

45
Q

Diagnosis of appendicitis

A

increased WBC, blood and leukocytes in UA, abdominal CT w/ contrast

Clinical medicine (19 decks)

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