Intestinal Disorders Flashcards
Inflammatory bowel dz types
Ulcerative colitis
Crohns Dz
IBD ethnic influence
More prominent in jews
IBD age
Mostly younger (10-30)
IBD patho
Defect in function of intestinal lumen.
Exposure of mucosa to bugs
T-cell mediated rxn
Systemic complications of IBD
apthous stomatitis Uveitis Arthritis Vascular complications Gallstones Malabsorption Kidney stones
Ulcerative colitis course (UC)
Flare ups and remissions
More common in nonsmokers
Sx may worsen in pts who stop smoking.
Higher risk for cancer.
UC S/S
Bloody diarrhea (at night)
Lower abd cramps
Fecal urgency
Can progress to fever, extreme pain, hypovolemia
Ulcerative colitis facts
Involves mucosal surface of colon, formation of crypt abscesses.
Alwats includes rectum, spreads proximally.
Uniform, no skip lesions
Ulcerative colitis labs
Anemia
Elevate sed rate
electrolyte disturbances
pANCA antibodies
UC dx
Best made w/ sigmoidoscopy
Bloody diarrhea
KUB
CT scan for complications
UC Tx
Sulfasalzine
Mesalamine
Prednisone
Crohn’s Dz
Transmural involvement w/ formation of fistulas, narrowing, obstruction.
Usually ileocolitis
What lifestyle choice is associated with crohns?
Smoking
Crohns dz usually spares the rectum
True
Differentiated from UC in that way
Crohns presentation
Insidious onset Weight loss, pallor Intermittent low grade fever, diarrhea, RLQ pain Pain after meal RLQ mass Perianal dz
Which skin lesions may precede intestinal sx of crohns?
Erythema nodosum
Crohns lesions
They are segmented and skip.
Are cobblestoned
Opposed to UC lesions, that are continuous.
Perianal changes in crohns
Abscess
Fistula
Skin tag
Anal stricture
ASCA test
Antibody test
Good to rule in, but lots of false negatives.
String sign
Seen in crohns
Crohns tx
Sulfasazine
Abx
Steroids
Infliximab
Irritable Bowel Syndrome
Functional GI dz with variable recurrent or chronic sx not explained by structural or biochemical abnormalities
20% of pop
dx of exclusion
IBS Dx
Continuous or recurrent sx for at least 3 months.
Abd pain, pain relieved by defecation.
Altered stool frequency, form, passage. Bloating, mucus
Systemic sx of IBS
Fatigue Back ache Early satiety Nausea HA Irritable bladder
Does IBS usually cause sleep disturbance?
Nope
IBS age range
Usually younger people
T or F: Ulcerative colitis often involves the small bowel as well.
False, UC is only on the large bowel.
