L17: IBD Flashcards

1
Q

Def of IBD

A
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2
Q

Characters of IBD

A

 Relapsing and remitting condition.

 Characterized by chronic inflammation at various sites in the GI tract.

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3
Q

Types of IBD

A

Crohn’s disease & Ulcerative colitis (UC).

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4
Q

Why is IBD Confused with IBS?

A

as both Result in diarrhea and abdominal pain.

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5
Q

Etiology of IBD

A
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6
Q

Def of Crohn’s disease

A

Chronic transmural inflammation affecting the gut from mouth to perianal region.

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7
Q

Def of UC

A

Inflammatory disease affecting Colonic mucosa anywhere from rectum to cecum

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8
Q

Age in Crohn’s disease

A

<30 years, second peak age 60.

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9
Q

Age in UC

A

2/3 onset by age 30

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10
Q

Sex in Crohn’s disease

A

Females > males.

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11
Q

Sex in UC

A

Females = males.

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12
Q

Smoking & Crohn’s disease

A

Increases CD

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13
Q

Smoking & UC

A

Risk is less in smokers

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14
Q

Site of Crohn’s disease

A

Any part of GIT, from mouthto anus, but mainly terminal ileum & ascending colon.

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15
Q

Site of UC

A

limited to the colon, but mainly affects the rectosigmoid region

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16
Q

Layers affected in Crohn’s disease

A

all layers

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17
Q

Granuloma in UC

A

no granuloma

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17
Q

Layers affected in UC

A

mucosa

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18
Q

Granuloma in Crohn’s disease

A

non caseating granuloma

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19
Q

Crypt Abcess in Crohn’s disease

A

No

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20
Q

Crypt Abscess in UC

A

Yes

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21
Q

Continuity of Lesions in Crohn’s disease

A

skip lesions

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22
Q

Continuity of Lesions in UC

A

continuous lesions

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23
Q

Extra-Intestinal Manifestations in IBD

A
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24
Q

Skin Manifestations in IBD

A

Erythema nodosum, Pyoderma gangrenosum, (skin tags, Oral Aphthous = Crohn’s)

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25
Q

Rhematological Manifestations in IBD

A

ankylosing spondylitis, Sacroiliitis, arthritis (commonest association)

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26
Q

Occular Manifestations in IBD

A

uveitis, scleritis, episcleritis, scleromalacia

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27
Q

Hepatic Manifestations in IBD

A

PSC, fatty liver, gall stones.

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28
Q

Other Extra-Intestinal Manifestations in IBD

A

vasculitis, osteoporosis, Vitamin deficiency, thromboembolism.

29
Q

Compare between Crohn’s Disease & UC in terms of:

  • Age
  • Sex
  • Smoking
  • Rectal Bleeding
  • Diarrhea
  • Pain
  • Urgency
  • Mass
  • Fever
A
30
Q

Compare between Crohn’s Disease & UC in terms of:

  • Complications
A
31
Q

INVx in IBD

A
32
Q

Colonoscopy in Crohn’s Disease

A
33
Q

Colonoscopy in UC

A
34
Q

Bariam Enema in Crohn’s Disease

A
35
Q

Barium Enema in UC

A
36
Q

CT/MR Colongraphy in IBD

A
37
Q

Capsule Endoscopy in IBD

A
38
Q

Serology in IBD

A
39
Q

Calprotectin & CRP in IBD

A
40
Q

Diet & Lifestyle Changes in TTT of UC

A
40
Q

TTT Options in IBD

A
  • Diet / Lifestyle
  • Antidiarrheal Drugs
  • Antibiotics
  • 5-ASA
  • Corticosteroids
  • Immunosuppresive Drugs
  • Biologic Drugs
  • Surgical TTT
41
Q

Diet & Lifestyle Changes in TTT of Crohn’s Disease

A
42
Q

Anttidiarrheal Drugs in TTT of Crohn’s Disease

A
43
Q

Anttidiarrheal Drugs in TTT of UC

A
44
Q

Antibiotic in TTT of Crohn’s Disease

A
45
Q

Antiobiotics in TTT of UC

A
46
Q

5-ASA in TTT of Crohn’s Disease

A
47
Q

5-ASA in TTT of UC

A
48
Q

Corticosteroides in TTT of Crohn’s Disease

A
49
Q

Corticosteroides in TTT of UC

A
50
Q

Immunosupressives in TTT of IBD

A
51
Q

Biological TTT of Crohn’s Disease

A
52
Q

Biological TTT of UC

A
53
Q

Surgical TTT of Crohn’s Disease

A
54
Q

Surgical TTT of UC

A
55
Q

Truelove and Witts’ classification of clinical severity of ulcerative colitis

A
56
Q

CP of Toxic or fulminant colitis

A

 Sudden violent diarrhea.
 Fever to 40° C (104° F).
 Abdominal pain.
 Signs of peritonitis.
 Extraintestinal manifestations particularly joint and skin complications

57
Q

Toxic or fulminant colitis is more common with ………

A

Ulcerative colitis

58
Q

Describe Toxic or fulminant colitis

A

 Occurs when transmural extension of ulceration results in localized ileus and peritonitis.

 The colon loses muscular tone and begins to dilate.

59
Q

Def of Megacolon

A

Transverse colon 5 – 6 cm diameter during an exacerbation.

60
Q

If fulminant colitis or toxic megacolon is suspected. ,,,,,

A
61
Q

In UC

  • The risk of colon cancer is proportional to:
A

 Duration of disease
 Amount of colon affected

62
Q

In UC

  • Sustained microscopic inflammation is → a risk factor.
A

63
Q

In UC

  • Cancer begins to appear by ….. from onset of illness in patients with extensive colitis
A

7 years

64
Q

In UC

  • Regular colonoscopic surveillance, any grade of definite dysplasia → a strong indication for total colectomy.
A

65
Q

managment of Obstuction in Crohn’s Disease

A

 Nasogastric suction and IV fluids.
 Immediate surgery.

66
Q

managment of Fulminant disease or abscess in Crohn’s Disease

A

 Hospitalized for IV fluids and antibiotics.

 Abscesses must be drained, either percutaneously or surgically.

67
Q

managment of Fistulas in Crohn’s Disease

A

 Treated initially with metronidazole.

 Severe refractory perianal fistulas may require temporary diverting colostomy.

 Best adjunct to Anti TNF.

68
Q

Compare between IBD & IBS in terms of:

  • CP
  • INVx
  • TTT
A
69
Q

Done

A