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P&T Block 3 Pulm & GI > L81 > Flashcards

L81 Flashcards

1
Q

2 IBD diseases

A

Crohn’s

Ulcerative colitis

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2
Q

What part of the bowel does UC always involve?

A

Rectum - can move backwards into the colon from there

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3
Q

UC: continuous or skip lesions

A

Continuous inflammation

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4
Q

Describe UC diarrhea

A

Bloody

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5
Q

Describe UC on colonoscopy

A

Red and pissed
Friable = white areas, mucous areas of repair
Pseudopolyps = look like holes

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6
Q

How deep does UC go into the bowel wall?

A

Shallow: mucosa and submucosa

Deeper is a sign of Crohn’s

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7
Q

What part of the GI is effected by Crohn’s

A

Anywhere! Most commonly SI

Skip lesions - jumps around

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8
Q

3 clinical patterns of Crohn’s

A

Inflammation
Obstruction - chronic inflammation caused narrowing
Inflam through entire bowel wall -> fistula

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9
Q

UC or Crohns: granuloma

A

Crohn’s

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10
Q

Describe Crohn’s diarrhea

A

Can or cannot be bloody

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11
Q

Describe Crohn’s on colonoscopy

A

War zone - super bumpy

“Cobblestone”

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12
Q

What are manifestations of UC outside the GI

A

Pyoderma grangrenosum = ulcerative rash
Erythema nodosum = papular + painful
PSC

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13
Q

What are extra-GI manifestations of Crohn’s

A

Pyoderma, erythema

Perianal disease

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14
Q

UC increases your risk for what kind of cancer

A

Colo-rectal

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15
Q

Best treatment for UC

A

Surgery is curative!

Ileal pouch-anal anastomosis

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16
Q

Do you do surgery for Crohn’s

A

You can - yes/no depends on case/if emergency

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17
Q

What is microscopic colitis

A

Endoscopy clear
Biopsy shows microscopic inflam
Common problem is can’t reabsorb water in colon -> diarrhea

18
Q

2 types of microscopic colitis

A

Collagenous

Lymphocytic

19
Q

How does collagenous colitis present? Pt pop. What is abnormal on histo?

A

Water diarrhea - no pain
Older women
See abnormal collagen layer

20
Q

How does lymphocytic colitis present? What is abnormal on histo?

A

Water diarrhea

High lymphocytes

21
Q

Treat microscopic colitis

A
  1. Anti-diarrheals
  2. Mild steroid = budesonide
  3. Bismuth salts, bile acid binders
22
Q

What does C.Diff cause?

A

Pseudomembranous colitis

23
Q

C.Diff: why type of bacteria, what are the bacteria’s products

A

GP bacillus

Toxins A + B

24
Q

Risk factors for developing C.Diff

A

Hospital
Antibiotics in non-hosp pts
PPI use

25
Q

C.Diff presentation

A

Watery diarrhea - really bad smell

High wt ct

26
Q

Dx C.Diff infection

A

PCR stool for the bug

See pseudomembranes on endoscopy = white milky patches of infection

27
Q

Treat C.diff

A

Metronidazole
Vanco
Relapses: fecal transplant

28
Q

Describe how polyps progress in colon cancer

A

Small adenoma -> large -> colon carcinoma

29
Q

Have what other cancers puts you at increased risk for colo-rectal cancer

A

Endometrial or ovarian

30
Q

3 ways to screen for colo-rectal cancer

A

Colonoscopy
Flexible sigmoidoscopy
Stool occult blood

31
Q

What 2 inherited conditions put you at highest risk for developing colo-rectal cancer

A

Familial adenomatous polyposis

Hereditary non-polyposis colorectal cancer syndrome

32
Q

Describe HNPCC

  • Age onset
  • Where in colon
  • Polyps?
  • Associated with what other cancer
A

Younger pts
R colon dominance
Presents as multiple primary cancers - FEW/NO polyps
Associated with endometrial cancer

33
Q

What is the Rome criteria?

A 
How dx IBS
3+ days per month
For at least last 3mo
Ab pain + 2 of the following:
1. Pain improves when you poop
2. Change in freq of stool
3. Change in appearance of stool
34
Q

Pathophys of IBS

A 
No structural abnormality
Some combo of:
- More gut motor activity
- SI + LI involvement
- CNS-ENS dysreg
35
Q

Most common IBS symptom

A

Bloating

36
Q

What is a diverticulum

A

Outpouching from the gut that doesn’t go anywhere

May have varying amts of gut layers assocaited

37
Q

What is diverticulosis

A

Many false diverticula of the colon

Often asymptomatic

38
Q

Risk factors for diverticulosis

A

Obesity

Diet low in fiber

39
Q

What is diverticulitis

A

A diverticulum gets inflam
LLQ pain
Fever
Maybe feel a mass

40
Q

Treat diverticulitis

A

Antibiotics + supportive

41
Q

How will ischemic colitis present?

A

Hematochezia

Acute ab pain

42
Q

Treat ischemic colitis

A

Treat underlying cause: clot, etc

Might need surg if has progressed (gangrene)

P&T Block 3 Pulm & GI (31 decks)

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