L81

Question 1

2 IBD diseases

Answer 1

Crohn’s

Ulcerative colitis

Question 2

What part of the bowel does UC always involve?

Answer 2

Rectum - can move backwards into the colon from there

Question 3

UC: continuous or skip lesions

Answer 3

Continuous inflammation

Question 4

Describe UC diarrhea

Answer 4

Bloody

Question 5

Describe UC on colonoscopy

Answer 5

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

Question 6

How deep does UC go into the bowel wall?

Answer 6

Shallow: mucosa and submucosa

Deeper is a sign of Crohn’s

Question 7

What part of the GI is effected by Crohn’s

Answer 7

Anywhere! Most commonly SI

Skip lesions - jumps around

Question 8

3 clinical patterns of Crohn’s

Answer 8

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

Question 9

UC or Crohns: granuloma

Answer 9

Crohn’s

Question 10

Describe Crohn’s diarrhea

Answer 10

Can or cannot be bloody

Question 11

Describe Crohn’s on colonoscopy

Answer 11

War zone - super bumpy

“Cobblestone”

Question 12

What are manifestations of UC outside the GI

Answer 12

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

Question 13

What are extra-GI manifestations of Crohn’s

Answer 13

Pyoderma, erythema

Perianal disease

Question 14

UC increases your risk for what kind of cancer

Answer 14

Colo-rectal

Question 15

Best treatment for UC

Answer 15

Surgery is curative!

Ileal pouch-anal anastomosis

Question 16

Do you do surgery for Crohn’s

Answer 16

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

Question 17

What is microscopic colitis

Answer 17

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

Question 18

2 types of microscopic colitis

Answer 18

Collagenous

Lymphocytic

Question 19

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

Answer 19

Water diarrhea - no pain
Older women
See abnormal collagen layer

Question 20

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

Answer 20

Water diarrhea

High lymphocytes

Question 21

Treat microscopic colitis

Answer 21

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

Question 22

What does C.Diff cause?

Answer 22

Pseudomembranous colitis

Question 23

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

Answer 23

GP bacillus

Toxins A + B

Question 24

Risk factors for developing C.Diff

Answer 24

Hospital
Antibiotics in non-hosp pts
PPI use

Question 25

C.Diff presentation

Answer 25

Watery diarrhea - really bad smell | High wt ct

Question 26

Dx C.Diff infection

Answer 26

PCR stool for the bug | See pseudomembranes on endoscopy = white milky patches of infection

Question 27

Treat C.diff

Answer 27

Metronidazole Vanco Relapses: fecal transplant

Question 28

Describe how polyps progress in colon cancer

Answer 28

Small adenoma -> large -> colon carcinoma

Question 29

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

Answer 29

Endometrial or ovarian

Question 30

3 ways to screen for colo-rectal cancer

Answer 30

Colonoscopy Flexible sigmoidoscopy Stool occult blood

Question 31

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

Answer 31

Familial adenomatous polyposis | Hereditary non-polyposis colorectal cancer syndrome

Question 32

Describe HNPCC - Age onset - Where in colon - Polyps? - Associated with what other cancer

Answer 32

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

Question 33

What is the Rome criteria?

Answer 33

``` 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 ```

Question 34

Pathophys of IBS

Answer 34

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

Question 35

Most common IBS symptom

Answer 35

Bloating

Question 36

What is a diverticulum

Answer 36

Outpouching from the gut that doesn't go anywhere | May have varying amts of gut layers assocaited

Question 37

What is diverticulosis

Answer 37

Many false diverticula of the colon | Often asymptomatic

Question 38

Risk factors for diverticulosis

Answer 38

Obesity | Diet low in fiber

Question 39

What is diverticulitis

Answer 39

A diverticulum gets inflam LLQ pain Fever Maybe feel a mass

Question 40

Treat diverticulitis

Answer 40

Antibiotics + supportive

Question 41

How will ischemic colitis present?

Answer 41

Hematochezia | Acute ab pain

Question 42

Treat ischemic colitis

Answer 42

Treat underlying cause: clot, etc | Might need surg if has progressed (gangrene)