Lecture 4 - Small Bowel/IBD/anorectal

Question 1

Crohn (CD) vs Ulcerative colitis (UC):
any portion of GI, usually terminal \_\_\_\_\_:
only colon:
transmural inflam:
only mucosal/submucosal:

Answer 1

CD (illeum);
UC;
CD;
UC

Question 2

CD vs UC:
noncaseating granulomas = 
cobblestone mucosa = 
crypt abscess = 
pseudopolyps =

Answer 2

CD;
CD;
UC;
UC;

Question 3

CD vs UC:
continuous involvment =
skip lesions =
always involves rectum =

Answer 3

UC;
CD;
UC

Question 4

CD vs UC:
associated with p-anca = 
calcium oxalate kidney stones =
large increased risk of carcindoma = 
for both, name 2 skin conditions seen

Answer 4

UC;
CD;
UC
pyoderma gangreosum, erythema nodosum

Question 5

CD vs UC:
string sign on barium swallow =
strictures =
loss of haustra –> ____ ____ on imaging =

Answer 5

CD;
CD;
lead pipe, UC

Question 6

CD vs UC:
bloody diarrhea is esp associated with ______;
fistulas =
toxic megacolon =

Answer 6

UC;
CD;
UC

Question 7

IBD:
notable arthritis that is associated =
bile problem =

Answer 7

ankylosing spondylitis;

primary sclerosing cholangitis

Question 8

sulfasalazine is a combination of a ____ and _____;

activated by ____ and is used for both IBDs

Answer 8

sulfapyridine (anti-biotic);
5-aminosalicylic acid (anti-inflam);
colonic bacteria

Question 9

what is target of infliximab and adalizumab?

Answer 9

soluble TNF alpha

Question 10

6-mercaptopurine and cyclosporine are typically used for _____ (Rather than the other IBD)

Answer 10

UC

Question 11

TNF alpha inhibitors need to be tested for ____ before starting therapy. there is also a potential risk of _____

Answer 11

Tb;

malignancy

Question 12

Celicac:
intolerance of what pathogenic molecule?
associated with HLA\_\_ and \_\_\_;
\_\_\_\_ of villi;
crypt \_\_\_\_;
intraepithelail \_\_\_\_\_

Answer 12

gliadin;
DQ2, DQ8;
atrophy;
hyperplasia;
lymphocytosis

Question 13

celiac:
usually affects _____ and ______;
associated with ____ deficiency;
anti-_____, anti ____, anti _____

Answer 13

distal duodenum, proximal jejunum;
IgA;
IgA anti-tissue transglutaminase, endomysial, deamidated gliadin

Question 14

celiac:
what skin condition is associated with it?
increased risk of what cancer (high yield according to pathoma)

Answer 14

dermatitis herpetiformis;

T-cell lymphoma

Question 15

most common small bowel malignancy:

Answer 15

adenocarcinoma

although these cancers are rare AF

Question 16

carcinoid syndrome:
_____ positive;
increased ____ in urine

Answer 16

chromogramin;

5-HIAA

Question 17

hemorrhoids:
internal ones are _____ pectinate line and are ____;
external ones are ____ pectinate line and are _____

Answer 17

above, painless;

below, painful

Question 18

hemorrhoids:
internal ones are covered with _____ epithelium;
external are covered with _____;
_____ are associated with prolapsing

Answer 18

columnar;
squamous;
internal

Question 19

anal fissure:
____ the pectinate line;
usually located ____ due to ____ perfusion here

Answer 19

below (ie painful);

posteriorly, poor

Question 20

HPV:
causes _____ ______ (warts)
high risk types are serotypes ___ and ___
cause _____ _____ lesions/cancer

Answer 20

condyloma acuminata;
16, 18;
squamous intraepithelial

Question 21

cancer above pectinate line?

cancer below pectinate line?

Answer 21

adenocarcinoma;

squamous cell