MedComplex-Exam 2 Part 3 (IBD,Liver,Pancreas)

Question 1

What is another name for CJ Crohn’s disease?

Answer 1

Regional Enteritis

Question 2

What is the BASIC etiology of Inflammatory Bowel Disease? What are two possible secondary explanations?

Answer 2

Basically Unknown…1)emotional 2)genetic

Question 3

CUC vs Crohns LET’S GO!!! Which one is 3x more common than the other?

Answer 3

CUC is 3x more common than Crohn’s

Question 4

CUC vs Crohns LET’S GO!!! more common in whites than blacks (esp. E. Euro Jews)

Answer 4

BOTH

Question 5

CUC vs Crohns LET’S GO!!! Peak in the 3rd decade of life

Answer 5

BOTH

Question 6

CUC vs Crohns LET’S GO!!! Familial predisposition

Answer 6

BOTH

Question 7

CUC vs Crohns LET’S GO!!! Extra intestinal complications

Answer 7

BOTH

Question 8

CUC vs Crohns LET’S GO!!! In the early stages, both diseases have _________ changes often indistinguishable from one another.

Answer 8

morphologic

Question 9

CUC vs Crohns LET’S GO!!! Peter’s Patches

Answer 9

Crohn’s Disease

Question 10

CUC vs Crohns LET’S GO!!! transmural inflammation

Answer 10

Crohn’s

Question 11

CUC vs Crohns LET’S GO!!! rubber-hose fibrosis

Answer 11

Crohn’s

Question 12

CUC vs Crohns LET’S GO!!! creeping fat

Answer 12

Crohn’s

Question 13

CUC vs Crohns LET’S GO!!! cobblestone

Answer 13

Crohn’s

Question 14

CUC vs Crohns LET’S GO!!! skip Holladay lesions

Answer 14

Crohn’s (Cj is a skippy/spotty hitter)

Question 15

CUC vs Crohns LET’S GO!!! The fibrotic intestines may be narrowed, causing intestinal stricture, and the inflammation of the serosa leads to adhesions with adjacent intestinal loops and the formation of “Fistulas”

Answer 15

Crohn’s

Question 16

CUC vs Crohns LET’S GO!!! Fistulas

Answer 16

Crohn’s

Question 17

CUC vs Crohns LET’S GO!!! Diffuse

Answer 17

CUC

Question 18

CUC vs Crohns LET’S GO!!! backwash ileitis

Answer 18

CUC

Question 19

CUC vs Crohns LET’S GO!!! Since we know Crohn’s is transmural, what layers are involved in CUC?

Answer 19

mucosa and submucosa

Question 20

CUC vs Crohns LET’S GO!!! Prone to bleeding

Answer 20

CUC (Uhh. fucking chronic ULCERATIVE colitis)

Question 21

CUC vs Crohns LET’S GO!!! surface of a football

Answer 21

CUC

Question 22

CUC vs Crohns LET’S GO!!! Crypt Abscesses

Answer 22

CUC

Question 23

CUC vs Crohns LET’S GO!!! Inflammatory Pseudopolyps

Answer 23

CUC

Question 24

____________ is the most significant late complication of CUC…what do they start from?

Answer 24

malignant transformation…start from pseudopolyps

Question 25

What % of CUC pt's are unlucky and need an entire colon replacement? What % are lucky and the CUC goes away after a single episode?

Answer 25

20% unlucky...10% lucky

Question 26

CUC vs Crohns LET'S GO!!! left side of the colon

Answer 26

CUC

Question 27

CUC vs Crohns LET'S GO!!! right side of colon and ileum

Answer 27

Crohn's

Question 28

CUC vs Crohns LET'S GO!!! Granulomas are diagnostic

Answer 28

Crohn's

Question 29

CUC vs Crohns LET'S GO!!! Toxic Megacolon

Answer 29

CUC

Question 30

***IMPORTANT POINT***** CUC vs Crohns LET'S GO!!! extraintestinal complications ( arthritis, eye lesions, and skin lesions)

Answer 30

IDENTICAL FOR BOTH

Question 31

CUC vs Crohns LET'S GO!!! Risk of cancer

Answer 31

CUC

Question 32

CUC vs Crohns LET'S GO!!! Exacerbations and remissions

Answer 32

BOTH

Question 33

What are the 4 major consequences of portal HTN?

Answer 33

1.Hepatic Encephalopathy 2.Ascites 3.Splenamegaly 4.Esophageal Varices (2 up from liver, 2 down/around from liver)

Question 34

Caput Medusae is a result of what?

Answer 34

Portal-Systemic Shunts in Portal HTN

Question 35

Ascites c/o portal HTN: ______ cannot be produced in a cirrhotic liver

Answer 35

Albumin

Question 36

Splenomegaly c/o portal HTN: The enlarged spleen has a tendency to sequester and destroy blood cells which can result in a _________.

Answer 36

pan-cytop-enia (pandemic broo)

Question 37

Why in the world did that God awful hemorrhoids picture show up?

Answer 37

c/o hepatic HTN

Question 38

Hepatic Encephalopathy: What is the chemical that the liver cannot handle?

Answer 38

ammonia

Question 39

How does the liver get FAT? Alcohol has a high caloric content and serves as a substrate for new fat formation in the liver cells ( called ___________)

Answer 39

neolipogenesis

Question 40

COME ON! YOU GOT THIS!! What are the 4 ways the liver becomes fat c/o EtOH?

Answer 40

1.Accumulation of Fat 2.EtOH is fuel for new fat 3.EtOH inhibits beta oxidation 4. no LDL/HDL export

Question 41

What is the first of the sequence to liver Cirrhosis?

Answer 41

fatty liver

Question 42

What is it called when the liver becomes enlarged, tan-yellow, fatty and greasy?

Answer 42

Steatosis

Question 43

Over 80% of Acute Pancreatitis is caused by which 2 factors?

Answer 43

1.Gall Stone obstruction 2.EtOH constriction

Question 44

In Acute Pancreatitis: Obstruction could also lead to the reflux of bile into the pancreas. ______ normally activates pancreatic proenzymes in the intestines and could activate enzymes prematurely in the ducts

Answer 44

BILE

Question 45

All these describe.... diabetes, fibrosis, entrapment of celiac nerve, calcifications, poor vitamin absorption

Answer 45

Chronic Pancreatitis

Question 46

#1 reason for chronic pancreatitis

Answer 46

surviving acute pancreatitis

Question 47

#1 pathogenesis in acute pancreatitis

Answer 47

autodigestion

Question 48

What is the enzyme that is activated to then spur auto digestion?

Answer 48

trypsinogen

Question 49

What two enzymes will show up in the blood within the first 24hrs of acute pancreatitis?

Answer 49

amylase and lipase

Question 50

Hepatits associations!! Hep A

Answer 50

fecal/oral route

Question 51

Hepatits associations!! co-infection/superinfection

Answer 51

Hep D (with Hep B)

Question 52

Hepatits associations!! Hep C

Answer 52

Blood Transfusion (non-a, non-b)

Question 53

Hepatits associations!! Fecal/oral route

Answer 53

A

Question 54

Hepatits associations!! Necrosis of the liver DURING PREGNANCY

Answer 54

Hep E...Get it PregnancEEEEE

Question 55

Hepatits associations!! Which is the only DNA virus?

Answer 55

Hep B!

Question 56

What is the only antibody that covers the "WINDOW PERIOD" of Hep B?

Answer 56

The Hep B Core Antibody (aka Anti-HBc) (window period is 5-6 mo post exposure