OnlineMedEd: Gastroenterology - "IBD" Flashcards

1
Q
Review the following for ulcerative colitis: 
• Population
•Endoscopy
•Biopsy
•Patient presentation
•Cancer
•Extraintestinal manifestations
•Surgery
A
  • Population: 20-30 yo
  • Endoscopy: continuous inflammation starting in the rectum
  • Biopsy: superficial inflammation with crypt abscesses
  • Patient presentation: bloody diarrhea
  • Cancer: hugely increased risk of colorectal cancer –start screening 8 years after symptom onset
  • Extraintestinal manifestations: PSC and pANCA
  • Surgery: colectomy curative
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2
Q
Review the following for Crohn's: 
• Population
•Endoscopy
•Biopsy
•Patient presentation
•Cancer
•Extraintestinal manifestations
•Surgery
A
  • Population: young people 20-30 and older people 50-75
  • Endoscopy: skip lesions anywhere in the GI tract
  • Biopsy: transmural inflammation with granulomas
  • Patient presentation: watery diarrhea
  • Cancer: no increased risk of cancer!
  • Extraintestinal manifestations: fistulas, strictures, B12 deficiency and fat malabsorption (due to inflammation in the terminal ileum), osteopenia and iron deficiency due to duodenal inflammation
  • Surgery: for fistulas
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3
Q

Review the treatment tiers for IBD.

A

•Mild:
- 5-ASA compounds (like sulfasalazine), which is a topical intraluminal agent for UC

• Moderate:
- Immune modulators (6-MP, azathioprine, methotrexate)

• Severe:

  • Infliximab (for Crohn’s)
  • Colectomy (for UC)
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4
Q

Steroids should only be used for _____________.

A

flares –never chronically

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5
Q

In IBD flare-ups, you need to rule out ______________.

A

infection

In fact, all IBD flare-ups should be treated with steroids and antibiotics.

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6
Q

What antibiotics should you use for IBD flare-ups?

A

Ciprofloxacin and metronidazole

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