part 8

Question 1

What decreases the risk and causes an exacerbation on Crohn’s disease?

Answer 1

• high fiber and fruit decrease risk

- oral contraceptives and NSAIDs exacerbate Crohn’s

Question 2

What decreases the risk of ulcerative colitis?

Answer 2

high veggie intake

Question 3

disease of the colon and rectum

Answer 3

ulcerative colitis

Question 4

cobblestoning of mucosa

Answer 4

ulcerative colitis: rare

crohn’s disease common

Question 5

tenesmus (a need to evacuate the bowels even after bowels were evacuated)

Answer 5

ulcerative colitis: common

crohns: rare

Question 6

rectal bleeding

Answer 6

ulcerative colitis: common

crohns: rare

Question 7

diarrhea

Answer 7

common for both colitis and crohns

Question 8

What will a CBC show when diagnosing IBD?

Answer 8

-iron deficiency anemia
vs
-blood loss

Question 9

Why might a pt with with IBD have decreased sodium, potassium, chloride, bicarbonate, and magnesium?

Answer 9

fluid and electrolyte losses from diarrhea and vomiting

Question 10

What are the blood and stool studies done for IBD?

Answer 10

Blood: 
CBC
serum electrolyte 
serum protein (hypoalbuminemia due to poor nutrition or protein loss) 
Stool: 
pus 
blood
mucus

Question 11

What labs point to inflammation?

Answer 11

elevated:
ESR
CRP
WBC

Question 12

What is the med therapy for IBD?

Answer 12

• 5-aminosalicylates: decreases inflammation by suppressing cytokines
• antimicrobials: prevent or treat secondary infx
• corticosteroids: decrease inflammation
• Immunosuppressants
• biologic and targeted therapy (immunomodulators): inhibit cytokine tumor necrosis