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Clin med A 2 > trigger colon and rectrum > Flashcards

trigger colon and rectrum Flashcards

1
Q

chronic RLQ pain w intermittent non-bloody diarrhea

A

crohns

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1
Q

arthralgia, arthritis, apthour ulcers

A

extraintestinal manifestations crohns

also include:
pyoderma gangrenosum
erythema nodosum
fistulas
iritis, uveitis
kidney stones
arthralgia
arthritis
apthous ulcers

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2
Q

pyoderma gangrenosum, erythema nodosum

A

extraintestinal manifestations crohns

also include:
pyoderma gangrenosum
erythema nodosum
fistulas
iritis, uveitis
kidney stones
arthralgia
arthritis
apthous ulcers

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3
Q

fistulas, iritis, uveitis, kidney stones

A

extraintestinal manifestations crohns

also include:
pyoderma gangrenosum
erythema nodosum
fistulas
iritis, uveitis
kidney stones
arthralgia
arthritis
apthous ulcers

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4
Q

hot red tender nodules 1-5cm in diameteer on surface of lower legs, ankles and calves

A

erythema nodosum as extraintestinal manifestation of crohns

these correlate w bowel symptoms (happens after bowel symptoms appear)

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5
Q

pustule lesions that can become ulcers with necrotic tissues. usually on dorsal feet and legs but can occur on arms and chest

A

pyoderma gangrenosum

extraintestinal manifestation of crohns. assocaited with SEVERE disease

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6
Q

cobblestoning appearance on colonoscopy

A

crohns disease

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7
Q

what labs can you order in crohns

A

CBC
Serum albumin
CMP
ESR
CRP
Iron
Vit D
B12
stool studies

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8
Q

goal of disease is minimize symptoms and complications NOT curative

A

crohns

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9
Q

smoking crazy assocaited with this dx

A

crohns

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10
Q

inflammation of only the colon

A

ulcerative colitis

mostly rectal and sigmoid colon

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11
Q

Step UP therapy with enteric coated budesonide (corticosteroid)

A

ileum/cecum low risk crohns treatment.

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12
Q

Mass in RLQ

A

crohns affecting terminal ileum

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13
Q

MC in female caucasions with western diet

A

crohns

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14
Q

MC in male caucasions with western diet

A

ulcerative colitis

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15
Q

oral prednisone for one week then taper off. can use 5 ASA as alternatice

A

mild to mod crohns (diffuse colitis or Left colonic involvement)

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16
Q

what is used for relapse of mild to moderate crohns

A

second course of glucocorticoid, Immunomodulator (azathioprine), biologic (infliximab)

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17
Q

infection, hygeien issues, abscess, malnutrition and diarrhea

A

complications of ulcers in crohns

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18
Q

start therapy with biologics (infliximab) + immunomodulators (azathioprine)

A

treatment to induce and maintain remission of high risk (mod-severe) crohns

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19
Q

hallmark sign is bloody diarrhea

A

ulcerative colitis

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20
Q

presents with fecal urgency, crampy lower abd pain that relieves with urgency, and anemia.

A

ulcerative colitis

also hallmark of bloody diarrhea

fever, fatigue, pus in diarrha

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21
Q

presents with fever, fatigue, pus in diarrhea

A

ulcerative colitis

also presents with bloody diarrhea, fecal urgency, crampy lower abd pain that relieves with urgency, and anemia.

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22
Q

complication including toxic megacolon and fulminant colitis.

A

ulcerative colitis

also see: perforation and severe bleed

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23
Q

ankylosing spondylitis

A

ulcerative colitis extraintestinal manifestation

also see: arthritis

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24
Q

smoking makes this better actually

A

ulcerative colitis

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25
Q

UC w a hematocrit of 26% and an albumin of 2.8

mild, mod or severe?

A

severe

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26
Q

sigmoidoscopy showing continuous friable mucosa

with pus, erosions, bleeding and erythema

A

ulcerative colitis gold standard

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27
Q

DO NOT do a colonoscpy w/ this

A

severe/fulminant colitis

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28
Q

colonic epithelial dysplasia and carcinoma are higher risk w what

A

ulcerative colitis

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29
Q

decrease caffeine

A

ulcerative colitis

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30
Q

what is the typical signs/symptoms and labs for toxic magacolon

31
Q

topical mesalamine (5-ASA) or hydrocortisone suppository

A

treatment for mild/mod UC limited to the distal colon (not past sigmoid)

32
Q

oral mesalamine + topical mesalamine. add on corticosteroids if unresponsive after 4-8 weeks

A

tx for mild - mod UC that extends past the sigmoid colon

33
Q

prednisone +/- immunomodulators (azathioprine or cyclosporine) / TNF blocker (infliximab)

only + the last 2 if unresponsive to corticosteroids or if flares occurs while tapering off corticosteroids

A

tx for mod-severe UC

34
Q

proctocolectomy with placement of ileostomy

A

curative tx for ulcerative colitis

35
Q

what is indicated if a UC patient has more than one relapse in a year

A

maintenance therapy with mesalamine.

also indicatd if pt has ulcerative proctosigmoiditis (rectum, sigmoid or anus involved) or if they have proximal/sigmoid (left sided colitis)

36
Q

inhibits prostaglandin production

A

5 -ASA/ aminosalicylates (mesalamine or sulfasalazine)

37
Q

inhibits DNA/RNA synthesis of lymphocytes

A

immunomodulators/immunosuppresents

azothioprine and purinethol

38
Q

SE leukemia, thrombopenia, anemia

A

immunomodulators/immunosuppresents

azothioprine and purinethol

also: NVD, infection, malaise

39
Q

BBW for rapid growing malignancy/lymphoma

A

immunomodulators/immunosuppresents

azothioprine and purinethol

40
Q

what immunomodulator is used if azothioprine fails

A

methotrexate.

not effective in UC

41
Q

MOA of interfering with cytokine driven inflammatory processes

A

ATN biologics

imab’s

42
Q

BBW of serious infections

A

ATN biologics (imab’s)

43
Q

SE are fever, urticaria, hypotension

A

ATN biologics (imab’s)

also: NV, myalgia, rigors

could also see sepsis and malignancy

44
Q

TOC for CD fistula

A

anti TNF (imab’s)

45
Q

used for fistula and abscess in CD

A

abx metonidazole or cipro

TOC for fistula only is anti TNF tho

46
Q

ileocolonoscopy in 6-12months

A

follow up treatment after asymptomatic

47
Q

caused by DNA changes in lining of colon

A

adenomatous polyps

48
Q

risk factors include being a dude, genetics, high fat diet, >50 yo, and obesity

A

adenomatous polyps

this is also the same risks for colon cancer (except the dude one)

49
Q

flat or sessile or pedunculated and slow growing

A

adenomatous polyps

flat = cancer
sessile and pedunculated = less likely cancer

50
Q

anemia, melena, weight loss, weakness, fatigue

A

proximal colon cancer

(also positive FOBT)

51
Q

obstruction, hematochezia, urgency/tenezmus

A

distal colon cancer

(also change in bowel habits)

52
Q

CEA is used for what

A

assessing colon cancer PROGNOSIS

NOT FOR SCREENING

53
Q

proctocolectomy with ileoanal anastomosis or ileorectal anastomosis

A

FAP, reccomended before 20

54
Q

autosomal dominant condition

A

lynch syndrome

55
Q

CRC inevitable by age 50 unless removed

56
Q

inherited APC gene mutation

57
Q

caused by mutations in a gene that detects and repairs DNA base pairs

A

Lynch syndrome

58
Q

few adenomas that are flat and more villous

A

Lynch syndrome

59
Q
  1. 1st degree relative w polyps prior to 50
  2. pt having polyps prior to 50
  3. 3+ relative w colon cancer
A

tool of “three” for lynch syndrome

60
Q

peophylactic hysterectomy and oopherectomy reccomended

A

lynch syndrome for women who are 40 or done having kids.

61
Q

increase venous pressure such as during straining, pregnancy, constipation and obesity

A

hemorrhoids

62
Q

right anterior, right posterior, left lateral

A

places for internal hemorroids

63
Q

below dentate line

A

external hemorroids

64
Q

hemorroids of the squamous epithelim

65
Q

nonpainful bleeding, mucoid discharge that is not painful. can present with prolapse

A

internal hemorroids

only becomes painful when its stage 4 and protruding outside the anus.

66
Q

proper toileting, high fiber, drink water, take laxatives

A

tx for stage 1-2 hemorroids

67
Q

rubber band ligation (preferred)
injection sclerotherapy

A

stage 1-2 with recurrent bleeding or failure of conservative tx.

stage 3-4

68
Q

hemorroidectomy

A

tx for severe stage 3 or stage 4.

69
Q

painful bluish nodule

A

external hemorroid

70
Q

warm sitz bath, topical ointment, evacuation of clots

A

external hemorroid tx.

71
Q

MC in posterior midline

A

anal fissures (linear ulcerations or tears around anus)

IF THEY ARE OFF MIDLINE suggests HIV/AIDS, crohn, TB, anal carcinoma

72
Q

tearing pain with defecation

A

anal fissures

73
Q

caused by fistulas

A

1/2 of all perianal abscesses

74
Q

throbbing, erythema, and swelling

A

perianal abscesses

75
Q

assocaited with purulent discharge that may lead to itching tenderness and pain

A

perianal fistula

Clin med A 2 (30 decks)

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