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27 Cards in this Set
- Front
- Back
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UC features?
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1. remission/relapse
2. ab pain = predefecatory 3. diarrhea = early, frequent 4. fever = rare 5. bright red blood |
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Crohn's features?
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1. dull, achy pain
2. ab pain = colicy 3. diarrhea = present but less likely 4. fever 5. steatorrhea |
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How to dx ulcerative colitis?
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1. sigmoidoscopy
2. ab mass - none 3. roentgen study - see pseudopolyps 4. circumfrential and ocntinuous ulcerations of mucosa 5. angiography - no help 6. biopsy - non specific inflammation of mucosa 7. L colon |
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How to dx crohns?
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1. apthoid ulcers - deep, ulcers with raised margins
2. right colon 3. cobblestone appearance 4. fissures, fistulas 5. microgranulomas made of langerhan's giant cells |
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UC see?
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1. initial attack
2. toxic megacolon - can cause death 3. abcess formation 4. in remission get fibroblasts laying down collagen 5. strictures, stenosis 6. pseudopolyps 7. high carcinoma risk |
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Crohn's see?
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1. acute attacks rare
2. fistula 3. abcess 4. strictures 5. carcinoma rare |
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How are pseudopolyps formed?
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lesions causes inflammed mucosa with small ulcer. collagen laid down. starts healing. contraction and mucosa comes together, get puckering of mucosa = pseudopolyp
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Tx crohns with?
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TPN
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how do you get diarrhea in crohns?
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-normally bile salts com down and circulate 2x with each meal
- in crohns..bacteria act against conjugated bile salts and decongugate them. thus not absorbed and get diarrhea |
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Carcinoma in UC
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- with UC get 5 to 10x greater carcinoma
-usually seen in transverse and r colon |
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Local complications of IBD
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1. pseudopolyp
2. stricture 3. perianal inflam 4. massive hemorrhage 5. carcinoma 6. perforation 7. toxic megacolon |
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Systemic Complications of IBD
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1. arthritis
2. skip lesions 3. hepatic lesions 4. ocular lesions - uveitis 5. thromboembolism 6. renal lesions 7 associated disease - SLE, scleroderma, chronic active hepatitis, thymoma with hypogammaglobulinemia |
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Management of IBD
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1. colon rest
2. bed rest 3. sedatives 4. psychotherapy 5. antidiarrheas 6. antispasmodics 7. fluid replacement 8. diet 9. vit 10. hematinics 11. ab 12. steroids 13. immunosuppressive therapy |
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Other diseases of the Colon
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1. gonorrheal proctitis
2. histoplasmosis 3. lymphogranuloma venerum 4. amebiasis 5. radiation proctitis 6. diverticulitis 7. ischemic colitis 8. pseudomembranous colitis 9. behcets syndrome |
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Differentials for IBD
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1. Idiopathic IBD - UC, crohns, colitis
2. Inflam caused by infectious agents - viruses, chlamydia, bact, fungi, parasite 3. Inflam associated with motor disorders - diverticultis, solitary rectal ulcer syndrome 4. Inflam secondary to vascular hypoperfusion - Ischemic colitis |
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Idiopathic IBD
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-UC
-proctitis -crohns -ileojejunitis colitis |
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Bacterial IBD
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-shigella, salmonella, yersinia, campylobacter, pseudomonoas, gonococcal, syphilitis, tb
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Viral IBD
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-lymphogranuloma venereum, cmb, behcet, hsv
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parasite IBD
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- E. histolytica
-histoplasmosis -blastomycosis |
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Miscellaneous IBd
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- ischemic colitis
-collagenous colitis -metabolic -hemolytic |
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Diagnostic Modalities for IBD
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1. dig rectal exam proctosigmoiddoscopy
2. barium enema 3. colonoscopy 4. cytology/biopsy |
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Factors related to malignancy in colorectal adenomas
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1. size
2. number 3. villous component 4. dysplasia 5. location |
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Screening for Colon Cancer: pt with no fam hx
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1.annual fecal occult blood tests
2. flexible sigmoidoscopy every 5 years - 50 or 1. colonoscopy 10 yrs or 1. double barium enema every 5-10 yr |
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Screening for colon cancer: pt with 1st degree relative
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1.annual fecal occult blood tests
2. flexible sigmoidoscopy every 5 years - 40 or 1. colonoscopy 10 yrs or 1. double barium enema every 5-10 yr |
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Screening for colon cancer: pt with more than 1 1st degree relative
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1. colonoscopy every 3 yr- 40
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Screening for colon cancer: pt with fam hx of HNPCC
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1. colonoscopy every 1 to 3 yrs starting at 21
2. genetic counseling 3. genetic testing |
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Hereditary nonpolyposis Colon Cancer
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1. colorectal cancer
2. few colon polyps 3. right colon 4. other associated cancers - uterine, ovarian, gastric, si, panc, ureteric |
