Gi: Celiac, Inflammatory Bowel Disease

Front 1

why is there increased fluid in bowel lumen in celiac disease

Back 1

crypts secrete fluid into the lumen, which normally gets absorbed by the villi, however the villi are not fxnal in celiac disease
crypts also hypertrophy in celiac disease

Front 2

what are the small bowel findings in celiac disease

Back 2

chronic fluid overload --> SB dilatation, decreased transit, malabsorption
dilution, dilatation, delay in transit, segmentation, flocculation of barium
moulage sign

Front 3

#1 cause of duodenitis

Back 3

celiac disease

Front 4

CT findings of celiac disease (small bowel and outisde of bowel)

Back 4

fluid filled dilated but not distended loops of SB with upper mesenteric nodes +
LAD
fluid filled distal loops of small bowel in the pelvis
dilution of po contrast
flocculation of ba
laminar flow of po contrast (mimics intuss, this is a feature of a malabsorptive state)
intramural fat in duo, jej
bwel wall may be thick
mesentery is hypervascular and"misty"
SB-SB intuss
SB loops "spooning" each other
nodes + malabsorption findings
splenic atrophy, fatty liver

Front 5

colon findings in celiac

Back 5

steatorrhea (check lung windows)
markedly dilated colon
unabsorbed fluid in right colon, which is flaccid
"peanut butter" coating colon
excess gas in colon
see stool with air in it
intramural fat in r colon

Front 6

"malabsorption pattern"

Back 6

dilated, non-distended sb
watery (diluated) barium that got mixed with fluid
delay of transit w no contrast reaching colon after prolonged time period

Front 7

ddx:
other etiologies for a malabsorptive pattern

Back 7

abn digestion:
pancreatic, hepatic, biliary insufficiency
celiac disease
lactase deficiency
CD. tropcial sprue, ischemia
short SB (rxsn, bypass, etc)
long SB (dysmotility, narcotics, chemotx)

abn ingestion:
high fat intake, bad sugars, cathartics, sorbital, cholestyramine

Front 8

where are the LN seen in celaic disease

Back 8

at the root of the mesentary
numerous and large

Front 9

why does the fold reversal pattern appear in celiac disease

Back 9

folds are destroyed in jejunum, so then the ileum, which is exposed to gluten is attacke by lymphocytes --> ileal wall and fold thickening (not just seen in FLX)

Front 10

t or f: skip areas in corhn disease can be circumferential

Back 10

true

Front 11

why is there bowel loop separation in crohns

Back 11

the fat (both in mucosa and peritoneum) hypertrophies so the adjacent loops of bowel separate

Front 12

what happens if there is gastric involvement in crohns (pathog appearance)

Back 12

wide pylorus, narrow antrum, narrow (or loss of fornices of duo bulb
(pathognomic)

Front 13

other appearance of stomach in crohn's
ddx

Back 13

double pylorus appearance
PUD, Crohns disease, CA

Front 14

what causes pseudodiverticula in crohns

Back 14

when crohns skips or spares a small patch of hte wall

Front 15

what is the primary site of abnormality in duodeno-colic fistulas from crohn's disease

Back 15

colonic origin
duodenum is ok

Front 16

stones assoc with crohns disease

Back 16

oxalate stones ((assoc w ileal crohns'), so always check for CD in pts who get a stone study

uric acid stones

Front 17

other renal abnormailities assoc with crohns

Back 17

renal amyloid
interstitial nephritis

Front 18

comb sign

Back 18

from hypertrophied/creeping fat

Front 19

what is the only type of fistula that can be asosc with UC

Back 19

colovaginal (b/c the tissue is so thin)

Front 20

what causes the pseudopolyp appearance in UC

Back 20

nml mucosa surrounded by eroded mucosa

Front 21

appearance of colon in UC

Back 21

toxic megalcolon (big tv colon in a toxic pt)
will also see pseudopolyps

Front 22

appearance of TI in backwash ileitis

Back 22

TI is dilated (unlike crohns disease which is narrowed)

Front 23

when do you see backwash ileitis in UC
appearance of TI

Back 23

only if there is pancolitis
backaash of colonic contents into TI --> local inflammation and pseduopolyps
diameter of TI is > than diameter of colon

Front 24

what accounts for the "leadpipe" appearance of backwash ileitis

Back 24

colon is ahaustral, tubular in appearance, and foreshortened
the terminal ileum diameter is greater than that of hte colon

Front 25

complications of UC

Back 25

toxic megacolon
massive hemorrhage
strx
colon CA

Front 26

extra-intestinal assoc of UC

Back 26

joints (arthritis, ank spond)
liver (sclerosing cholangitis, hepatitis, cholangioCA)
skin (pyoderma gangrenosum, erythema nodosum)
uteitis, iritis

Front 27

most frequent cause of pseudopolyps

Back 27

UC

Front 28

radiologic findings of uc

Back 28

granular mucosa wiht confluent shallow ulcers
polyps (pseudopolyps and hyperplastic)

Front 29

presentation of toxic megacolon

Back 29

fever, hihg WBC
pt is sick
shocky

Front 30

appearance of toxic megacolon

Back 30

irregular thick walled colon
R and L colon are collapsed or fluid fille
look for free air

Front 31

findings of behcets disease

Back 31

recurrent ulcers (oral, genital, skin, GI)
fistulae
uveitis
BV aneurysms
arthritis

Front 32

which type of fistula is most common in nbehcets

Back 32

colovaginal fistula

Front 33

which parts of bowel are most affectd by nsaid enterocolitis

Back 33

SB and right colon (--> strx, fold thickening, distroted loops, short submuocsal strx)

Front 34

most strongly suggestive finding of nsaid enterocolitis

Back 34

short submucosal strictures (diaphragm like)

Front 35

solitary rectal ulcer syndrome 2/2

Back 35

internal rectal intussusception caused by straining

Front 36

what is solitary rectal ulcer syndrome assoc w

Back 36

colitis cystica profunda
anismus