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62 Cards in this Set

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  • Back
IBS
irritable bowel syndrome
IBD
inflammatory bowel disease
_____ is a chronic unexplained abdominal pain with altered stools. Very common cause of physician visits (10% of PCP visits) & missed work
IBS
is IBS more common in women or men
women
how long does IBS last
usually life long
IBS is characterized by increased ______________
bowel motility, especially after meals,
IBS is blocked by ___________
anti-cholinergic drugs
IBS pts have increased bowel sensitivity ____________
to pain, but not increased non-GI pain sensitivity
In IBS there is increased retention and perception of intestinal ____
gas
IBS is associated with altered ____ activity with bi-directional involvement
CNS
IBS
irritable bowel syndrome
IBD
inflammatory bowel disease
_______ and the _________ regulate bowel function and perception
CNS
enteric nervous system
IBS may present _________
post-enteric infection
5-HT (serotonin) is primarily in _______
GI tract
5-HT subtypes regulate ________ and ______ in GI tract
motility
sensation
______ agonists and antagonist drugs are main focus of IBS clinical drug research
5-HT
New onset of symptoms in patients 50+ years indicates
“Red flag” ---may suggest an alternative or coexisting diagnosis to IBS
Anemia
“Red flag” ---may suggest an alternative or coexisting diagnosis to IBS
Fever
“Red flag” ---may suggest an alternative or coexisting diagnosis to IBS
Persistent diarrhea
“Red flag” ---may suggest an alternative or coexisting diagnosis to IBS
Rectal bleeding
“Red flag” ---may suggest an alternative or coexisting diagnosis to IBS
Severe constipation
“Red flag” ---may suggest an alternative or coexisting diagnosis to IBS
Weight loss
“Red flag” ---may suggest an alternative or coexisting diagnosis to IBS
Nocturnal pain & abnormal bowel fxn
“Red flag” ---may suggest an alternative or coexisting diagnosis to IBS
Family history of GI CA, IBD, or celiac disease
“Red flag” ---may suggest an alternative or coexisting diagnosis to IBS
_______ most often appears in adulthood with symptoms similar to IBS
Celiac disease
_______ is a genetic immune intolerance to wheat (gluten) and similar cereals
Celiac
Diagnosis of celiac dz is suspected by _______
anti-body tests (endomysial or tissue transglutaminase)
Treatment for celiac is _______
life-long gluten-free diet
Treatment of IBS includes :
Patient ___________
communication & education
Treatment of IBS includes :
__________ only if inciting foods identified
Dietary
Treatment of IBS cludes :
PRN Rx with __________
anti-diarrheals (loperamide)
Treatment of IBS includes :
PRN _______ for spasm
anti-cholinergics
Treatment of IBS includes :
Bulk & osmotic (no stimulants) _______
laxatives
Treatment of IBS includes :
PRN _______ for “gate” to reduce pain
tricyclics
Treatment of IBS includes :
_________ drugs – looks promising!
5-HT3 and 5-HT4
Treatment of IBS includes : ________ for temporary relief?
Antibiotics
IBD onset is most common in ________, in the _________
young adults
industrialized northern hemisphere
__________ has diffuse mucosal inflammation limited to the colon
Ulcerative colitis
_________ has patchy, transmural inflammation anywhere in the GI tract
Crohn’s disease
__________ are uncommon complications of UC
Megacolon & perforation
Mucosal inflammation & crypt abscesses occur with
UC
__________ are the most common symptoms
Bleeding & diarrhea
________increase > 7 yrs with UC
Colon dysplasia & cancer
___________ often related to UC
Sclerosing cholangitis
This IBD is characterized by aphthous & stellate ulcers & skip areas. Transmural, strictures, fistulas, perforations. Perianal disease is common
CD
CD is often _______, but can also occur anywhere in GI tract
ilial
In CD, _______ is seen at surgery
Creeping fat
Complications of both UC & Crohns:
Colon inflammatory _______
Osteopenia and _________
Inflammatory ________
E. nodosum & pyoderma _______
Episcleritis and ________
“pseudo-” polyps
osteoporosis
arthritis
grangrenosum
uveitis
Childhood Onset of IBD: Is often atypical presentations with ________(4)
fever, anemia, arthritis, or growth failure
Theories on cause of IBD:
Genetic + exposure to luminal antigens, trigger an uncontrolled immune response
& release of ________
cytokines (e.g. IL-1)
______ drugs are the main treatment & safest treatment for IBD
5-ASA
_________ are used primarily to induce remission in IBD
Steroids
alternatives to steroids for IBD
6 M-P & azathioprine
Infliximab primarily for _____
Crohn’s
Surgery cures _______
UC, not Crohn’s
This other cause of colitis & enteritis is characterized by chronic watery diarrhea with normal gross appearance
Microscopic colitis –
This other cause of colitis & enteritis is characterized by acute onset, many PMS’s
Infectious colitis –
This other cause of colitis & enteritis resembles Crohn’s
NSAIDs colitis
This other cause of colitis & enteritis is characterized by prevolence in watershed areas
Ischemic colitis
This other causes of colitis & enteritis is characterized by no inflammation
IBS –