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20 Cards in this Set
- Front
- Back
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Name the types of IBD that the following sets of sx describe:
Colon only Diffuse, contiguous Mucosal Non-smoker Any GI Segment Focal, asymmetric Transmural inflammation Smoker +/- Perianal +/- Fistula +/- Granuloma |
UC
Crohn's |
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Ulcerative Colitis:
- racial/ethnic predom? - seen in smoking? - increased risk from oral contraceptives? - is an appendectomy protective? - gender predom? Crohn's Dz: - racial/ethnic predom? - seen in smoking? - increased risk from oral contraceptives? - is an appendectomy protective? - gender predom? |
- White > nonwhite; jewish > non
- non-smokers - no - no - none - same as UC - smokers - yes (?) - protective (?) - slightly more females |
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Are both types of IBD seen more in the young or the old?
Is IBD seen more in northern areas or southern areas? We currently think that the confluence of which three things is necessary for IBD? Do we think that cytokines are involved in IBD? |
young, but the distribution is two-peaked.
Northern. Genetic susceptibility, Environmental triggers, Immune dysregulation A cytokine imbalance is involved, yes. (chronic inflammation) |
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Which IBD shows greater concordance in monozygotic twins? What does this suggest?
On which chromosomes have IBD-linked loci been confirmed? |
Crohn's.
likely a complex, non-Mendelian genetic disorder 12 and 16 (I think this may just be for Crohns) |
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Which genetic mut increases susceptibility to Crohn's dz?
- associated with what types of difference in pathophysiology? - what is the normal physiological role of this protein? - useful in predicting onset of CD? - " " course of dz? - " " response to tx? |
NOD2 allelic variant (27-39%)
- younger onest, fibrostenosing dz, and SmBowel involvement. - recognition of microbes and innate immunity - not by itself - maybe - unknown |
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Which IBD can involve all parts of the GI tract, from the mouth to the Anus, and is associated with transmural inflammation?
- can this dz also involve the skin, liver, eyes and joints? |
Crohn's dz
- yes |
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Where in the GI tract is most Crohn's dz found?
What type of diarrhea is seen w/ Crohn's? |
Ileum and colon.. but it *can* be found anywhere from the mouth to the anus.
Inflammatory Diarrhea |
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Which IBD (can) presents with:
abdominal pain inflammatory diarrhea weight loss Growth retardation in children Fever Perianal dz What blood studies should be run on this dz? Imaging? |
Crohn's Dz
CBC (anemia) CRP / sed rate Albumin (drops with ^ dz b/c of "leaky gut") SBFT, CT enterography Colonscopy w/ ileal intubation |
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In which IBD are "skip areas" sometimes seen?
What are the three major categories of clinical presentation with CD? |
Crohn's
inflammation (pain, tenderness, chronic/noctural diarrhea) obstruction (cramps, distention, vomiting) fistulization (diarrhea, damage to skin, air/feces in urine, fever) |
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Are abscesses a common feature of UC?
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No, just of Crohn's.
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With the inflammation from Crohn's, or with resection as tx, what complications of terminal ileum dz might be seen?
A resection above 100cm is associated with what? |
B12 deficiency
bile salt diarrhea (choleretic diarrhea) fat malabsorption |
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What types of tx are used in Crohn's (answer for mild, moderate, and severe dz)?
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Mild: AntiBs
Mod: Immunomodz & CorticoS Severe: Surgery Anti-TNFa tx is used all the time: infliximab, adalimumab, certilizumab |
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Which IBD presents (can present with):
Bloody diarrhea Tenesmus Crampy abdominal pain w/ bowel movement Weight loss Fever Growth retardation in children Blood studies to run? Imaging? |
UC
Tenesmus (feeling of difficulty during bowel movement) CBC, CRP, sed rate, albumin Plain film of the abdomen - can help rule out toxic dilation Sigmoidoscopy or Colonoscopy |
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What are 2 complication of ulcerative colitis?
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Toxic Megacolon:
Complication of UC, it is a surgical emergency: high risk of perforation Colorectal cancer |
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Name the IBD with which these sx are specific (or close to it):
cobblestoning bloody stool fistulas Small intestine obstruction Response to antiB Recurrance after surgery Mucus in stool continuous dz granuloma on biopsy Rectal sparing |
CD
UC CD CD CD CD UC UC CD (occasionally) CD |
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What is the most common MSK dz associated with IBD?
Which tx is especially effective? In which IBD is ankylosing spondylitis more common? What is "bamboo spine"? Are pain meds and NSAIDs useful in these cases? |
Arthririts: it can precede bowel sx actually.
5-aminosalicylates ( esp. sulfasalazine) is especially beneficial UC X-ray finding in those with Ankylosing spondylitis No. |
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What is the HLA-B27 haplotype?
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genetic mut associated with ankylosis spondilitis and Uveitis
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What is Uveitis?
Is it the most common ocular complication of IBD? |
Uveitis, or iritis, is an inflammatory lesion of the anterior chamber of the eye that is associated with the HLA-B27 haplotype.
- ground glass pain in eye (SERIOUS) No, that is Scleritis/episcleritis. |
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Primary sclerosing cholangitis is associated with which IBD?
Do pts w/ this combo have elvated risks of cholangiocarcinoma and dysplasia? |
UC
Approximately 50% to 70% of patients with PSC have IBD, often in the absence of bowel symptoms Yes. |
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How are the mouth ulcers (aphthous stomatitis) in cases of IBD tx'ed?
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lidocane, beclomethasone, or AntiBs.
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