MUSOM Surgery OSCE 2 IBD Flashcards

Terms Definitions
What causes IBD, what is the MOA?
No one knows, but its causes by over reaction of the mucosal immune system against normal intraluminal flora.
Who are the major players in IBD (2)?
Crohn's and UC
What is the mnemonic for extraintestinal manifestations of IBD?
A PIE SACK
What are the extraintestinal manifestations of IBD?
Ankylosing Spondylitis/Arthritis, Pyoderma Gangrenoeosum, Iritis, Erythema Nodosum, Sclerosing Cholangitis, Apthous Ulcers, Finger Clubbing, Kidney Disease (amyloid/Nephritic)
Crohns vs UC: Sharp Delineations/ Skip Lesions?
Crohn's
Crohns vs UC: Transmural Involvment
Crohn's
Crohns vs UC: Noncaseating Granulomas
Crohn's
Crohns vs UC: Fissuring and abscesses
Crohn's
Crohns vs UC: Involves mucosa and submucosa
UC
Crohns vs UC: Always starts in rectum
UC
Crohns vs UC: Spreads in a continuous fashion
UC
Crohns vs UC: Crypt Abscesses
UC
Crohns vs UC: Cobblestone Mucosa
Crohns
Crohns vs UC: Linear Ulceration
Crohns
Crohns vs UC: Transverse Fissures
Crohns
Crohns vs UC: Xray shows linear ulcers with asymmetrical bowel wall involvement
Crohns
Crohns vs UC: Xray and barium swallow shows string sign (strictures)
Crohns
Crohns vs UC: Gross Bleeding
UC
Crohns vs UC: Weight loss from malabsorption
Crohns
Crohns vs UC: Weight loss from anorexia
UC
Crohns vs UC: Tenesmus (hurts to shit)
UC
Crohns vs UC: Watery Diarrhea
Crohns
Crohns vs UC: Bowel Perf / Perotinitis
Crohns
Crohns vs UC: Palpable Mass
Crohns
Crohns vs UC: Risk of obstruction
Crohns
Crohns vs UC: Propensity for terminal ileum and cecum
Crohns
Crohns vs UC: Women at greater risk
Crohns
Crohns vs UC: Men at greater risk
UC
dx tools in Crohns
Endoscopy with biopsy, Xray, Barium Swallow with small bowel follow through, Stool Cultures, Ct, Enema
Dx tools in UC
Endoscopy with biopsy, Xray, Barium Swallow with small bowel follow through, Stool Cultures, Ct, Enema
Crohns vs UC: Lead Pipe on barium Enema
UC
Crohns vs UC: Pseudopolyps
UC
Crohns vs UC: Dialated mucosal vessells
UC
Tx of Crohns
Roids, AminoASA, Infliximab (anti TNF), Metrinidazole, Loperamide
Tx of perianal dz in corhns
Metrinidazole
Indications of surgery in Crohns
Obstruction, fistula, abscesses, cancer, massive bleeding, perf, toxic megacolon, strictures, dysplasia
What causes the lead pipe sign in UC?
inflammation-> chronic scarring -> loss of haustra
Study that rules out Crohns
Barium swallow with small bowel follow through.
Why do stool cultures?
Rule out infection.
Type of Surgical Intervention in UC
Total Proctocolectomy with either brooke ileostomy or distal mucosectomy and ileoanal pullthrough.
MC and 2nd MC site for Crohns?
MC is terminal ileum and cecum, 2nd MC is confined to SI.
Hallmark location for Crohns?
Terminal Ileum
Most common indication for surgery in crohns?
SBO (intermittent at first from edema and spasm, but later, scarring nad thickening of bowel causes chronic narrowing of lumen)
How can Crohns cause cholelithiasis?
From decreased bile acid absorption.
Do you get reoccurence after surgical resection in crohns? how about in UC?
You can in Crohns but not in UC.
UC involves the rectum in ___% of the cases?
100
MC site of UC, 2nd MC site?
Rectum and Lt Colon then Rectum lt colon and rt colon.
Is Sclerosing Cholangitis is associated with UC or Crohns?
UC.
Leading cause of death in UC?
Toxic Megacolon.
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