BII

Question 1

Cofactorii din etiologia BII

Answer 1

1. Susceptibilitate genetik
2. Factori de mediu
3. Microbiota intestinala
4. Rsp imun al gazdei

Question 2

Cel mai mare factor de risc independent pt BII

Answer 2

Istoricul familial pozitiv

Question 3

Factorii genetici majori pt BC

Answer 3

1. Gena NOD2
2. Genele autofage
3. Calea Th17

Question 4

Unde este exprimata NOD2

Answer 4

1. Cel epiteliale
2. Macrofage
3. Cel endoteliale

Question 5

Factorii de mediu si alti factori de risc

Answer 5

1. Fumatul
2. AINS
   3 Igiena
3. Factori nutritionali
4. Factori psihologici
5. Apendicectomia (pt BC)

Question 6

Receptorii Toll-like

Answer 6

Prin intermediul lor actioneaza liganzii bacterieni cu sist imun innascut si dobandit

Question 7

Inflamazomul

Answer 7

Senzor de alerta intracelular al sist imun innascut - declanseaza activarea mediatorilor inflamatiei

Question 8

BC are o tendinta particulara de a afecta …

Answer 8

Ileonul terminal si colonul ascendent

Question 9

Tipuri de CU

Answer 9

1. Proctita (rect)
2. Colita stg (sigmoid + descendent)
3. Colita extensiva (tot)

Question 10

Semn precoce in BC

Answer 10

Ulceratia aftoida la niv colonului

Question 11

CU macroscopic

Answer 11

Mucoasa eritematoasa, inflam, sageranda (friabila).
Ulcere extensive
Aspect de polipi post-inflamator

Question 12

Unde apare ileita de reflux

Answer 12

CU

Question 13

BC microscopic

Answer 13

1. Cel inflam cronice
2. Hiperplazie limfoida
3. Granuloame
4. Cel caliciforme +
5. Abcese criptice +

Question 14

CU microscopic

Answer 14

1. Cel inflam cronice
2. Granuloame rare
3. Depletia cel caliciforme
4. Abcese criptice ++

Question 15

Anticorpii

Answer 15

ANCA - CU

ASCA - BC

Question 16

Tipurile de artropatii

Answer 16

Tip 1 (pauci) - acute / auto-limitate (<10 sapt) -> recaderi BII + asociate cu alte manif extraint
Tip 2 (poli) - luni / ani -> independent de BII + ascociere cu uveita

Question 17

Simptome majore in BC

Answer 17

1. Diaree
2. Durere abd
3. Pierdere in greutate

Question 18

Manifestari tegumentare in BII

Answer 18

1. Eritem nodos

2. Pyoderma gangrenosum

Question 19

Teste sangvine in BC

Answer 19

1. Anemie
2. PCR, VSH, leucocite, trombocite
3. Hipoalbuminemie
4. Biochimie hepatik
5. Hemoculturi
6. ASCA

Question 20

Teste de scaun in BC

Answer 20

1. Coprocultura -> C. difficile
2. Microscopia -> paraziti
3. Calprotectina fecala, lactoferina

Question 21

Tratament pt inductia remisiei in BC

Answer 21

1. Glucocorticoizi
2. Nutritie enterala
3. Atc anti-TNF
4. Atb (ciprofloxacin, metronidazol)

Question 22

Glucocorticoizii in BC

Answer 22

In forme moderat severe
Prednisolon oral 30-60 mg/zi

Budesonid - boala ileocecala usoara moderata

Question 23

Contraindicatii glucocorticoizi in BC

Answer 23

1. Boala penetranta intestinala

2. Sepsis perianal

Question 24

Mentinerea remisiei in BC

Answer 24

Azatioprina, Mercaptopurina, MTX

Anti-TNF

Question 25

Agentii anti-TNF in BC

Answer 25

Infliximab Adalimumab Certolizumab pegol

Question 26

Terapii biologice noi

Answer 26

Vedolizumab | Ustekinumab

Question 27

Simptomul major in CU

Answer 27

Diaree cu sange si mucus

Question 28

Megacolonul toxic

Answer 28

Colon dilatat > 6cm, pereti subtiri, cu gaze si psuedopolipi

Question 29

Teste sangvine in CU

Answer 29

``` Anemie feripriva VSH, PCR, leucocite, trombocite Hipoalbuminemie Biochimie hepatica ANCA ```

Question 30

Standardul de aur in CU

Answer 30

Endoscopia cu biopsii

Question 31

5-ASA

Answer 31

Sulfasalazina Balsalazida Olsalazina

Question 32

Tratamentul in proctita

Answer 32

Supozitoare 5-ASA -> prima linie Steroizi topici <<<<< ASA 5-ASA oral +++++ 5-ASA no work => prednisolon oral

Question 33

Tratament in colita stanga

Answer 33

5-ASA topice -> prima linie 5-ASA oral +++++ 5-ASA no work => prednisolon oral

Question 34

Tratament in pancolita

Answer 34

5-ASA oral 5-ASA clisma +++++ 5-ASA no work => prednisolon oral

Question 35

Tratament colita refractara

Answer 35

Terapie biologica - anti-TNF: Infliximab, Adalimumab, Golimumab - anti-integrina: Vedolizumab - Tofacitinib (inhib Janus-kinaza 1-3)

Question 36

Terapia initiala in colita severa

Answer 36

Hidrocortizon 100 mg iv 6h | Heparina cu greutate molec mica

Question 37

Terapia de salvare in CU

Answer 37

PCR >45 / > 8 scaune / zi dupa 3 zile de hidrocortizon iv => | Ciclosporina 2mg/kg iv, Infliximab

Question 38

Interventia chir de electie in CU acuta

Answer 38

Colectomie subtotala cu ileostoma finala