GI - Colitis

Question 0

Mesenteric ischemia – typical patient?

Answer 0

Patient older than 50 years, with known atherosclerotic vascular disease. Pain is he cute and often after meals. No fever.

Question 1

Differential diagnosis for colitis?

Answer 1

1. Ischemic
2. Infectious
3. Radiation
4. IBD
5. Mesenteric

Question 2

IBD is most commonly diagnosed at what age groups?

Answer 2

Bimodal: 15 to 25, and 60 to 70 year of age

Question 3

Anemia in IBD due to?

Answer 3

1. Iron deficiency anemia from bleeding

2. Anemia of chronic disease

Question 4

IBD that presents with grossly bloody stool?

Answer 4

Ulcerative colitis

Question 5

IBD that can present anal fissures and nonhealing ulcers?

Answer 5

Crohn’s disease

Question 6

IBD that can present with strictures caused by fibrosis which leads to?

Answer 6

Crohn’s disease. Can lead to bowl obstruction

Question 9

Extraintestinal manifestations: Crohn’s disease Chris’s ulcerative colitis

1. Skin
2. Joints
3. Ocular
4. Hepatobiliary
5. Urologic

Answer 9

1. Erythema nodosum versus erythema nodosum/pyoderma gangrenosum
2. Asymmetric arthritis/ankylosing spondylitis versus less
3. Uveitis for both
4. Cholelithiasis fatty liver versus fatty liver/primary sclerosing cholangitis
5. Nephrolithiasis verses nothing

Question 10

Treatments used in Mild–moderate and moderate–severe ulcerative colitis?

Answer 10

Mild-moderate: Sulfasalazine/Mesalamine

Moderate – severe: Corticosteroids

Question 11

Treatments used in severe ulcerative colitis?

Answer 11

Severe: 6MP, azathioprine, methotrexate, infliximab

Question 12

When is surgery performed for ulcerative colitis?

Answer 12

Carcinoma, toxic megacolon, perforation, uncontrollable bleeding

Question 13

Definition of toxic megacolon? Associated with?

Answer 13

Colon Dilated >6 cm.

Gen: Fever, leukocytosis
heart: tachycardia, hypertension, CNS: altered mental status

Question 14

Patient arrives with suspected toxic megacolon - immediate management?

Answer 14

1. IV fluids
2. NG tube
3. IVM biotics (in anticipation perforation)
4. IV steroids

Question 15

Patients with ulcerative colitis should begin getting annual colonoscopies when?

Answer 15

8 years after diagnosis of pancolitis

Question 16

Patients with IBD are at an increased risk for what bile duct pathology?

Answer 16

Primary sclerosing cholangitis

Question 17

Crohn’s disease v ulcerative colitis

1. Site of origin
2. Pattern
3. Thickness
4. Sx

Answer 17

1. Terminal ileum versus rectum
2. Skip lesions versus continuous
3. Transmural versus mucosal
4. Cramps versus bloody diarrhea

Question 18

Crohn's disease versus ulcerative colitis
1. complications
2 radiographic findings
3 risk of colon cancer
4. surgery used for?

Answer 18

1. Fistulas/abscess/extraction versus hemorrhage/toxic megacolon
2. String sign versus leadpipe:
3. Slight increase verses marked increase
4. Strictures versus cure