Master the board step 3

Gastroenterology
Inflammatory Bowel Disease (IBD)
Both Crohn’s disease (CD) and ulcerative colitis (UC) can present with fever,
abdominal pain, diarrhea, blood in the stool, and weight loss. UC most often
presents with abdominal pain and bloody diarrhea.
The extraintestinal manifestations of IBD are as follows:
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Joint pain
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Eye findings (iritis, uveitis)
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Skin findings (pyoderma gangrenosum, erythema nodosum)
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Sclerosing cholangitis
Features more common to Crohn’s disease are the following:
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Masses
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Skip lesion
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Involvement of the upper GI tract
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Perianal disease
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Transmural granulomas
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Fistulae
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Hypocalcemia from fat malabsorption
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Obstruction
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Calcium oxalate kidney stones
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Cholesterol gallstones
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Vitamin B12 malabsorption from terminal ileum involvement
Both Crohn’s disease (CD)
that involves the colon and
ulceratative colitis (UC)
can lead to colon cancer.
Screening colonoscopy
should be performed every
1–2 years after 8–10 years
of colonic involvement.
Diagnostic Testing
Endoscopy is diagnostic in both CD and UC. Barium studies are also diagnostic
in both. When the diagnosis is not clear from endoscopy or barium
studies, blood tests are helpful.
Crohn’s Disease
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Antisaccharomyces cerevisiae (ASCA): Positive
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Antineutrophil cytoplasmic antibody (ANCA): Negative
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