*IBD 2 (Lecture 2) Flashcards Preview

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Flashcards in *IBD 2 (Lecture 2) Deck (40):
1

Where is Crohn's disease most commonly found?

Terminal ileum and colon

2

Does Crohn's disease occur in children?
More common in males or females?

Yes - occurs in young patients (50% are 20-30 with 90% being 10-40)
Males

3

What is the clinical course of Crohn's disease?

Chronic
Exacerbation and remissions
Unpredictable response to therapy
Subgroup of patients who go into lasting remission within 3 years of diagnosis

4

How are patients with Crohn's disease diagnosed pathologically?

Endoscopy and mucosal biopsy

5

What type of -omas form in Crohn's disease?

Granulomas

6

What causes chronic active inflammation with crypt branching and granulomas?

Crohn's disease

7

Are the granulomas in Crohn's disease caseating?

No

8

Why do patients with Crohn's disease get a bowel obstruction?

Due to stricture formation (or inflammation)

9

What produces the cobble stoning of mucosa in Crohns disease?

Deep fissures

10

Can you get pseudo polyps in Crohns disease?

Yes (not common)

11

Does Crohn's disease cause transmural or superficial inflammation?

Transmural

12

What complications of Crohns can occur in the crypts?

Cryptitis
Crypt abscesses

13

What are the major complications of Crohn's disease?

Malabsorption (can be iatrogenic - short bowel syndrome)
Gallstones
Fistulas
Anal disease
Intractable disease
Bowel obstruction
Perforation
Malignancy
Amyloidosis
Extra-intestinal manifestations
Rarely toxic megacolon

14

What are signs of malabsorption?

Vitamin deficiency
Anemia
Hypoproteinemia

15

What is the name for a fistula between the colon and small intestine?

Enterocolic fistula

16

What is blind loop syndrome?

n blind loop syndrome a portion of the small intestine becomes bypassed and thus cut off from the normal flow of food. This may lead to malabsorption and small intestinal bacterial overgrowth syndrome (SIBO). It may also be associated with short bowel syndrome.

17

What kind of anal disease can occur with Crohn's diseases?

Sinuses
Fissures
skin tags
Abscesses
Perineum falls apart

18

What is intractable disease?

Disease that doesn't respond to therapy meaning the patient continues to experience symptoms

19

What is amyloidosis?

Amyloidosis is a group of rare but serious conditions caused by deposits of abnormal protein, called amyloid, in tissues and organs throughout the body.

20

What could explain the segmental distribution of Crohn's disease?

Vasculitis

21

How is the immune system related to Crohn's disease?

Persistent activation of T cells and macrophages (failure to switch off)
Excess pro-inflammatory cytokine production

22

Is ulcerative colitis more common in males or females?

Males

23

Can you get Crohn's disease in children?

Yes but not nearly as much as you get Crohn's disease in children

24

Do patients who get UC tend to be older or younger than those who get Crohns?

A bit older but still young (can get it in children or elderly people too)

25

Clinical course of UC?

Chronic course with exacerbation and remission
Can have continuous low grade activity
Can have a single attack
Can cause toxic megacolon

26

Basal lymphoplasmacytic infiltrate with irregular shaped branching crypts?

Ulcerative colitis

27

What disease has severe ulceration with fibrinopurulent exudate?

Ulcerative colitis

28

Why do you get diarrhoea with UC in chronic active disease?

Crypts burn themselves out meaning there is not enough crypts to absorb the fluid

29

Does UC causes superficial or transmural inflammation?

Superficial inflammation

30

What is the only time with UC when the inflammation is not confined to the mucosa and submucosa?

Toxic megacolon

31

Do you get granulomas with uc?

No

32

Complications of UC?

Intractable disease
Toxic megacolon
Colorectal carcinoma
Blood loss
Electrolyte disturbance (hypokalaemia)
anal fissures
Extra GI manifestations

33

What causes flares of UC in intractable disease?

Intercurrent infection by enteric bacteria
CMV

34

How can intractable UC be treated?

Total colectomy

35

Treatment for toxic megacolon?

Emergency colectomy

36

How UC lead to colorectal carcinoma?

Chronic inflammation leads to epithelial dysplasia and then carcinoma

37

Immune system role in ulcerative colitis?

Persistent activation of T cells and macrophages
Autoantibodies e.g. ANCA present
Excess proinflammatory cytokine production and bystander damage due to neutrophilic inflammation

38

Are fistulae more common in Crohns or UC?

Crohns

39

Are extra GI manifestations more common is Crohns or UC?

UC

40

Is the cancer risk higher in Crohns or UC?

UC