Flashcards in IBD 2 - Pathology Deck (40)
Where is Crohn's disease most commonly found?
Terminal ileum and colon
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
What is the clinical course of Crohn's disease?
Chronic Exacerbation and remissionsUnpredictable response to therapySubgroup of patients who go into lasting remission within 3 years of diagnosis
How are patients with Crohn's disease diagnosed pathologically?
Endoscopy and mucosal biopsy
What type of -omas form in Crohn's disease?
What causes chronic active inflammation with crypt branching and granulomas?
Are the granulomas in Crohn's disease caseating?
Why do patients with Crohn's disease get a bowel obstruction?
Due to stricture formation (or inflammation)
What produces the cobble stoning of mucosa in Crohns disease?
Can you get pseudo polyps in Crohns disease?
Yes (not common)
Does Crohn's disease cause transmural or superficial inflammation?
What complications of Crohns can occur in the crypts?
What are the major complications of Crohn's disease?
Malabsorption (can be iatrogenic - short bowel syndrome)GallstonesFistulasAnal diseaseIntractable diseaseBowel obstructionPerforationMalignancyAmyloidosisExtra-intestinal manifestationsRarely toxic megacolon
What are signs of malabsorption?
What is the name for a fistula between the colon and small intestine?
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.
What kind of anal disease can occur with Crohn's diseases?
SinusesFissuresskin tagsAbscessesPerineum falls apart
What is intractable disease?
Disease that doesn't respond to therapy meaning the patient continues to experience symptoms
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.
What could explain the segmental distribution of Crohn's disease?
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
Is ulcerative colitis more common in males or females?
Can you get Crohn's disease in children?
Yes but not nearly as much as you get Crohn's disease in children
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)
Clinical course of UC?
Chronic course with exacerbation and remission Can have continuous low grade activityCan have a single attackCan cause toxic megacolon
Basal lymphoplasmacytic infiltrate with irregular shaped branching crypts?
What disease has severe ulceration with fibrinopurulent exudate?
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
Does UC causes superficial or transmural inflammation?
What is the only time with UC when the inflammation is not confined to the mucosa and submucosa?
Do you get granulomas with uc?
Complications of UC?
Intractable diseaseToxic megacolonColorectal carcinomaBlood lossElectrolyte disturbance (hypokalaemia)anal fissuresExtra GI manifestations
What causes flares of UC in intractable disease?
Intercurrent infection by enteric bacteriaCMV
How can intractable UC be treated?
Treatment for toxic megacolon?
How UC lead to colorectal carcinoma?
Chronic inflammation leads to epithelial dysplasia and then carcinoma
Immune system role in ulcerative colitis?
Persistent activation of T cells and macrophagesAutoantibodies e.g. ANCA presentExcess proinflammatory cytokine production and bystander damage due to neutrophilic inflammation
Are fistulae more common in Crohns or UC?
Are extra GI manifestations more common is Crohns or UC?