Flashcards in Inflammatory Bowel Diseaes Deck (32):
What is the onset age of IBD?
What is the first complain of someone with ulcerative colitis?
What is the first complain of someone with crohns?
abd pain then non-bloddy diarrhea
What is the primary site of UC?
where is the primary site of Crohn's
Smoking in IBD does what to the rates of UC? rates of Crohn's?
Decreases UC, increases Crohn's
How do appendectomy, high-sanitation level in childhood and high-intake of refined carbs affect CD?
they increase the risk, while cigarette smoking and appendectomy decrease the risk of UC
Explain the hygiene hypothesis
Incidence of immune-mediated diesases rising in developed countries (possibly due to lack of exposure to bacteria)
What is the characteristic pathologic finding of UC
dilated and thinned colon with severe universal inflammation
Skip lesions with UC?
On endoscopy what do you see in UC?
hyperemia, edema granularity with friability, easy bleeding, broad based ulceration, pseudopolyps, tunnels with mucosal bidges, rarely perforation
What is toxic megacolon?
shutdown of neuromuscular function secondary to exposure of fecal material to muscularis mucosae and neural plexus
What is the gross pathology of UC
edematous, congested and hemorrhagic mucosa with superficial ulceration and loss or normal folding pattern, leaving behind islands of mucosa at the previous surface level are the pseudopolyps
On microscopic histology what do you see in UC
edematous congested musocs with more blue than normal (because of inflammatory cells). LIMITED TO THE MUCOSA. Crypt abscessed with polys and crypt architecturla distortion
In UC, are there granulomas?
What is ulcerative proctitis?
inflammation confind the rectum, rectal bleeding may be only sign of dz, rectal pain, feeling of urgency or tenesmus
What is proctosigmoiditis?
involves rectum and sigmoid, bloody diarrhea abd cramps and pain and tenesmus are common. disease is continuous
What is left-sided colitis?
inflammation extends up from rectum to the left side. continuous. bloody diarrhea, abd cramping and pain on left side with unintended weight loss
what is pancolitis?
affecting entire colon with bloody diarrhea, that may be sever, abd cramps and pain with fatigue and significant weight loss
What is fulminant colitis?
uncommon life-threatening, affects entire colon, severe pain, profuse diarrhea, dehydration shock and sirs. associated with extensive and deep colonic injury
On endoscopy, what disappear with UC?
the appearance of blood vessels goes away
Where is the most common location for crohn's disease?
ileum and cecum.
what structures can crohn's affect?
apthoid ulcers in mouth, esophageal ulcers, gastricdz, and small bowel
When ddoes the age of dx from crohns typically occur?
What are the typical things seen in CD
dz can be limited to right colon
What are the general characterisitcs of CDs in terms of depth of invasion? Reactions?
transmural involvement, non-caseating granulomas
What is the gross pathology of cd?
transmural dz with cobblestone mucosa, skip lesions (alternating areas of involved and univolved bowel), creeping fat on the serosa, pseudopolyps
Microscopic pathology of CD
fistula, edema inflammation with neutrophils, lymphocytes, plasma cells, eosinophils, and macrophages forming granulomas!!!
Pain in LRQ can be confused between what two dzs?
appendicitis and crohn's disease
What are some extra-intestinal manifestations of cd?
enterocutaneous fistula, aphtoid ulcers, erythema nodosum, pyoderma grangrenosum, uveitis,
what is hematochezia?
passage of fresh blood through anus, typically do to rectal bleeding because the colon did not have time to change the blood