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Flashcards in Inflammatory Bowel Diseaes Deck (32):
1

What is the onset age of IBD?

20-29

2

What is the first complain of someone with ulcerative colitis?

bloody diarrhea

3

What is the first complain of someone with crohns?

abd pain then non-bloddy diarrhea

4

What is the primary site of UC?

rectum

5

where is the primary site of Crohn's

ilecolic

6

Smoking in IBD does what to the rates of UC? rates of Crohn's?

Decreases UC, increases Crohn's

7

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

8

Explain the hygiene hypothesis

Incidence of immune-mediated diesases rising in developed countries (possibly due to lack of exposure to bacteria)

9

What is the characteristic pathologic finding of UC

dilated and thinned colon with severe universal inflammation

10

Skip lesions with UC?

No

11

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

12

What is toxic megacolon?

shutdown of neuromuscular function secondary to exposure of fecal material to muscularis mucosae and neural plexus

13

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

14

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

15

In UC, are there granulomas?

NOPE

16

What is ulcerative proctitis?

inflammation confind the rectum, rectal bleeding may be only sign of dz, rectal pain, feeling of urgency or tenesmus

17

What is proctosigmoiditis?

involves rectum and sigmoid, bloody diarrhea abd cramps and pain and tenesmus are common. disease is continuous

18

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

19

what is pancolitis?

affecting entire colon with bloody diarrhea, that may be sever, abd cramps and pain with fatigue and significant weight loss

20

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

21

On endoscopy, what disappear with UC?

the appearance of blood vessels goes away

22

Where is the most common location for crohn's disease?

ileum and cecum.

23

what structures can crohn's affect?

apthoid ulcers in mouth, esophageal ulcers, gastricdz, and small bowel

24

When ddoes the age of dx from crohns typically occur?

20s

25

What are the typical things seen in CD

asymmetrical dz
apthous ulcers
rectal sparing
skip lesions
deep ulcerations
stricture formation
fistula
dz can be limited to right colon

26

What are the general characterisitcs of CDs in terms of depth of invasion? Reactions?

transmural involvement, non-caseating granulomas

27

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

28

Microscopic pathology of CD

fistula, edema inflammation with neutrophils, lymphocytes, plasma cells, eosinophils, and macrophages forming granulomas!!!

29

Pain in LRQ can be confused between what two dzs?

appendicitis and crohn's disease

30

What are some extra-intestinal manifestations of cd?

enterocutaneous fistula, aphtoid ulcers, erythema nodosum, pyoderma grangrenosum, uveitis,

31

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

32

Who is at risk for colorectal cancer with IBD

extensive ibd
long duration of ibd
young onset of dz
severe ibd
presence of backwash ileitis (UC)
family hx of crc
personal hx of sclerosing cholangitis