Inflammatory Bowel Disease

Question 1

Define toxic megacolon

Answer 1

Transverse or right colon with diameter of > 6 cm

Question 2

peak age onset UC and CD

Answer 2

15-30 years old

60-80 years old

Question 3

male slightly > female

Answer 3

crohn’s

Question 4

UC or CD:

increased risk with OCPs

Answer 4

crohn’s

Question 5

UC or CD:

58% concordance in monozygotic twins, compared to the other, only 6%

Answer 5

crohn’s

Question 6

UC or CD:

smoking, appendectomy protective

Answer 6

UC

Question 7

UC or CD:

4% concordance in dizygotic twins, compared to the other, 0%

Answer 7

crohn’s

Question 8

can present with Crohn’s like disease of small bowel

Answer 8

Glycogen storage disease type 1b

Question 9

Diseases with genetic factors shared with IBD

Answer 9

SLE
Asthma
DM
RA
AS
Psoriasis

Question 10

Anti inflammtory cytokines responsible for oral tolerance

Answer 10

IL 10

TGF B

Question 11

responsible for neutrophilic recruitment

Answer 11

TH17

Question 12

Initiates TH1 cytokine pathway and is key cytokine in the pathogenesis of experimental models of mucosal inflammation

Answer 12

IL12

Question 13

Possible infectious cause of IBD

Answer 13

Salmonella
Shigella
Campylobacter
Clostridium diff

Question 14

UC or crohn’s:

involves the rectum and extends to colon in 40-50%

Answer 14

UC

Question 15

UC or crohn’s:

skip lesions

Answer 15

CD

Question 16

UC or crohn’s:

mild= mucosa resembles sandpaper

Answer 16

UC

Question 17

UC or crohn’s:

Px with fulminant disease can resemble toxic megacolon

Answer 17

UC

Question 18

UC or crohn’s:

process limited to mucosa and submucosa

Answer 18

UC

Question 19

My distinguish UC from infectious or acute colitis

Answer 19

1) crypt architecture of the colon is distorted

2) (+) basal plasma cells and multiple basal lymphoid aggregates

Question 20

Changes in patients with backwash ileitis

Answer 20

1. villous atrophy and crypt regeneration
2. inc neutro and mono inflame
3. patchy cryptitis, crypt abscess

Question 21

UC or crohn’s:

rectal sparing

Answer 21

crohn’s

Question 22

UC or crohn’s:

transmural

Answer 22

CD

Question 23

UC or crohn’s:

rarely may involve liver and pancreas

Answer 23

CD

Question 24

UC or crohn’s:

pseudo polyps can form

Answer 24

both

Question 25

UC or crohn’s:

“creeping fat” encase the bowel

Answer 25

Crohn’s

Question 26

earliest lesions Crohn’s

Answer 26

focal crypt abscess

aphthoid ulcerations

Question 27

UC or crohn’s:
Bleeding
Diarrhea nocturnal, postpranial

Answer 27

UC

Question 28

highly sensitive marker for determining intestinal inflammation

Answer 28

fecal lactoferrin

Question 29

pouchitis, predict relapses

Answer 29

Fecal calprotectin

Question 30

Collar button ulcers

Answer 30

UC

Question 31

Two patterns of disease in crohn’s

Answer 31

1) fibrostenotic obstructing pattern

2) penetrating fistulous pattern

Question 32

UC or crohn’s:

(+) palpable mass in RLQ

Answer 32

CD

• inflammed bowel and indurated mesentery
• enlarged abdominal lymph nodes

Question 33

UC or crohn’s:

“string sign”

Answer 33

CD

Question 34

first line test to evaluate suspected CD and its complications

Answer 34

CT enterography

Question 35

CD gene associated with small bowel disease, fibrostenosing and internal penetrating disease

Answer 35

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