inflammatory bowel disease: UC + Chron's Disease Flashcards Preview

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Flashcards in inflammatory bowel disease: UC + Chron's Disease Deck (18):
1

TRANSMURAL inflammation EVERYWHERE
ANYWHERE: mouth to anus (small intestine + large intestine, most common location: TERMINAL ILEUM)
SKIP LESIONS
SPARING OF RECTUM: 50%

Chron's disease

2

imbalance between intestinal flora → inflammation

Chron's disease

3

treatment of Chron's disease

probiotics: maintain healthy bacterial flora

4

diagnosis of Chron's disease

transmural inflammation→narrowed lumen (barium swallow - "string sign")

5

complications of Chron's disease

stricturing
diarrhea
malabsorption (inflammation prevents absorprtion by enterocytes)
weight loss
fissures
fistulas
↑ risk colon cancer
systemic symptoms:
arthritis (IBD - HLA B27 seronegative spondyloarthropathies)
immunologic problems
erythema nadosum

6

types of fistulas in Chron's disease

enterocolonic: small intestine and colon
enterovesicular: small intestine and bladder
enterovaginal
enterocutaneous

7

IBD associated with erythema nadosum: red, painful subq nodules on shins

Chron's disease

8

histology of Chron's disease

non-caseating granulomas (= chronic inflammation)

9

treatments for chron's disease

mild disease: 5-ASA agents (mesealamine, sulfasalazine)
azathioprine or mercaptopurine > methotrexate
anti-TNF agent (infliximab, adalimumab): if have IBD + arthritis
steroids +/- antibiotics for acute exacerbation

10

MUCOSA + SUBMUCOSA inflammation in COLON only
starts in distal colon → proximal
CONTINOUS lesions
ALWAYS affects rectum

ulcerative colitis

11

autoimmune IBD

ulcerative colitis

12

diagnosis of ulcerative colitis

barrium enema: haustra are obliterated "lead pipe"

13

histology of ulcerative colitis

crypt abscesses
ulceration
bleeding

14

complikcation

bloody diarrhea (rectum involved)
malnutrition
↑ risk of colon cancer (more than IBD)
1° sclerosing cholangitis (scarring, inflammation of biliary tract)
pyoderma gangrenosum
sacroilitis or uveitis (HLA-B27 association)

15

IBD associated with pyoderma gangrenosum

ulcerative colitis

16

treatment of ulcerative colitis

salicylates (5-ASA agent): sulfasalazine (bound to salicylate when in colon it breaks apart so will only work in colon)
6-mercaptopurine
infliximab: anti-TNFalpha
TNF-alpha inhibitors
colectomy (cure)

17

IBD associated with primary sclerosing cholangitis

ulcerative colitis

18

IBD associated with ankylosing spondylitis

ulcerative colitis and
chron's disease (type of arthritis - HLA-B27)