Inflammatory Bowl Disease Flashcards
(34 cards)
What are common symptoms of both ulcerative colitis and Crohn’s disease?
Bloody, mucoid stools
These symptoms are characteristic of both conditions.
What HLA antigen is associated with inflammatory bowel disease?
HLA-B27
This antigen is linked with conditions like psoriasis, ankylosing spondylitis, reactive arthritis, and IBD.
If a patient has psoriasis and bloody stools, what condition might be suspected?
Inflammatory Bowel Disease
The presence of both symptoms suggests a possible link to IBD.
What other autoimmune diseases can be associated with ulcerative colitis and Crohn’s disease?
Vitiligo
Autoimmune conditions unrelated to HLA-B27 can also occur with IBD.
What ocular condition can both ulcerative colitis and Crohn’s disease cause?
Anterior uveitis
This is a non-specific finding seen in many autoimmune diseases.
Which type of inflammatory bowel disease has a higher risk of colon cancer?
Both Crohns and UC. But, UC has a greater risk because the colon is always involved in UC, unlike Crohn’s.
What are the first-line treatments for inflammatory bowel disease?
5-ASA NSAID compounds (mesalamine / sulfasalazine) or steroids
Mesalamine or sulfasalazine are preferred over steroids when listed.
What is the preferred initial treatment for Crohn’s disease when 5-ASA is not listed?
Steroids (ie. Prednisone)
This treatment may appear in exam questions but is not the first choice.
What type of agents are used for IBD in patients who fail initial treatment (5-ASA NSAID compounds (mesalamine / sulfasalazine) or steroids)?
Anti-TNF-a agents
Examples include infliximab, adalimumab, and etanercept.
Which cytokine is known to have anti-inflammatory effects for IBD?
IL-10
IL-10 and TGF-b are primarily anti-inflammatory mediators.
What layers of the bowel does ulcerative colitis affect?
Only the mucosa and submucosa
This means fistulae are not seen in ulcerative colitis.
What does colonoscopy reveal in patients with ulcerative colitis?
Pseudopolyps and crypt abscesses
You do not need to know the appearance, just that they indicate UC.
What is the characteristic appearance of the colon in a barium enema for ulcerative colitis?
Lead-pipe appearance
This is due to the loss of haustra.
What serious liver condition can be associated with ulcerative colitis?
Primary sclerosing cholangitis
This can be associated with pANCA antibodies.
What is pyoderma gangrenosum?
A necrotic skin lesion seen rarely in patients with UC
It is described as an ‘ulcer with necrotic debris’.
What can toxic megacolon present as in a patient with ulcerative colitis?
SIRS and sometimes low BP
An abdominal x-ray may show a 12-cm cecum (normal range is 3-8 cm).
What is the first-line treatment for toxic megacolon in a UC patient with normal BP?
Steroids
If the patient is unstable, a laparotomy is indicated.
Is colectomy common in patients with ulcerative colitis?
Sometimes performed, but very rarely in Crohn’s disease
Colectomy is more common in cases of severe ulcerative colitis.
Where can Crohn’s disease occur?
Mouth to anus
Crohn’s disease can affect any part of the gastrointestinal tract.
What is the highest yield location for Crohn’s disease?
Terminal ileum
The terminal ileum is often highlighted in exams for its significance in Crohn’s disease.
What is the characteristic symptom of Crohn’s disease that USMLE frequently tests?
Mouth ulcers
Mouth ulcers are a common presentation in patients with Crohn’s disease.
What part of the gastrointestinal tract does Ulcerative Colitis (UC) primarily affect?
Rectum (ascending)
What is a defining characteristic of Crohn’s disease?
Transmural inflammation, can cause anal fistulae and affect other organs
What do colonoscopy findings reveal in Crohn’s disease?
Skip lesions, with alternating diseased and normal bowel segments and cobblestone ulcers
