Path IBD

Question 1

2 major forms of IBD

Answer 1

ulcerative colitis

Crohn’s disease

Question 2

Cigarette smoking effect on CD & UC

Answer 2

CD increased

UC decreased!

Question 3

Appendectomy effect on CD & UC

Answer 3

CD increased

UC decreased

Question 4

high sanitation level in childhood effect on CD & UC

Answer 4

CD increase

UC no effect

Question 5

High intake of refined carbohydrates effect on CD & UC

Answer 5

CD increase

UC no effect

Question 6

description of UC and CD affected GI areas

Answer 6

UC always rectum, retrograde continuous spread

CD anywhere, including ilium and colon. big diversity

Question 7

broad based ulcerations

Answer 7

UC

Question 8

skip lesions

Answer 8

CD

Question 9

toxic megacolon as potential sequelae

Answer 9

UC

Question 10

pseudopolyp

Answer 10

UC

Question 11

bloody diarrhea

Answer 11

UC

Question 12

gross pathology of UC

Answer 12

hemorrhagic, edematous, mucosa with superficial ulceration, loss of folding pattern. pseuopolyps.

Question 13

microscopic pathology of UC

Answer 13

inflammatory cells, superficial ulceration (mucosa +/- submucosa) crypt abscesses

Question 14

crypt abscess

Answer 14

UC (even when no necrosis)

Question 15

granulomas in UC?

Answer 15

no

Question 16

inflammatory cells in UC

Answer 16

lymphocytes, plasma cells, eosinophils, macrophages, but no granulomas

Question 17

ulcerative proctitis

Answer 17

UC limited to rectum
rectal bleeding, pain, urgency, tenesmus

mildest form of UC

Question 18

proctosigmoiditis

Answer 18

UC of rectum and sigmoid
bloody diarrhea, abdominal cramps, pain, tenesmus.

continuous

Question 19

left-sided colitis

Answer 19

bloody diarrhea, abdominal cramps, pain, unintended weight loss.

continuous

Question 20

pancolitis

Answer 20

all colon. bloody diarrhea, abdominal cramps, pain, fatigue

Question 21

fulminant colitis

Answer 21

uncommon, life-threatening

entire colon - pain, diarrhea, dehydration/shock, SIRS. Deep colonic injury

Question 22

most sensitive test for free air (as in toxic megacolon with perforation)

Answer 22

CT

Question 23

What imaging for detail of mucosa?

Answer 23

barium contrast. CT is poor at this

Question 24

CD location

Answer 24

any part of GI tract mouth to anus.

small bowel & proximal colon most common

Question 25

CD age

Answer 25

peak at 20-29

Question 26

aphthous ulcers association?

Answer 26

CD

Question 27

rectal sparing?

Answer 27

CD

Question 28

skip lesions

Answer 28

CD

Question 29

deep ulcerations

Answer 29

CD

Question 30

stricture formation

Answer 30

CD

Question 31

fistulas

Answer 31

CD

Question 32

CD: small intestine alone % small intestine & colon % colon alone %

Answer 32

small intestine alone 30% small intestine & colon 40% colon alone 30%

Question 33

noncaseating granuloma

Answer 33

CD

Question 34

cobblestone mucosa

Answer 34

CD

Question 35

inflammatory cells in CD

Answer 35

neutrophils, lymphs, plasma cells, eosinophils, macrophages w/granulomas (35%)

Question 36

extra-intestinal manifestations of IBD (9)

Answer 36

``` enterocutaneous fistula apthoid ulcer erythema nodosum pyoderma gangrenosum scleritis, episcleritis, uveitis gallstones uric acid & oxalate stones hypercoagulable state peripheral neuropaty ```

Question 37

IBD risk factors for colorectal CA (6)

Answer 37

``` extensive IBD long term IBD young age of onset IBD backwash ileitis (UC) family history of colorectal ca hx of sclerosing cholangitis ```

Question 38

etiology of CD & UC

Answer 38

CD - disordered response to intestinal bacteria | UC - autoimmune

Question 39

creeping fat, bowel wall thickening

Answer 39

CD

Question 40

lead pipe appearance on imaging

Answer 40

UC