Week 3: Inflammatory Bowel Disease Flashcards
(74 cards)
1
Q
Case 1 history
A
2
Q
Case 1 additional history
A
3
Q
Case 1 Labs
A
4
Q
Case 1 colonoscopy
A
5
Q
Case 2 history
A
6
Q
Case 2 additional history
A
7
Q
Case 2 labs
A
8
Q
Case 2 contrast
A
9
Q
Case 2 Colonoscopy
A
10
Q
What is IBD?
A
11
Q
What types of IBD are there?
A
Crohn’s Disease
Ulcerative Colitis
12
Q
Other causes of intestinal inflammation
A
- Infections
- Medications (NSAIDs, Antibiotics)
- Ischemia
- Radiation
13
Q
Proposed etiologies of IBD
A
- Genetic
- Infection (dysbiosis)
- immune dysfunction
- Environmental factors
- Intestinal barrier defect
14
Q
Pathogenesis of IBD
A
15
Q
IBD pathways
A
16
Q
Genetic factors of IBD
A
- Genetic mutation in NOD-2 gene in 10-15% of patients with Crohn’s disease most common in Jews
*
17
Q
Role of microbes
A
18
Q
Epidemiology of IBD
A
19
Q
Risk factors for IBD
A
20
Q
A broad overview of how Ulcerative colitis and Crohn’s disease
A
21
Q
Ulcerative colitis location of inflammation
A
Inflammation in the colonic mucosa where only the colon is involved
inflammation affects the rectum and extends proximally to affect a variable extent of colon
22
Q
Ulcerative colitis duration of inflammation
A
Continuous inflammation
23
Q
Forms of IBD that are associated with extraintestinal complications
A
Both
- Crohn’s Disease
- Ulcerative colitis
24
Q
Way to remember ulcerative colitis
A
ULCCCERS
- Ulcers
- Large intestine
- Continuous/Colon cancer/ Crypt abscesses
- extends proximally, red diarrhea, sclerosing cholangitis
25
Crohns disease location
* chronic transmural inflammation
* may involve any part of the GI tract from oral to anus
* Typically affects the ileum and colon
26
Most common Crohn's disease location
Typically affects the ileum and colon
27
Describe the distribution of Crohn's Disease
* distribution tends to be focal, asymmetric or segmental (skipped lesions)
28
Crohn's disease complications
frequently complicated by fistulas and perianal disease
Also
Associated with extraintestinal complications
29
Anatomic distribution of ulcerative colitis
30
Anatomic distribution of Crohn's Disease
31
Gross histology of non-universal ulcerative coliiis
32
Crohn's disease anatomic distribution frequency
33
Ulcerative colitis clinical presentation
* Diarrhea (small frequent BM)
* Blood stools
* Abdominal pain
34
Crohn's Disease clinical presentation
* Diarrhea (less freq)
* Blood stools (less)
* Right lower quadrant abdominal pain and mass
* Obstructive sxs (decrease in bm)
* Intestinal fistulas and fissures
35
What is the most common extraintestinal manifestation of ulcerative colitis?
Skeletal (osteoarthritis, ankylosing spondylitis, sacroiliitis)
36
What are the skeletal extraintestinal manifestations of ulcerative colitis?
Skeletal (osteoarthritis, ankylosing spondylitis, sacroiliitis)
37
What are the ocular extraintestinal manifestations of ulcerative colitis?
* Uveitis
* episcleritis
* iritis
38
What are the biliary extraintestinal manifestations of ulcerative colitis?
* primary sclerosing cholangitis (PSC)
* It is rare for patients with UC to develop PSC but up to 90% of all patients affected by PSC will also be affected by UC
39
What are the cutaneous extraintestinal manifestations of ulcerative colitis?
* erythema nodosum
* pyoderma gangrenosum
* aphthous stomatitis
40
What are the general extraintestinal manifestations of ulcerative colitis?
* fatigue
* Fever
41
What are the adolescent or seen in children extraintestinal manifestations of ulcerative colitis?
* growth retardation
* delayed puberty
42
What is this?
* Left is pyoderma gangrenosum
* Right is erythema nodosum
43
Ulcerative colitis Dx is based on?
44
Labs for Ulcerative colitis
45
Endoscopy of UC
46
Endoscopy of Crohn's Disease
47
Endoscopic spectrum of proctocolitis
48
Describe the appearances of Crohn's Disease endoscopic feature
49
Histology of UC
Mucosal inflammation
50
51
Gross histology and histology of mild UC
52
Gross histology and histology of severe UC
53
Histology of Crohn's disease
* Transmural inflammation
* Non-caseating granulomas
* Giant cells
* NEutrophilic inflammation of the crypts
54
Describe Crohn's Disease histology granuloma
55
Describe Crohn's Disease histology cross-section
56
Describe Crohn's Disease histology
transmural process
57
Describe Crohn's Disease histology fistula
58
Describe Crohn's Disease histology enteric fistulae
59
Describe Crohn's Disease histology enterocutaneous fistulae
60
Describe Crohn's Disease histology perianal fistulae and abscess
61
Describe Crohn's Disease histology perineal complications of Crohn's disease
62
Describe how radiology can be used to identify IBD
63
UC radiology
64
Crohn's radiology
65
What is this?
String sign in Crohn's disease
66
What is this?
ileitis in Crohn's Disease
67
What is this?
Gastro-duodenitis in Crohn's Disease
68
Treatment of Crohn's disease
69
Describe step-up therapy for Crohn's disease
70
Describe surgical options for UC
Colectomy is curative for UC
71
Crohn's Disease surgical options
* Surgery is to be avoided if possible
* High-rate of postoperative recurrence at the site of the resection
72
Summary of Crohns to UC
73
Case 2 recap
Ulcerative colitis
74
Case 1 recap
Crohn's Disease
