012215 IBD Flashcards
ulcerative colitis
continuous inflam colon only superficial inflam risk of cancer extraintestinal manifestations goes from rectum to more proximal
clinical presentation of UC
diarrhea, typically bloody w mucus abdominal pain loss of appetite, weight loss fever fatigue urgency for bowel mvmt children-developmental failure
endoscopic findings of UC
erythema friability (when touched, bleeds) pseudopolyps (benign) erosions ulcers (in severe cases) cecal patch backwash ileitis (only w pancolitis)
etc
Crohn’s dis
pathcy inflam can involve anywhere from mouth to anus full thickness inflam (all layers of bowel) cobblestone look fistulae-peritoneum, bladder strictures and surgery (due to inflam) extraintestinal manifestations
most common site for Crohn’s dis
terminal ileum, cecum
clinical presentation of Crohn’s dis
abd pain diarrhea weight loss anorexia vomiting rectal bleeding stunted growth in children fevers
3 major endoscopic findings SPECIFIC for Crohn’s dis
aphthous ulcers (canker sores)
cobblestoning
discontinuous lesions
you see ulcers more often with Crohn’s dis or UC?
Crohn’s
UC always affects the
rectum
fistulas and strictures are seen in Crohn’s and not UC b/c
Crohn’s has full thickness inflam
granulomas on biopsy favors Crohn’s or UC?
Crohn’s
extraintestinal manifestations of IBD
acute arthropathy erythema nodosum choledocholithiasis ocular complications sacroilliits ankylosing spondylitis pyoderma gangrenosum PSC (more UC than Crohn's)
pathogenesis of IBD
genetic-NOD2 mutations
mucosal immune responses (Th17 cells)
epithelial defects (tight jxns)
microbiota (rxns against microbiota)