Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

M2 GI > 22a. IBD Preview > Flashcards

22a. IBD Preview Flashcards

1
Q

Name the 2 diseases that are under the umbrella term “Inflammatory Bowel Disease”

A

Ulcerative Colitis

Crohn’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

UC: what layers of the GI epithelium are involved?

A

mucosal layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Crohn’s: what layers of the GI epithelium are involved?

A

Transmural involvement: mucosal, submucosa, muscaris, serosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

UC: what parts of the GI are involved?

A

limited to colon (rectum –> cecum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Crohn’s: what parts of the GI are involved?

A

can be anywhere from mouth to anus. most common: small bowel alone, colon only, or both large and small simultaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

UC: what is the distribution (diffuse or patchy)?

A

Diffuse/continuous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Crohn’s: distribution is diffuse or patchy?

A

Patchy/intermittent, may be skip lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

UC: starts where?

A

starts in rectum, extends continuously through large bowel.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Crohn’s: complications?

A
  • Strictures
  • fistulas
  • abscesses
  • perianal disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

UC: can surgery help?

A

surgery may be curative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What’s this? Notable features?

A

Severe ulcerative colitis.

Note erythema, easy friability (would bleed easily), ulceration, exudates, circumferential involvement

note the “fingerprinting” of the mucosa - evidence of submucosal edema.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is this? features?

A

normal colon

No villi, crypts are uniform and parallel to each other, perpendicular to the surface.

Top surface is flat.

WTF is the COLON? Jen, it’s the LARGE INTESTINE. Duh.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is this? features?

A

Active Ulcerative Colitis.

***remember this slide per Benson***

Diffuse inflammation, complete ulceration of surface epithelium, distortion/destruction of glands.

Crypt lumens are filled with inflammation, necrotic debris.

Bottom line: architectural distortion and diffuse inflammation –> chronic UC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

IBD: geographical prevalance?

A

Highest in N America, Europe.

Highest prev in industrialized nations, more northern areas.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

IBD: typical age of onset?

A

***Know this***

IBD can occur at any age!

however, peak incidence is in late adolescence and early adulthood.

Generally M=F.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

IBD: genetic susceptability?

A

Crohn’s: monozygotic twin concordance =50%

UC: monozyg twin concordance = 5-14%

Genetic susceptability + environmental triggers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Impact of smoking on UC? Crohns?

A

Smoking is protective for UC (interesting: pts who present with late onset UC sometimes have quit smoking several months ago)

Increases disease activity, risk of Crohn’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Impact of appendectomy on UC? Crohn’s?

What about high sanitation level, high intake of refined carbs?

A

Appendectomy: protective for UC, no impact on Crohn’s

High sanitation level: no effect on UC, increases Crohn’s

High intake of refined carbs: no effect on UC, increases Crohn’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Crohn’s: possible etiology?

A

Possible that Crohn’s is due to exposure to a virus: measles, or a version of TB that is seen in cows??

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Overall picture for IBD etiology: what three elements combine to cause these diseases?

A
  • Presence of luminal antigens (enteric microbiome)
  • Genetic susceptibility
  • Enviromental triggers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the environmental triggers that can cause onset or flare of IBD?

A
  • antibiotics
  • diet
  • NSAIDs
  • stress (can cause flare, not new onset)
  • smoking

–>these all incr uptake of bacteria, which can initiate inflammatory response

22
Q

UC: symptoms?

A

Hematoschezia, Diarrhea (low volume, high freq), abd pain, tenesmus (dry heaves of the rectum), urgency, systemic sx (may be fevers, night sweats), extraintestinal manifestations

23
Q

UC: categories of severity?

A

Can be MILD, MODERATE, SEVERE

Mild = < 4stools/day, no Sx symptoms, NL ESR

Moderate: > 4stools/day, some systemic problems

Severe: > 6/day, bloody. Fever, HR >90, anemia

24
Q

What is this picture of? What else could it be?

A

Normal appearance of colon.

Could be normal, could also be microscopic colitis (will see histo changes on biopsy)

25
Q

What is this?

A

Mild UC. Note mild, continuous inflammation

26
Q

UC: extent of the disease - how much of the colon is involved?

A

May be just proctitis (only rectal involvement), but may present with pancoloitis (whole bowel). The farthest it will extend is the cecum.

Possible presentations: proctitis, proctosignoiditis, left-sided, extensive, pancolitis.

27
Q

What’s this? What is notable?

A

UC case with cut-off point in the middle of the transverse colon.

Note the diffuse, symmetrical, uninterrupted distribution from rectum to proximal transverse colon.

28
Q

UC: different clinical courses that it may take?

A
  • Majority of cases are recurring episodes of mild to moderate
  • Most severe is fulminating: at risk for perforation, may require IV steroids
  • May have chronic active disease (smoldering)
  • Proctitis: localized, but difficult to treat
29
Q

UC: complications?

A
  • massive hemorrhage
  • toxic megacolon

-perforation

-colon cancer

30
Q

What is this? notable?

A

Toxic megacolon.

Sign of this is accumulation of gas over a long segment of colon (left pic)

Right pic is more classic appearance of toxic metacolon: gas accumulates here (superior location when pt is supine)

R pic: note thumbprinting (edema of the bowel wall –> soft tissue densities protrude into lumen)

31
Q

What’s this? How bad is it?

A

Perforated bowel. most lethal complication of UC.

Mortality 15-20%

left pic: luminal gas has dissected the bowel wall, runs parallel to the wall. sign of necrosis and impending perf.

R pic: free air

32
Q

What are the risks of colorectal cancer in pts with IBD?

A

Risk factors include the duration of the disease and the extent of the disease.

Risk increases 8-10 y post onset of dz. Generally get periodic colonoscopies w biopsy to check for dysplasia.

33
Q

What is microscopic colitis? what are the sx? what does the bowel look like on colonscopy?

A

Microscopic Colitis (collagenous or lymphocytic): other dz’s under the umbrella of IBD.

watery, non-bloody diarrhea. colonic mucosa looks normal but there is microscopic inflammation

34
Q

Crohn’s: complications?

A

The complications relate to the fact that it has transmural extent: fibrosis, narrowing of the lumen, obstruction, fistulas.

35
Q

Name a few distinguishing features of Crohn’s (clinical, endoscopic, pathologic)

A

Small bowel involvement, sparing of the rectum, granulomas….

36
Q

What disease is this? notable?

A

Crohn’s Endoscopy

Note nodules, ulcerations (look like the oral apththous ulcers), exudate, luminal narrowing

37
Q

what is this? what disease does it indicate?

A

Cobblestoning due to heaped-up edematous mucosa.

Crohn’s

38
Q

What does each arrow point to? what disease is this?

A

Granulatous inflammation of Crohn’s. NON caseating.

39
Q

What is the typical clinical presentation of Crohn’s?

A

RLQ pain (due to ileocecal involvement). May be a palpable mass there. diarrhea, may have systemic symptoms: fever, anorexia, wt loss. abdominal tenderness.

40
Q

In what way can crohn’s mimic appendicitis?

A

If there is an ileal perforation - may mimic s/s of appendicitis or diverticulitis.

41
Q

How can Crohn’s lead to obstruction?

A

due to transmural inflammation

–>fibromuscular proliferation, collagen deposition in the intestinal wall

–> narrowed lumen

–> obstruction.

Obstruction may cause cramps post-meals, or vomiting if severe obs.

42
Q

what disease? what feature?

A

Crohn’s: multiple strictures due to skip lesions. patrern of chronic obstruction –> appearance of string of sausages

43
Q

Various forms of fistulas we see with Crohn’s?

A
44
Q

disease, features?

A

Perianal disease, unique to Crohn’s.

Left = perirectal abscess. Right = buttock fistulae. may drain stool out through skin.

45
Q

What is pictured? what disease?

A

top right: abscess.

center: anal skin tag (elephant ear). overlies a chronic anal fissure

Crohn’s

46
Q

What are some extraintestinal manifestations of IBD? associated with UC or Crohns or both?

A

4 general categories: eye, mouth, shin, arthritis (not shown).

All these are associated with both forms of IBD

47
Q

What are these called? which is more frequently associated with UC, which is more frequently associated with Crohn’s?

A

Left: Erythema Nodosum (Crohns)

Right: Pyoderma Gangrenosum (UC)

Maybe remember this since Crohn’s can be skip lesions, and the ED looks more patchy here, while the Pyoderma looks more “continuous” -> UC

48
Q

If an IBD is associated with arthritis, what pattern will the arthritis take? Which form of IBD is more associated with arthritis?

A

“Colitic Arthtiris”: Seroneg spondyloarthropathy (most common extracolonic association). Note NO synovial destruction.

seen in UC > Crohn’s

49
Q

If there is eye involvement with one of the IBDs, which one is it likely to be? What form will the eye involvement take?

A

L: episcleritis

R: anterior uveitis. usually occurs alongside axial arthritis–>associated with HLA-B27

UC, not Crohn’s

50
Q

What is primary sclerosing choleangitis? where does it occur? what disease is it associated with? What’s going on in this pic?

A

Systemic complication of UC. Liver: peri-ductal fibrosis or “onion skinning”

Inflammatory infiltrate, ductal proliferation, peri-ductal fibrosis.

Imaging pic = for an ECRP study: note pruned-tree appearance of biliary tree. Distorted, truncated, distorted.

M2 GI (41 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions