6: Pathology - IBD Flashcards
Although Crohn’s disease affects anywhere from the mouth to the anus, where is it most commonly seen?
Terminal ileum
Colon
Which type of inflammation is seen in Crohn’s disease?
Transmural inflammation
Who tends to be diagnosed with Crohn’s disease?
Younger people (10-40 years old)
Crohn’s disease tends to ___ over time.
relapse
___ mucosa is typical of Crohn’s disease.
Cobblestone
Crohn’s disease is (continuous / segmental) with ___ lesions.
segmental , skip
What are skip lesions?
Alternating areas of normal and inflamed tract
What is a granuloma?
Collection of macrophages surrounding a foreign particle
What aspect of the gut tissue is invaded/destroyed/inflamed in Crohn’s disease?
Crypts
Crohn’s granulomas are (caseating / non-caseating).
non-caseating
they DON’T look like cheese
What drugs are used to treat Crohn’s disease?
Steroids
Immunosuppressants
If a Crohn’s disease patient doesn’t respond to treatment, what complication can occur?
Bowel obstruction
What rare structures may be seen in the gut wall of a Crohn’s disease patient?
Pseudopolyps
In Crohn’s disease, deep fissures form a ___ mucosa.
cobblestone
Crohn’s disease inflammation is transmural. What does this mean?
Affects mucosa, lamina propria and submucosa
What is a complication of Crohn’s disease?
Malabsorption
Short bowel syndrome due to resection
GALLSTONES
Fistulas
Perianal disease
Which gene is involved in the development of Crohn’s disease?
NOD2
Smoking (exacerbates / alleviates) the symptoms of Crohn’s.
exacerbates
Which immune cells are responsible for Crohn’s disease?
T lymphocytes
Macrophages
too many pro-inflammatory cytokines
What is ulcerative colitis?
Chronic inflammation of the rectum and colon only
Does ulcerative colitis affect the whole thickness of the gut wall?
No - mucosa only
Who tends to be diagnosed with ulcerative colitis?
Tends to be young, but not children
and the elderly as well
Crohn’s disease and ulcerative colitis are more common in (males / females).
males
Which part of the GI tract is nearly always involved in ulcerative colitis?
Rectum
Which parts of the GI tract is ulcerative colitis constricted to?
Rectum
Colon
What is the main symptom of UC?
Diarrhoea +/- blood and mucus
Like Crohn’s disease, ulcerative colitis tends to come in ___.
waves
Ulcerative colitis, untreated, causes colon swelling and perforation. What is this called?
Toxic megacolon
quite uncommon now due to effectiveness of drugs - look out for characteristic features on AXR
Ulcerative colitis is a (continuous / segmental) disease.
continuous
What is the only example of a skip lesion seen in UC?
Caecal patch
for some reason
Under the microscope, the tissue of someone with UC will be infiltrated by ___ cells.
inflammatory
What is it called when neutrophils infiltrate and destroy a gland?
Cryptitis
When crypts are full and distended due to neutrophil accumulation, what is this called?
Crypt abscess
If a patient with UC fails to respond to antibiotics, what procedure is performed?
Colectomy
May lead to anaemia, shock
Ulcerative colitis causes a lot of ___.
bleeding
Fat wrapping around the bowel wall is indicative of (Crohn’s disease / ulcerative colitis).
Crohn’s disease
Are granulomas seen in UC?
No
A complication of UC is toxic megacolon - massive swelling of the bowel. What can occur as a result of this?
How is it treated?
Perforation, peritonitis, sepsis, death
Total colectomy
Ulcerative colitis is associated with the development of ___ ___.
Why?
colorectal cancer
Chronic inflammation progresses to dysplasia and then carcinoma
Why type of cancer can develop following ulcerative colitis?
Colorectal carcinoma
Which immune cells are vital to the development of UC?
T cells
Macrophages
Is smoking associated with UC?
No - Crohn’s is though
