Chapter 50: IBD- Ulcerative Colitis Flashcards
1
Q
Incidence?
A
10/100,000
2
Q
At-risk population
A
- High in the Jewish population
- low in the African American population
- Positive family history in 20% of cases
3
Q
Sex?
A
Male > female
4
Q
Distribution?
A
Bimodal distribution at
- 20 to 35 and
- 50 to 65 years of age
5
Q
Initial symptoms
A
Bloody diarrhea (hallmark)
fever
weight loss
6
Q
Anatomic distribution
A
Colon only
7
Q
Route of spread
A
Almost always involves the rectum and spreads proximally always in acontinuous route without “skip areas”
8
Q
What is “backwash” ileitis?
A
Mild inflammation of the terminal ileum in ulcerative colitis; thought to be “backwash” of inflammatory mediators from the colon into the terminal ileum
9
Q
Bowel wall involvement
A
Mucosa/submucosa only
10
Q
Anal involvement
A
Uncommon
11
Q
Rectal involvement
A
100%
12
Q
Mucosal Findings
A
- Granular, flat mucosa
- Ulcers
- Crypt abscess
- Dilated mucosal vessels
- Pseudopolyps
13
Q
Diagnositc tests
A
- Colonoscopy
- barium enema
- UGI with small bowel follow through (to look forCrohn’s disease)
- stool cultures
14
Q
Complications
A
- Cancer
- toxic megacolon
- colonic perforation
- hemorrhage
- strictures
- obstruction
- complications of surgery
15
Q
Cancer risk
A
- ≈5% risk of developing colon cancer at 10 years;
- then, risk increases ≈1% per year;
- thus, an incidence of ≈20% after 20 years of the disease (30% at 30 years)
