Clinic-IBD Flashcards
colon only
UC
focal and patchy
CD
transmural inflammation
CD
occurs in smokers
CD
diffuse and contiguous
UC
can present with perianal sx, fistulas, and/or granulomas
CD
both UC and CD are more prevalent in the (North/South)
North
age of onset for IBD
15-30
females are more likely to get this one
CD
whites and jewish more likely to get this one
UC
associated with chromosome 16 mutation (NOD2)
CD
smoking may have a protective effect for this one
UC
appendectomy may be protective for this one
UC
incidence of IBD peaks at what two points in life
20, 50
IBD is more prevalent in the developing/developed world
developed
theory behind IBD
overly aggressive T cell response directed against environment and/or commensal bacteria
chronic inflammation in IBD is due to an imbalance between?
pro- and anti-inflammatory mediators
dysbiosis
both
hygeine hypothesis of IBD
increase hygeine = decreased development of immune system as child = imbalance between Th1 and Treg cells
genetics associated with CD relate to?
microbe recognition, innate immune system
genetics associated with UC relate to?
HLA genes, intestinal barrier integrity
____ allelic variants seen in 27-39% of CD pts, confers worse dz and earlier onset
NOD2
role of NOD2 protein
recognition of microbes and innate immunity
extra-intestinal manifestations of IBD occur in? (4 places)
skin, liver, eyes, joints
70% of CD involves what part of the intestines?
ileum
clinical presentation of crohn’s (6 things)
abdominal pain, diarrhea, weight loss, growth retardation, fever, perianal dz
SBFT of CD shows?
high grade strictures (inflammation in bowel)
CT of CD shows?
thickened wall
linear ulcers in SB sign of?
CD
skip lesions
CD
2 major complications of CD
obstruction, fistulas (abscesses)
signs of obstruction
cramps, distension, vomiting
removal of the terminal ileum may cause?
B12 deficiency, bile salt diarrhea, fat malabsorption if >100cm
clinical presentation of UC (6 things)
bloody diarrhea, tenesmus, crampy abdominal pain with BM, weight loss, fever, growth retardation
if concerned about UC, always do an X-ray to rule out?
toxic megacolon
UC is dx by?
sigmoidoscopy or colonoscopy
___ increases risk of colorectal cancer (significant risk by ___ years after diagnosis)
UC; 30 (screen at 10 years)
___ (from last exam) is a risk factor for colorectal ca in pts with UC
PSC
surgical tx of UC
proctocolectomy (koch pouch or ileal pouch anal anastomosis)
skin disorders in IBD
erythema nodosum, pyoderma gangrenosum, cutaneous CD
MSK disorders in IBD
peripheral arthritis, sacroileitis (central arthritis), ankylosing spondylitis (back pain)
this MSK disorder parallels gut dz, the others do not
peripheral arthritis
name 2 ocular disoders seen in IBD; which is worse?
uveitis & scleritis; uveitis is worse (both are inflammation)
name 4 hepatobiliary disorders associated with IBD
PSC, pericholangitis, cholangiocarcinoma, gallstones
name 2 additional EIMs seen in IBD
mouth ulcers, DVT/PE
blood in stool
UC
mucus
UC
systemic symptoms
CD
pain
CD
abdmominal mass
CD
perineal/perianal dz
CD
fistulas
CD
small intestine/colonic obstruction
CD
response to ABX
CD
surgery is effective for (UC/CD)
UC
cobblestoning
CD
granulomas
CD (40-50%)
rectal sparing
CD
