crohns vs uc

Question 1

Location: Crohn’s vs UC

Answer 1

Crohn’s = skip lesion w/ rectal sparing. Terminal ileum or colon; UC = continuous colonic lesions w/ rectal involvement

Question 2

Gross - crohn’s

Answer 2

transmural. Cobblestone mucosa. Creeping fat. Fissures, fistulas.

Question 3

Gross - UC

Answer 3

Mcuosal and submcuosal inflammtion. Pseudopolyps. Loss of haustra (lead pipe on imaging)

Question 4

Histo - Crohn’s

Answer 4

noncaseating granulomas.

Question 5

Histo - UC

Answer 5

Crypt abcesses and ulcers. NO granulomas.

Question 6

Complications of crohn’s

Answer 6

strictures, fistulas, perianal disease, coloretal cancer

Question 7

Complication of UC

Answer 7

Primary sclerosing cholangitis. Toxic megacolin. Colorectal cancer.

Question 8

Clinical manifestation - Crohn’s

Answer 8

secretory diarrhea. Migratory polyarthritis, erythema nodosum, ankylosing spondylitis, uveitis, oxalate nephrolithiasis

Question 9

Clinical manifestations - UC

Answer 9

bloody diarrhea. Pyoderma gangrenosum. PSC, ankylosing spondylitis, uveitis.

Question 10

Therapy for crohn’s

Answer 10

corticosteroids, azathioprine, MTX, infliximab, adalimumab

Question 11

Therapy for UC

Answer 11

ASA preparations (sulfasalazine), 6MP, Infliximab, colectomy.

Question 12

Why do you get oxalate stones in Crohn’s?

Answer 12

decreased fat absorption. Low fat absorption = low serum Ca = increased oxalate in urine bec/ Ca binds oxalate in blood

Question 13

What is toxic megacolin?

Answer 13

cessation of neuroactivity in intestinal wall –> distension of abdomen. Tympanic percussion. Tx: IV fluids.