FN: IBD: Pathology and Presentation

Question 1

UC
Prevalence
Age
Sex
Aetiology

Answer 1

1. 100-200/100,000
30w
F>M
Concordance = 10%
Smoking protective
TH2-mediated

Question 2

Crohns
Prevalence
Age
Sex
Aetiology

Answer 2

50-100/100,000
Smoking increases risk
Th1/Th7 mediated

Question 3

UC macroscopic
Location
Ditribution
Strictures?

Answer 3

1. Rectum + colon ± backwash ileitis
2. Distribution contigupus
3. Strictures No

Question 4

Crohns Macroscopic
Location
Dstribtuion
Strictures?

Answer 4

1. Mouth to anus esp. terminal ileum
2. skip lesions
3. TEs

Question 5

UC microscopic

1. inflammation
2. Ulceration
3. fibrosis
4. Granulomas
5. Pseudopolyps
6. fistulae

Answer 5

1. Mucosal
2. shallow, broad
3. None
4. None
5. Marked
6. No

Question 6

Crohns

1. inflammation
2. Ulceration
3. fibrosis
4. Granulomas
5. Pseudopolyps
6. fistulae

Answer 6

1. Transmura
2. Deep thin, serpiginous –> cobblestone mucosa
3. Marked
4. Present
5. Minimal
   6.

Question 7

Uc symptoms

Answer 7

Systemic: fever, malaise, anorexia, wt. loss in active disease
Abdominal:
1. diarrhoea
2. blood ± mucus PR
3. Abdominal discomfort
4. Tenesmus, faecal urgency

Question 8

Crohns symptoms

Answer 8

systemic: fever, malaised, anorexia, wt. loss in active disease
abdominal:
1. diarrhoea (not usually bloody)
2. Abdominal pain
3. Wt. loss

Question 9

UC signs abdominal

Answer 9

fever

Tender, distended abdomen

Question 10

Crohns signs abdomen

Answer 10

Apthous ulcers, glossitis

2. abdominal tenderness
3. RIF mass
4. Perianal abscessess, fistulae, tages
5. Anal/rectal strictures

Question 11

UC and crohns extra-abdominal skin

Answer 11

Skin:

1. clubbing
2. erythema nodosum
3. pyoderma gang (esp. Uc)

Question 12

UC and crohns extra-abdominal eyes

Answer 12

1. iritis
2. Conjunctivitis
3. Episcleritis
4. Scleritis

Question 13

UC and crohns extra-abdominal joints

Answer 13

Arthritis (non-deforming, asymmetrical)
sacroilitis
Ank spond

Question 14

UC and crohns extra-abdominal HPB

Answer 14

PSC + cholangiocarcinoma (esp. UC)
Gallstones
Fatty liver

Question 15

UC and crohns extra-abdominal other

Answer 15

Amyloidosis

Oxalate renal stones (esp. Crohns)

Question 16

Complications UC

Answer 16

1. Toxic megacolon (risk of perf)
2. bleeding
3. Malignancy - CRC in 15 w/ pancolitis for 20 yrs
   Cholangiocarcinoma
   Strictures - obstruction
   Venous thrombosis

Question 17

Complications Crohns

Answer 17

Fistulae
Stricture
Abscesses
Malabsorption

Question 18

Fistulae

Answer 18

Entero=enteric/colonic –> diaarhoea
Enerterovesical –> freqeuncy, UT
Enterovaginal
Perianal - pepperpot anus

Question 19

Stricture lead to

Answer 19

Obstruction

Question 20

Abcessess

Answer 20

Abdomina

anorectal

Question 21

Malabsorption

Answer 21

Fat - steatorrhoea, gallstones
B12 - megaloblastic anaemia
3. Vit D --> osteomalacia
Protein - oedema
toxic megacolon and Ca