GI Autoimmune Diseases

Question 1

What is mucosa associated lymphoid tissue (MALT)?

Answer 1

Specialized immune system which protects mucosal surfaces.

Question 2

What are environmental triggers for IBD?

Answer 2

Foreign substances (antigens)

Question 3

How does the immune system play into IBD

Answer 3

Bacteria may stimulate the immune system to produce inflammation

Question 4

IBD reflects an imbalance of … and accumulation of …

Answer 4

imbalance of inflammatory response

accumulation of excess infiltrating lymphocytes

Question 5

Risk factors for IBD

Question 6

When diagnosing IBD, we want to rule out…

Answer 6

infection

Question 7

2 subsets of IBD

Answer 7

1. Crohn’s disease
2. Ulcerative colitis

Question 8

Describe Crohn’s disease

Question 9

3 main clinical patterns of Crohn’s disease

Answer 9

1. Inflammatory (inflammation of bowel)
2. Fistulizing (channel formation between bowel loops)
3. Fibrostenotic (narrowing due to cirrhosis resulting from chronic inflammation)

Question 10

Name morphological features of Crohn’s disease

Answer 10

1. Mucosal erythema/edema
2. Superficial ulcers (in mouth
3. Deep linear ulcers on axis
4. Nodularity from skip areas (cbblestoning)
   …?

Question 11

Natural history of OBD: CD

Answer 11

Disease location remains stable over time
1/3 of patients have penetrating/stricturing complications

Question 12

What is the main histological distinction between Crohn’s disease and ulcerative colitis?

Answer 12

CD: granulomas
UC: no granulomas

Anything else?

Question 13

Extra-intestinal manifestations of IBD (CHEATS)

Answer 13

C: cholangitis
H: hemotologic
E: eye
A: arthritis
T: thromboembolism
S: skin

Question 14

Name the 3 genetic factors that are associated with celiac disease

Answer 14

HLA
DQ2
DQ8

(gene loci)

Question 15

5 types of celiac disease

Answer 15

1. classic or typical CD
2. atypical celiac sprue
3. asymptomatic (silent) CD
4. Latent (potential) celiac disease)
5. Refractory celiac disease

Question 16

Which is more common?
a) silent celiac sprue
b) symptomatic celiac sprue

Answer 16

a) silent celiac sprue is 7x more common

Question 17

Clinical presentation of celiac disease (main symptoms)

Answer 17

1. Main age at presentation: 45
2. Episodic diarrhea
3. Distention
4. Steatorrhea

Question 18

Describe stages zero to four of celiac disease (Marsh classification)