GI II

Question 1

Why do you get increased risk for renal stones with crohn’s?

Answer 1

Oxalate absorption is enhanced, leading to calcium oxalate stones

Question 2

Crohn’s genetics

Answer 2

Big face above the gazebo wearing a chicken hat is nodding to me + Nicole Simmonds standing behind it/mutations in the NOD2 gene have a strong association with Crohn disease. NOD2 activates the NF-kB pathway. NF-kB is a proinflammatory transcription factor that increases cytokine production. Inactivation of NF-kB impairs innate immune response of intestinal mucosa. Loss of natural barrier allows luminal bacteria to penetrate submucosal tissues, causing an exaggerated response by the adaptive immune system, resulting in chronic GI inflammation.

Question 3

Why are Crohn’s patients at increased risk for gallstones?

Answer 3

bile acids are not reabsorbed in the terminal ileum, which increases so the cholesterol:bile acid ratio increases and cholesterol stones precipitate.