IBD Flashcards
Ulcerative colitis is an inflammatory bowel disease which causes ulcers of the _ and _ layer
Ulcerative colitis is an inflammatory bowel disease which causes ulcers of the submucosa and mucosa
UC is associated with continuous colonic lesions starting in the _
UC is associated with continuous colonic lesions starting in the rectum
* Extends to the cecum
The chronic inflammation of the colon and rectum in UC is mediated by _ and _
The chronic inflammation of the colon and rectum in UC is mediated by Th2 cells and cytokines
UC can cause pain in _ quandrant
UC can cause LLQ pain
Describe the diarrhea in UC
Chronic bloody diarrhea
UC can cause inflammation of the eye, resulting in pain and blurry vision called _
UC can cause inflammation of the eye, resulting in pain and blurry vision called uveitis
UC can cause extraintestinal sx such as uveitis, arthritis, aphthous ulcers, and skin lesions like _ and _
UC can cause extraintestinal sx such as uveitis, arthritis, aphthous ulcers, and skin lesions like erythema nodosum and pyoderma gangrenosum
Ulcerative colitis is also associated with a chronic liver disease that causes the bile ducts to become inflammed and scarred called _
Ulcerative colitis is also associated with a chronic liver disease that causes the bile ducts to become inflammed and scarred called primary sclerosing cholangitis
UC is also associated with an inflammatory disease of the spine that can lead to fusion of vertebrae called _
UC is also associated with an inflammatory disease of the spine that can lead to fusion of vertebrae called ankylosing spondylitis
UC patient presents with abdominal distention, bloody diarrhea, fever, and signs of shock what should you be concerned for?
UC patient presents with abdominal distention, bloody diarrhea, fever, and signs of shock what should you be concerned for? Toxic megacolon
Toxic megacolon is associated with severe septic shock and lots of air inside the peritoneal space which we call _
Toxic megacolon is associated with severe septic shock and lots of air inside the peritoneal space which we call pneumoperitoneum
Very severe UC which involves lots of stools per day and an accumulation of sores/ulcers is called _
Very severe UC which involves lots of stools per day and an accumulation of sores/ulcers is called fulminant colitis
Colorectal cancer is associated with UC and often involves early _ mutations and late _ mutations
Colorectal cancer is associated with UC and often involves early p53 mutations and late APC mutations
UC may be identified on imaging with _ sign
UC may be identified on imaging with lead pipe sign
UC on histology will reveal _ and _
UC on histology will reveal crypt distortion and abscesses with neutrophils
UC can be identified on colonoscopy by _
UC can be identified on colonoscopy by friable inflammatory pseudopolyps
UC is associated with _ genetic marker
UC is associated with HLA-B27
UC will be _ ANCA pos/neg
UC will be pos for p-ANCA
Two inflammatory markers on CBC that will be elevated in UC are _ and _
Two inflammatory markers on CBC that will be elevated in UC are ESR and CRP
* These are also elevated in Crohn’s
_ and _ are two products made by neutrophils that indicate inflammation (seen in IBD)
Lactoferrin and Calprotectin are two products made by neutrophils that indicate inflammation (seen in IBD)
We can treat UC with 5-ASA compounds like _ and _
We can treat UC with 5-ASA compounds like mesalamine and sulfasalazine
We can treat UC flares with _
We can treat UC flares with:
* Steroids
* Infiliximab
* Adalimumab
* 6-mercaptopurine
Crohn’s disease is chronic inflammation mediated by _ and cytokines
Crohn’s disease is chronic inflammation mediated by Th1 cells and cytokines
Crohn’s disease can involve _ lesions from mouth to anus
Crohn’s disease can involve “skip lesions” from mouth to anus
The most commonly affected site in Crohn’s disease is the _
The most commonly affected site in Crohn’s disease is the terminal ileum
Crohn’s disease is associated with a mutation in _ gene
Crohn’s disease is associated with a mutation in NOD2
The NOD2 receptor normally binds to _ to trigger _ pathway
The NOD2 receptor normally binds to LPS to trigger NF-kB pathway activation
* Decreased alpha definsin production
* Impaired innate immune response
Crohn’s disease is associated with (inc/dec) innate immune response and (inc/dec) adaptive immune response
Crohn’s disease is associated with decreased innate immune response and increased adaptive immune response
Describe the pathogenesis of fistulas in crohn’s disease
Transmural inflammation –> epithelialization across bowel wall –> sinus tract formation –> fistulas
Smoking increases the risk of _ IBD but decreases the risk of _
Smoking increases the risk of Crohn’s but decreases the risk of Ulcerative colitis
Crohn’s disease is associated with _ genetic marker
Crohn’s disease is associated with HLA-B27
Explain the pathogenesis of strictures in crohn’s disease
Chronic inflammation –> fibrosis, wall thickening –> narrowing of the lumen
Crohn’s disease is associated with _ quandrant pain
Crohn’s disease is associated with RLQ pain
Malabsorption is more of a concern in (UC/ Crohn’s)
Malabsorption is more of a concern in Crohn’s
* Concern for B12 and fat-soluble vitamin malabsorption
Name three types of fistulas that may occur from Crohn’s complications
- Enteroenteric
- Enterocutaneous
- Enterovesical
Extraintestinal complications of Crohn’s include:
Extraintestinal complications of Crohn’s include:
* Uveitis
* Arthritis
* Erythema nodosum
* Pyoderma gangrenosum
(Crohn’s/UC) is associated with perianal disease, gallstones, nephrolithiasis, increased risk for colorectal cancer
Crohn’s is associated with perianal disease, gallstones, nephrolithiasis, increased risk for colorectal cancer
* Prone to calcium oxalate stones because calcium binds to fat that is not being properly absorbed
Crohn’s disease is associated with _ and _ on histology
Crohn’s disease is associated with lymphoid aggregates and noncaseating granulomas on histology
Crohn’s disease is associated with _ sign on X-ray
Crohn’s disease is associated with string sign on X-ray (ileum)
_ is associated with knife-like fissures, creeping fat, and cobblestone mucosa
Crohn’s disease is associated with knife-like fissures, creeping fat, and cobblestone mucosa
Management for Crohn’s disease may include:
Management for Crohn’s disease may include:
* Corticosteroids, TNF-a inhibitors (infiximab)
* 5-ASA (mesalamine, sulfasalazine)
* Immunosuppressors (6-mercaptopurine)
* Colectomy, ileectomy
