IBD Flashcards
IBD definition:
dysregulated inappropriate response of the intestinal mucosal immune system to otherwise innocuous luminal antigens in a genetically susceptible host
2 main types IBD?
UC
CD
UC definition?
mucosal ulceration in colon
CD defintiion?
transmural inflammation in any part of GI system (usually distal ileum and R side colon)
Spread of inflammation in UC?
affects continuously - not patchy
Spread of inflammation in CD?
patchy
*patient who smoke are less likely to get? moer likely to get?
less UC
more CD
Count me in! get me a cigarette!
3 main factors for IBD pathogenesis?
luminal antigens
genetics - NOD2 mutation
environmental triggers
TH1 t-cell response seen in:
Cell-mediated granulomas (CD or celiac)
IFN gamma
IL2
TNF
TH2 t-cell response seen in:
hypersenitivity - food allergy, worm inf, UC?
IL4
IL5
IL10
Proinflammatory cytokines:
TNF IL1beta IL6 IL12 IL18 IL4 IFNgamma
Antiinflammatory cytokines:
IL10 TGFbeta IL1Ra IL13 PGE2 PGI2
see fistula in patient so you know its which disease?
CD!
Hallmark of CD
non-caseating granuloma
gold standard test for CD?
MR interography
typical look of colon mucosa with CD?
cobblestone!
Which IBD has rectal sparing?
CD!
IBD extraintestinal manifetations:
apthous stomatitis episcleritis and uveitis arthritis vascular complications (clotting) E Nodosum P gangrenosum BONE DISEASE
more inflammation cytokines with which IBD?
more with CD!
IBD peripheral arthritis:
- affects whihc joints?
- how does it affect?
- large joints
- monoarticular
- asymmetric
- no synovial destruction
- seroneg
UC and liver complication:
primary sclerosing cholangitis –
only sulfa -related toxicity?
male infertility
hemolytic anemia
agranulocytosis
Sulfa and 5ASA toxicity?
alveolitis
pancreatitis
5ASA toxicity
nephritis
Sullfa much more often that 5ASA toxicity?
Rash fever headahce nausea dyspepsia neutropenia hepatitis
Highest risk drugs to use for IBDs:
steroids and narcotics
