IBD Flashcards
Continuous inflammation
Colon only
Superficial inflammation
Risk of cancer
Ulcerative colitis
Diarrhea, bloody with mucus
Abdominal pain and tenderness
Children: growth and development failure
Clinical presentation of ulcerative colitis
Endoscopic findings of UC
Erythema Friability Edema Pseudopolyps Cecal patch Backwash ileitis
Severe ulcerative colitis with:
Fever, elevated WBC, unstable vitals
High risk of perforation
Fulminant colitis
Patchy inflammation Mouth to anus involvement Full thickness inflammation Cobblestone appearance Strictures and surgery
Crohn’s disease
Abdominal pain Diarrhea Weight loss Anorexia Vomiting Rectal bleeding Stunted growth fever
Crohn’s disease presentation
What are 3 major endoscopic findings that are specific for Crohn’s disease?
Aphthous ulcers
Cobblestoning
Discontinuous lesions
What are some findings that favor Crohn’s disease over UC?
Rectal sparing (UC always effects the rectum)
Normal vasculature next to affected tissue
Isolated involvement of terminal ileum = backwash ileitis which is only seen in pancolitis
Fistulas or strictures
Granulomas on biopsy
What are some extra-intestinal manifestations of IBD?
Erythema nudism Choledocholithiasis Sacroiliitis Ankylosing spondylitis Pyoderma gangrenosum Amyloidosis
Most common mutation in IBD?
NOD2 mutations
What is the mucosal immune response to IBD?
Th17 cells
What 4 things contribute to the pathogenesis of IBD?
- NOD2 mutations
- Th17 cell immune response
- Defects in epithelial tight junctions
- Microbiota
What is the most predominant non-genetic factor in IBD?
The microbiota
- IBD is characterized by an amplified response to the intestinal microbiota
- Differences in microbiota composition and diversity may also contribute to IBD
Anti-TNF’s used for IBD
Infliximab
Certolizumab pegol
Adalimumab
- Shown to induce and maintain remission
