IBD -Davis Flashcards
What is the MOST definitive test for IBD?
biopsy
Is there visible damage found in IBS? Should a biopsy be performed to diagnose IBS?
NO! and NO!
Which chromosomes are involved in the genetic component of Crohn’s? Which genes are involved?
chromosomes: 16, 5, 10
genes:
- CD 19 (B-lymphocyte function)
- Sialophorin (leukocyte adhesion)
- CD11 integrin cluster (microbacterial cell)
- IL-4 receptor
What is the most common form of Crohn’s disease? What kind of pain does this present with and what can this be confused for?
Ileocolitis
RLQ pain
appendicitis
What do UC lesions look like?
- Large mucosal ulcers with copious purulent exudate (diarrhea)
- affect only the mucosa and submucosa
- Mucous membrane is erythematous, finely granular, and friable, with scattered hemorrhagic areas.
When is surgery indicated for IBD?
ONLY if non-responsive to medical management or experience recurring problems
What are the surgical options for UC? What % of people with UC will need surgery at some point?
- Bowel resection- Removes a portion of the large intestine
- Resection of the entire large intestine- removes the entire large intestine including rectum–> make a J pouch
15-40% need surgery
*What is a rare complication of UC that can be life threatening?
Toxic megacolon involves widening of the colon often with overwhelming bacterial infection (sepsis).
–> loss of blood flow==> ischemic or dying tissue
-30% mortality if the colon ruptures
What are the signs of toxic megacolon?
- Abdominal pain and tenderness
- Distended abdomen (colon diameter >8cm)
- Rapid heart rate
- Decreased blood pressure
- Leukocytosis (high white blood cell count)
- Evidence of colonic distension on abdominal x-ray
- High fever (40° C [104° F])
- Dehydration
What percentage of people with Crohn’s need surgery at some point? Is this curative?
65-75% (strictures, fistula, bleeding in the intestine)
*NOT curative
When should you begin screening IBD patients for Colorectal cancer?
8 years after diagnosis
screen every 1-3 years
