Inflammatory Bowel Diseaes

Question 1

What is the onset age of IBD?

Answer 1

20-29

Question 2

What is the first complain of someone with ulcerative colitis?

Answer 2

bloody diarrhea

Question 3

What is the first complain of someone with crohns?

Answer 3

abd pain then non-bloddy diarrhea

Question 4

What is the primary site of UC?

Answer 4

rectum

Question 5

where is the primary site of Crohn’s

Answer 5

ilecolic

Question 6

Smoking in IBD does what to the rates of UC? rates of Crohn’s?

Answer 6

Decreases UC, increases Crohn’s

Question 7

How do appendectomy, high-sanitation level in childhood and high-intake of refined carbs affect CD?

Answer 7

they increase the risk, while cigarette smoking and appendectomy decrease the risk of UC

Question 8

Explain the hygiene hypothesis

Answer 8

Incidence of immune-mediated diesases rising in developed countries (possibly due to lack of exposure to bacteria)

Question 9

What is the characteristic pathologic finding of UC

Answer 9

dilated and thinned colon with severe universal inflammation

Question 10

Skip lesions with UC?

Answer 10

No

Question 11

On endoscopy what do you see in UC?

Answer 11

hyperemia, edema granularity with friability, easy bleeding, broad based ulceration, pseudopolyps, tunnels with mucosal bidges, rarely perforation

Question 12

What is toxic megacolon?

Answer 12

shutdown of neuromuscular function secondary to exposure of fecal material to muscularis mucosae and neural plexus

Question 13

What is the gross pathology of UC

Answer 13

edematous, congested and hemorrhagic mucosa with superficial ulceration and loss or normal folding pattern, leaving behind islands of mucosa at the previous surface level are the pseudopolyps

Question 14

On microscopic histology what do you see in UC

Answer 14

edematous congested musocs with more blue than normal (because of inflammatory cells). LIMITED TO THE MUCOSA. Crypt abscessed with polys and crypt architecturla distortion

Question 15

In UC, are there granulomas?

Answer 15

NOPE

Question 16

What is ulcerative proctitis?

Answer 16

inflammation confind the rectum, rectal bleeding may be only sign of dz, rectal pain, feeling of urgency or tenesmus

Question 17

What is proctosigmoiditis?

Answer 17

involves rectum and sigmoid, bloody diarrhea abd cramps and pain and tenesmus are common. disease is continuous

Question 18

What is left-sided colitis?

Answer 18

inflammation extends up from rectum to the left side. continuous. bloody diarrhea, abd cramping and pain on left side with unintended weight loss

Question 19

what is pancolitis?

Answer 19

affecting entire colon with bloody diarrhea, that may be sever, abd cramps and pain with fatigue and significant weight loss

Question 20

What is fulminant colitis?

Answer 20

uncommon life-threatening, affects entire colon, severe pain, profuse diarrhea, dehydration shock and sirs. associated with extensive and deep colonic injury

Question 21

On endoscopy, what disappear with UC?

Answer 21

the appearance of blood vessels goes away

Question 22

Where is the most common location for crohn’s disease?

Answer 22

ileum and cecum.

Question 23

what structures can crohn’s affect?

Answer 23

apthoid ulcers in mouth, esophageal ulcers, gastricdz, and small bowel

Question 24

When ddoes the age of dx from crohns typically occur?

Answer 24

20s

Question 25

What are the typical things seen in CD

Answer 25

``` asymmetrical dz apthous ulcers rectal sparing skip lesions deep ulcerations stricture formation fistula dz can be limited to right colon ```

Question 26

What are the general characterisitcs of CDs in terms of depth of invasion? Reactions?

Answer 26

transmural involvement, non-caseating granulomas

Question 27

What is the gross pathology of cd?

Answer 27

transmural dz with cobblestone mucosa, skip lesions (alternating areas of involved and univolved bowel), creeping fat on the serosa, pseudopolyps

Question 28

Microscopic pathology of CD

Answer 28

fistula, edema inflammation with neutrophils, lymphocytes, plasma cells, eosinophils, and macrophages forming granulomas!!!

Question 29

Pain in LRQ can be confused between what two dzs?

Answer 29

appendicitis and crohn's disease

Question 30

What are some extra-intestinal manifestations of cd?

Answer 30

enterocutaneous fistula, aphtoid ulcers, erythema nodosum, pyoderma grangrenosum, uveitis,

Question 31

what is hematochezia?

Answer 31

passage of fresh blood through anus, typically do to rectal bleeding because the colon did not have time to change the blood

Question 32

Who is at risk for colorectal cancer with IBD

Answer 32

``` extensive ibd long duration of ibd young onset of dz severe ibd presence of backwash ileitis (UC) family hx of crc personal hx of sclerosing cholangitis ```