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Inflammatory Bowel Disease Flashcards

(52 cards)

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1
Q

What is inflammatory bowel disease?

A

chronic recurring inflammation secondary to abnormal prolonged immune response to a normal stimulus in genetically susceptible individuals

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2
Q

What is the cause of Crohn’s disease?

A

immune dysregulation and dysbiosis which promotes chronic inflammation, the ultimate cause of which is not fully understood

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3
Q

what are the risk factors for crohn’s disease?

A
  1. active and passive smoking of tobacco
  2. familial aggregation
  3. genetic predisposition - NOD2 gene
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4
Q

What are skip lesions?

A

pattern of patchy, discontinuous inflammation in the bowel

affected areas interspersed with normal tissue

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5
Q

What is the pathology of crohn’s disease? (4)

A
  1. skip lesions
  2. creeping fat
  3. hypertrophic lymph nodes
  4. transmural inflammation
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6
Q

What are the histological characteristics of crohn’s disease?

A
  1. noncaseating granulomas
  2. giant cells
  3. distinct lymphoid aggregates of the lamina propria
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7
Q

What are the constitutional symptoms of crohn’s disease? (3)

A
  1. low grade fever
  2. weight loss
  3. fatigue
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8
Q

What are the intestinal symptoms of crohn’s disease? (6)

A
  1. chronic diarrhoea - nonbloody
  2. abdominal pain - typically in the right lower quadrant
  3. malabsorption
  4. palpable abdominal mass in the right lower quadrant
  5. enterocutaneous perianal fistulas
  6. oral aphthae
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9
Q

Where does crohn’s disease typically manifest?

A

in the terminal ileum

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10
Q

What are the joint manifestations of crohn’s disease?

A

enteropathic arthritis

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11
Q

what are the manifestations of crohn’s disease in the eyes? (3)

A
  1. uveitis
  2. Iritis
  3. episcleritis
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12
Q

What are the manifestations of crohn’s disease in the liver/bile ducts?

A

cholelithiasis

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13
Q

Why does crohn’s disease cause cholelithiasis?

A

Due to malabsorption, the bile acid for lipid digestion is lost, increased cholesterol concentration promotes stone formation

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14
Q

What are the manifestations of crohn’s disease in the urogenital system?

A

urolithiasis

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15
Q

What does a crohn disease activity index (CDAI) score of 0-149 indicate?

A

asymptomatic remission

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16
Q

What does a crohn disease activity index (CDAI) score of 150-220 indicate?

A

low to moderate activity

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17
Q

What does a crohn disease activity index (CDAI) score of 221-450 indicate?

A

moderate to high activity

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18
Q

What does a crohn disease activity index (CDAI) score of 451-1100 indicate?

A

high activity, fulminant disease

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19
Q

How is crohn’s disease diagnosed? (3)

A
  1. coloscopy
  2. gastroscopy
  3. x ray of small intesting
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20
Q

How is crohn’s disease monitored?

A
  1. ultrasound

2. CT

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21
Q

What is the pathophysiology of crohn’s disease?

Study These Flashcards
A

mediated by dysfunctional IL-23-Th17 signalling

22
Q

What is the pathophysiology of ulcerative colitis?

Study These Flashcards
A

mediated by Th2 cells

23
Q

What is the frequency and characteristics of defaecation in crohn’s disease? (2)

Study These Flashcards
A
  1. increased defaecation

2. typically nonbloody, watery diarrhoea

24
Q

What is the frequency and characteristics of defaecation in ulcerative colitis? (4)

Study These Flashcards
A
  1. greatly increased
  2. bloody diarrhoea with mucous
  3. tenesmus
  4. urgency
25
What is the nutritional status of someone with crohn's disease?
poor or malnurished
26
what is the nutritional status of someone with ulcerative colitis?
mostly normal
27
What is seen on physical examination of someone with crohn's disease? (3)
1. mostly constant pain in right lower quadrant 2. palpable abdominal mass 3. low grade fever
28
What is seen on physical examination of someone with ulcerative colitis? (4)
1. painful defaecation located in left lower quadrant 2. abdominal cramps and tenderness 3. tachycardia 4. orthostatic hypotension
29
What are the extraintestinal manifestations unique to crohn's disease? (2)
1. nephrolithiasis | 2. cholelithiasis
30
What are the extraintestinal manifestations unique to ulcerative colitis?
primary sclerosing cholangitis
31
What are the extraintestinal manifestations common to crohn's disease and ulcerative colitis? (7)
1. pyoferma gangrenosum 2. erythema nodosum 3. uveitis 4. episcleritis 5. aphthous stomatitis 6. peripheral arthritis 7. spondylitis
32
What are fistulas like in crohn's disease?
1. common to skin, bladder or in between loops | 2. may cause pneumaturia and/or recurrent UTIs
33
What are fistulas like in ulcerative colitis?
Rare
34
What are the complications of crohn's disease?
1. abscess 2. strictures 3. perianal fissures
35
What are the complications of ulcerative colitis?
1. fulminant colitis 2. toxic megacolon 3. perforation
36
What is the cancer risk common to CD and UC? (2)
1. increased due to underlying pathology | 2. increased secondary to immunosuppression
37
What type of cancer is associated with crohn's disease? (3)
1. small intestine 2. colon 3. non-hodgkin lymphoma
38
What type of cancer is associated with ulcerative colitis? (2)
1. cholangiocarcinoma | 2. colorectal cancer
39
What antibodies are associated with crohn's disease?
anti-saccharomyces cerevisiae antibodies (ASCA)
40
What antibodies are associated with ulcerative colitis?
Myeloperoxidase antineutrophil cytoplasmic antibody (p-ANCA)
41
Where is crohn's disease located?
1. terminal ileum and colon with rectal sparing | 2. may affect the entire GI tract
42
where is ulcerative colitis located?
colon
43
What is the pattern of inflammation seen with crohn's disease?
discontinuous | skip lesions
44
What is the pattern of inflammation seen with ulcerative colitis?
continuous
45
What is the typical diagnostic findings with crohn's disease? (5)
1. cobblestone sign 2. pinpoint lesions 3. snail trails 4. creeping fat 5. string sign
46
What is the typical diagnostic findings with ulcerative colitis? (4)
1. friable mucosa 2. mucosal ulcerations - deep or superficial 3. crypt abscesses 4. loss of haustra - led pipe sign
47
What is the histology of crohn's disease? (4)
1. transmural inflammation 2. noncaseating granulomas 3. giant cells 4. lymphoid aggregates
48
What is the histology of ulcerative colitis? (2)
1. confined to mucosa and submucosa | 2. no granulomas
49
What is the medication used to treat crohn's disease? (4)
1. corticosteroids 2. thiopurine analogues 3. anti-p40 antibodies 4. alpha 4 integrase inhibitors
50
What is the medication used to treat ulcerative colitis?
1. 5-aminosalicylic acid 2. 6-mercaptopurine 3. calcineurin inhibitors
51
What surgical treatment is used for crohn's disease?
noncurative surgery can be used to alleviate symptoms
52
What surgical treatment is used for ulcerative colitis?
curative surgery possible | proctocolectomy

GI/GU Illness (15 decks)

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