Inflammatory Bowel Disease

Question 1

Inflammatory Bowel Disease is defined as

Answer 1

a group of chronic inflammatory conditions of the colon and small intestine

Question 2

Two major forms of IBD

Answer 2

Crohn’s and Ulcerative Colitis

Question 3

The Hygiene hypothesis is

Answer 3

Incidence of immune-mediated diseases is rising in developed countries and many scientists wonder whether it may be due to relatively good modern hygiene or lack of exposure to bacteria.

The data surrounding this and IBD is conflicting

Question 4

What is ulcerative colitis?

Answer 4

Chronic inflammatory disorder of the GI tract affecting the large bowel. Features a dilated and thin colon whith severe inflammation

Question 5

Where does ulcerative colitis start?

Answer 5

Begins in the rectum and extends proximally

Question 6

What is seen on endoscopy with ulcerative colitis?

Answer 6

hyperemia (redness), edema, granularity, easy bleeding, broad based ulceration, pseudopolyps,rarely perforation

Question 7

Toxic megacolon is?

Answer 7

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

Question 8

Psuedopolyps=

Answer 8

ulcerative colitis

Question 9

On microscopic pathology, ulcerative colitis is limited to what areas?

Answer 9

mucosal and submucosal layers. This is characteristic of ulcerative colitis

Question 10

ulcerative proctitis

Answer 10

confined to rectum

Question 11

In ulcerative proctitis rectal bleeding may be the only sign of the disease. May also have rectal pain, a feeling of urgency or inability to move bowels in spite of the urge to do so (tenesmus)

Answer 11

ok

Question 12

Proctosigmoiditis

Answer 12

Involves the rectum and sigmoid. Bloody diarrhea, cramps, tenesmus

Question 13

Left sided colitis

Answer 13

Disease extends from the rectum up the left side and through the sigmoid and descending colon. You would see bloody diarrhea, pain on left side, and wt loss

Question 14

Wt loss first seen in what type of UC

Answer 14

Left sided

Question 15

Pancolitis

Answer 15

Affects the entire colon.

You would see bouts of bloody diarrhea, abdominal cramps and pain, fatigue, wt loss

Question 16

Fulminant Colitis

Answer 16

Uncommon, life-threatening, affects the entire colon.
Severe pain, profuse diarrhea, shock and dehydration, SIRS
Associated extensive and deep colonic injury

Question 17

What does CT scan do well in regards to analysis of ulcerative colitis?

Answer 17

Evaluates free air and allows you to see other structures in the abdomen like mesenteric inflammation or lymphadenopathy

Question 18

What does a CT scan do not do well?

Answer 18

Does not demonstrate mucosal detail which Barium studies can do

Question 19

Crohn’s disease involves what sections of the GI tract

Answer 19

Can involve any section though it has a propensity for distal small bowel and proximal colon. Can involve anywhere from mouth to anus. May see apthous ulcers in the mouth, esophageal ulcers, gastric disease, small bowel

Question 20

Ways in which Crohn’s is different than ulcerative

Answer 20

• rectal sparing (spares the rectum)
• Skip lesions
• Its very asymmetrical
• Deep ulcerations
• Stricture formation
• Fistula

Question 21

Characteristics of Crohn’s…

Answer 21

• Transmural involvement
• Noncaseating Granuloma
• Fissuring with Fistula
• Skip lesions

Question 22

Cobblestone mucosa

Answer 22

Crohn’s

Question 23

Transmural lesion

Answer 23

Crohn’s