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OSD_GI > Inflammatory Bowel Disease > Flashcards

Inflammatory Bowel Disease Flashcards

1
Q

Definition of IBD?

A

An immune-mediated, chronic inflammatory response to intestinal bacteria in a genetically susceptible individual

(which would otherwise result in acute, controlled inflammation in a normal person)

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2
Q

Which has a greater genetic influence: Crohn’s Disease or Ulcerative Colitis?

A

Crohn’s Disease, which also has specific phenotype/location similarities amongst affected family members

(although both have 15-20% chance of having an affected relative)

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3
Q

T or F?

w/out resident bacteria in lumen, Crohn’s Disease & Ulcerative Colitis would be asymptomatic

A

True

Colitis = Macrophage & Th1 immune activation

Normal = no immune activation

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4
Q

NOD-2 : genetic mutation “buzzword” for what diagnosis?

A

Crohn’s Disease

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5
Q

Mucosal Barrier cells that have:

Tight junctions?

A

Epithelial cells

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6
Q

Mucosal Barrier cells that contribute:

mucous layer

A

Goblet cells

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7
Q

Mucosal Barrier cells that contribute:

Defensins

A

Paneth cells

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8
Q

Mucosal Barrier cells that contribute:

Ability to regenerate & repair cells

A

Epithelial cells

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9
Q

Mucosal Barrier cells that contribute:

IgA secretion

A

B cells

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10
Q

Naive T-cells can differentiate into at least 3 distinct subsets when faced w/ antigen presenting cells (APCs).
What is the route that mediates granulomatous & cell-mediated inflammation?

(ex: Crohn’s or Celiac’s Disease)

A
  • APCs release IL-12
  • IL-12 stimulates Th0 cells to differentiate into Th1 cells
  • Th1 cells produce IFN-gamma, IL-2, & TNF
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11
Q

Naive T-cells can differentiate into at least 3 distinct subsets when faced w/ antigen presenting cells (APCs).
What is the route that mediates hypersensitivity reactions?

(ex: food allergy, helminthic infections, & possible Ulcerative Colitis)

A
  • Th0 cells differentiate into Th2 cells

- Th2 cells produce IL-4, IL-5, & IL-10

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12
Q

Naive T-cells can differentiate into at least 3 distinct subsets when faced w/ antigen presenting cells (APCs).
What is the route that mediates tolerance?

(ex: normal response to commensal bacteria & dietary antigens)

A
  • APCs release IL-10
  • IL-10 stimulate Th0 differentiation into regulatory T-cells (TR1) & Th3-cells
  • TR1-cells secrete IL-10
  • Th3 cells secrete TGF-beta
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13
Q

Name some pro-inflammatory cytokines

A
  • TNF
  • IFN-gamma
  • IL-4, IL-5, IL-13, IL-17, IL-21, IL-22, IL-26
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14
Q

What are some effects of TNF-alpha?

A
  • Activation of T-helper cells
  • inc’d production of pro-inflammatory cytokines
  • PMN & Mononuclear cell adherence to intestinal wall capillaries
  • Release of chemokines
  • Release of toxic metabolites from PMNs & Mononuclear cells
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15
Q

Crohn’s Disease- typical anatomic locations of involvement?

A
  • 50% include both small & large bowels (Ileocolitis)
  • ⅓ confined to small bowel (regional enteritis) –usually involving the Ileum (ileitis)
  • 20% confined to colon alone (colitis)

(50% have perianal lesions, but infrequently alone or as first presenting sign

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16
Q

Inflammation, Obstruction, Microperforation, & Fistulization are typical clinical patterns of what?

A

Crohn’s Disease

17
Q

Drug therapy classes involved in potential Tx for Crohn’s Disease?

A
  • Antibiotics (ex: metronidazole, quinolones)
  • Immunomodulators
  • Corticosteroids
  • Aminosalicylates
  • Supportive agents (i.e. antidiarrheal, bile sequestrants, bulk formers, antidepressants, pain-killers, anti-spasmodics)
18
Q

What 2 characteristics about Crohn’s Disease seen on Barium enema are best at distinguishing it from Ulcerative Colitis?

A
  • Skip Lesions

- Relative Rectal Sparing

19
Q

Crohn’s Disease vs. Ulcerative Colitis:

Malabsorption?

A

CD - Yes

UC - No

20
Q

Crohn’s Disease vs. Ulcerative Colitis:

Malignant potential?

A

CD - Only w/ colonic involvement

UC - Yes

21
Q

Crohn’s Disease vs. Ulcerative Colitis:

Recurrence after surgery?

A

CD - Common

UC - No

22
Q

Crohn’s Disease vs. Ulcerative Colitis:

Toxic Megacolon?

A

CD - No

UC - Yes

23
Q

Crohn’s Disease vs. Ulcerative Colitis:

Stricture?

A

CD - Yes

UC - Rare

24
Q

Crohn’s Disease vs. Ulcerative Colitis:

Wall thickness?

A

CD - Thick

UC - Thin

25
Q

Crohn’s Disease vs. Ulcerative Colitis:

Pseudopolyps?

A

CD - Moderate

UC - Marked (more common)

26
Q

Crohn’s Disease vs. Ulcerative Colitis:

Ulcers?

A

CD - Deep, fissuring ulcers

UC - Broad-based, superficial

27
Q

Crohn’s Disease vs. Ulcerative Colitis:

Lymphoid reaction?

A

CD - Marked (full-thickness infiltrate)

UC - Moderate

28
Q

Crohn’s Disease vs. Ulcerative Colitis:

Serositis?

A

CD - Marked

UC - Moderate

29
Q

Crohn’s Disease vs. Ulcerative Colitis:

Granulomas?

A

CD - Yes (~35%)

UC - No

OSD_GI (13 decks)

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