Inflammatory Bowel Disease Flashcards
what are the two idiopathic chronic inflammatory diseases involved in IBD?
Ulcerative colitis
Crohn’s disease
what do ulcerative colitis and Crohn’s disease have in common?
epidemiology
clinical cases
therapeutic characteristics
How do ulcerative colitis and Crohn’s disease differ?
clinical presentation
pathology
what are the 3 main factors involved in the pathogenesis of IBD?
Genetic predisposition
Mucosal Immune system
Environmental triggers
Is there a genetic link in IBD?
yes
which chromosome is thought to be involved in the genetic link in IBD?
Chromosome 16
In Crohn’s disease what is the section in which a mutated form causes the disease?
NOD2
How does NOD2 cause Crohn’s disease?
encodes for a protein involved in bacterial recognition
What is used in the treatment of peri-anal Crohn’s disease?
antibiotics
In which type of Crohn’s disease is antimicrobial activity highest?
Colonic Crohn’s
what was does smoking effect IBD?
Aggravates Crohn’s disease
Protects agains ulcerative colitis
What environmental factors can cause IBD?
smoking NSAIDs use Vasculitis Infectious agents Sterile environment therapy
what is pancolitis?
Ulcerative colitis which affects the whole colon
what is proctitis?
Ulcerative colitis which affects the anus and anal canal only
what are the symptoms of ulcerative colitis?
Diarrhoea and bleeding Increased bowel habit urgency Tenesmus Incontinence Lower abdominal pain - LIF Night rising
to determine sever UC 6 or more bloody stool need to be passed in 24 hours along with what else?
one or more of the following: Fever Tachycardia Anaemia Elevates ESR
what investigations would be used for ulcerative colitis?
Bloods - CRP and albumin
AXR
Endoscopy
Histology
what might an AXR show in ulcerative colitis?
no stool present in inflamed colon
Mucosal oedema - thumb printing
Toxic megacolon
what would be present at endoscopy in a patient with ulcerative colitis?
loss of vessel pattern
Granular mucosa
Contact bleeding
what differs in the histology of ulcerative colitis?
abscence of goblet cells
crypt distortion and abscess
which layer does ulcerative colitis effect in the colon?
mucosal layer
what determines the risk of cancer in ulcerative colitis?
Severity of inflammation
Duration of disease
Disease extent
what is Primary sclerosing cholangitis?
Chronic inflammatory disease of the biliary tree
How may primary sclerosing colangitis present?
mostly asymptomatic or presents as an itch and rigors
In which IBD does primary sclerosing colangitis present?
Ulcerative colitis