Inflammatory Bowel disease Flashcards
describe feautures concerning Chron’s disease
- Location
- Gross
- microscopic
- diharrea classification
- wall appearence
- malabsorbtion Yes or no?
Chrons=CROWN KING
- its the boss>> skips lesions, rectal sparing, TRANSMURAL inflamamtion, anywhere in GI (mostly terminal ileum and colon)
- 9j king 7aywan ;)*
- Cobblestone, creeping fat, perianal fistula and strictures, Anal lesions
- Granny> noncaseating granuloma
- THICK wall
YES
DEfine IBD inflammatory bowel disease
possible causes? (3)
chronic inflammatory condition resulting from inappropriate mucosal immune activation!
Causes
- genetics – could be heriditary
- disruption to the immune system – inflammation may be caused by the immune system attacking healthy tissue inside the digestive system while fighting off a virus or bacteria
- Gut organisms
name the 2 conditions
symtoms of chrons
which disease has a ‘cobble stone’ appearence? why?
Chrons disease
bc it skips lesions> scattered lesions> giving it a cobble stone appearence.
what is the main location of chrons disease?
all over GI from mouth to anus
but…
mostly ILEUM and COLON
Treatments in chron’s
Ulcerative colititis causes ULCCCERS
- *U**lcers
- *L**arge intestine
- *C**rypt abssess
- *C**olorectal carcinoma
- *C**ontinous
- *E**xtends proxiamally
- *R**ed diharrea
- *S**celording cholangitis
which of the 2 has Significant increased risk of colon cancer
why
UC> bc it is mostly related to the bowel
which one is most often severe in distal colon
UC
what is colectomy? which of the 2 is mostly asspciated in it?
Colectomy is a surgical procedure to remove all or part of your colon
UC
Patients with UC may develop complications in organs or tissues other than the gastrointestinal system.
Which organs/tissues can be involved and what complications can occur in them?
Skin= rash on legs, erythema nodosum/ painful Pyoderma gangrenosus(ulceration on leg) lump + ulceration of skin
- *Liver**= Primary sclerosoing cholangitis
- *Eye**= iris uveitis
- *Joints**= Ankylosing spondylitis
which of the 2 is most likley to be autoimmune disease?
UC
what is sclerosing cholangitis?
A breach in the lining of the bowel to the level of the submucosa or deeper (accept through the muscularis mucosa)
ulcer
2 classicial histological frautures of Chrons
Granulomas
trasmural (full thickness)
Difference in thichkness of lesion in chrONS and UC
Chrons >> transmural full thickness!
difference in Stools btw the 2?
chrons: nonbloody diharrea (but could be)
UC: BLOODYY
what is the typical presentation of Crohn’s disease?
multiple non-bloody loose stools/day
weight loss
right lower quadrant pain
in a 15-30 year old.
(some joint pains also)
smoker
why do u get thickening of the bowel wall in chrons?
cuz theres inflammation, so it heals then gets worse, heals then get worse>> making bowel thicker!
what is this called? why has it formed? what is it a9lan?
cobble stone appearence in chrons
the blobs r regenerating mucosa or edematous mucosae
and the redness in btw r deep ulceration!
how can u get a fistula in chrons?
They can occur if the abscess doesn’t heal properly after the pus has drained away.
investigations in chrons?
why cant we only rely on colonoscopy?
CT/MRI
barium enima>> reveals bowel obstruction, strictures and fistulae. (A barium enema is a test that helps to highlight the large bowel, so it can be clearly seen on an X-ray.)
Colonoscopy >> shows a cobblestone appearance and skip lesions.
we cant only do a colonoscopy bc remember chrons can effect anywhere in th GI!
which one most commonly effects YOUNG ADULTS?
Ulcerative colitis
describe feautures concerning UC disease
- Location
- Gross
- microscopic
- diharrea classification
- wall appearence
- malabsorbtion Yes or no?
TREATMENT.
3 young adults running away PROXIMALLY from the bloody dihrrea on FRIDAY (friable muscousa) > trying not to fall into the crypt abscess. And pseudopolyps! They lost heir houses (haustra)
Aminosalicyclic tries to help them
Lead pipe apearence!
Investigation of ulcerative colitis
colonoscopy which will reveal a
continuous pattern of inflammation/ulceration.
treatment options?
immunomoduators used ONLY for nasty cases and if u become resistence to the above drugs
effect of smoking on Chron’s and UC?
smokers>> more likely to develop Crohn’s
Mr. Chrons likes to smoke
In contrast…smoking appears to decrease the severity of UC
How to differentiate btw IBD and IBS in a patient symptoms?
IBD>> nocturial diharrea
Markers for IBD?
Fecal lactoferrin
fecal calprotectin
