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Patho Midterm 1 > Inflammatory Bowel Disease (IBD) > Flashcards

Inflammatory Bowel Disease (IBD) Flashcards

1
Q

What is Inflammatory bowel disease?

A

Inflammation of the small and large intestine

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2
Q

Are IBD conditions acute or chronic?

A

Chronic

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3
Q

What are the 2 chronic conditions in IBD?

A
  1. Crohn Disease

2. Ulcerative Colitis

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4
Q

Etiology of IBD

A
  • Genetic susceptibility
  • Complex trait etiology-> always have environmental triggers (In most cases, bacteria is the trigger)
  • Loss of immune tolerance for normal gut flora
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5
Q

Is IBD classic autoimmunity?

A

NO, because the immune system is not targeting the intestinal wall but is targeting the bacteria that is attached to the wall. This triggers inflammation and by default causes damage.

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6
Q

Type of inflammation in crohn disease.

A

Granulomatous

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7
Q

Type of inflammation in UC

A

Ulcerative and exudative

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8
Q

Level of involvement in crohn disease

A

primarily submucosal

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9
Q

Level of involvement in UC

A

primarily mucosal

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10
Q

Extent of involvement in crohn disease

A

skip lesions

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11
Q

Extent of involvement in UC

A

continuous lesions

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12
Q

Areas of involvement in crohn disease

A

Primarily ileum, secondarily colon

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13
Q

Area of involvement in UC

A

primarily rectum & left colon

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14
Q

Is diarrhea common in crohn disease and UC?

A

yes

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15
Q

Is rectal bleeding common in crohn disease and UC?

A

crohn disease = no

UC = yes

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16
Q

Are fistulas common in crohn disease and UC?

A

crohn disease = yes

UC = no

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17
Q

Are strictures common in crohn disease and UC?

A

crohn disease = yes

UC = no

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18
Q

Are perianal abscesses common in crohn disease and UC?

A

crohn disease = yes

UC = no

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19
Q

Is the development of cancer common in crohn disease and UC?

A

crohn disease = no

UC = yes

20
Q

Granulomatous?

A

Bumps of scar tissue

21
Q

What is the appearance of granulomatous tissue in a scope?

A

Cobblestone like appearance

22
Q

What are the statistics of the areas affected in Crohn disease?

A

~40% of cases affect the small intestine, ~30 of cases affect the large intestine, ~30% of cases affect both the small and large intestine

23
Q

Does crohn disease slowly or quickly progress and is it aggressive or non-aggressive?

A

It slowly progresses and is non-aggressive

24
Q

Manifestations of Crohn disease

A
  • Intermittent diarrhea
  • Colicky pain (spasmodic) in the abdomen
  • Weight loss
  • fluid-electrolyte imbalance d/t diarrhea
25
Q

Why does weight loss occur in Crohn disease?

A

The ileums major function is absorption and with damage to the intestinal wall this function is impaired so nutrients are not absorbed as much

26
Q

Complications of crohn disease?

A
  • Fistulas
  • Abscesses
  • Strictures
  • Bowel obstruction
27
Q

Fistula?

A

An abnormal connection b/w two body parts

28
Q

Abscess?

A

Swollen area of the body, containing accumulation of pus

29
Q

Where is the abscess in Crohn disease?

A

Perianal area

30
Q

Stricture?

A

Constriction of a tube [aka the intestine, may result in obstruction]

31
Q

What are 3 reasons weight loss occurs in IBD?

A
  • decrease absorption SA in SI (only in Crohns)
  • fluid loss d/t diarrhea
  • malnutrition
32
Q

What kind of spread occurs from the rectum in US?

A

proximal spread

33
Q

Crypt abscesses?

A

Crypts of Leiberkuhn

34
Q

Crypts of leiberkuhn?

A

Tubular glands of the intestinal mucosa, attached to the villi of the intestines AKA intestinal crypt or intestinal gland

35
Q

What do the crypts secrete?

A

They normally secrete digestive enzymes and regenerate new tissue when damaged.

36
Q

Where can accumulation of pus in UC occur and what occurs when this happens?

A

In the crypts. This prevents the regrowth of new tissue (which is thought to lead to colorectal CA)

37
Q

What type of ulcers occur in UC?

A

bleeding ulcers aka lacerations

38
Q

Lacerations

A

A cut in the tissue, open sore

39
Q

What kind of tissue do you see in a pt with UC?

A

thickened and inflamed tissue

40
Q

Polyps?

A

invagination of granulation tissue into the lumen (the opposite of an out pouching such as diverticula)

41
Q

What kind of “sores/ulcers” do you see in UC?

A

pseudepolyps

42
Q

Pseudopolyps?

A

Pseudopolyps assume the appearance of a polyp, but contain inflammatory tissue so there is a substantial amount of exudate produced

43
Q

What can result due to the pseudopolyps in UC?

A

Can result in edema & fluid in the lumen which can cause congestion

44
Q

Manifestations of UC?

A

intermittent, bloody diarrhea d/t bleeding ulcers

abdominal cramping

45
Q

How do you diagnose UC?

A

scoping [colonoscopy/sigmoidoscopy]

- exclude GI infections by using lab tests

46
Q

What are treatment options for a pt with IBD?

A
  • Anti-inflammatories (eg. Sulfasalazine -> used for chronic inflammation)
  • Steroids
  • Immunoregulatory drug (Methotrexate)
  • Antibiotics to control an overgrowth of normal flora (low dose bc you do not want to wipe out the normal flora)
  • Surgery may be required
  • Lifestyle modifications (decrease ingestion of offending foods)
47
Q

In which cases would surgery be required in IBD?

A
  • fistulas cause a bowel obstruction
  • drain a bleeding ulcer
  • bowel ressection

Patho Midterm 1 (18 decks)

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