Lecture 15

Question 1

inflammatory bowel disease is mainly 2 conditions

Answer 1

Crohn’s/ UC

Question 2

both have similar symptoms…

Answer 2

diarrhoea, rectal bleeding, abdominal pain, weight loss and fatigue

Question 3

crohn’s can affect…

Answer 3

any part of the Gi tract- most common part is the terminal ileum

Question 4

there are skip lesions in

Answer 4

Cronh’s-

Question 5

UC only affects the

Answer 5

large intestine but will affect the rectum

Question 6

UC affecting just the rectum=

Answer 6

proctitis

Question 7

UC affecting bottom part of the colon=

Answer 7

distal colitis

Question 8

both also cause…

Answer 8

extra intestinal manifestations

Question 9

fistulae is the…

Answer 9

connection between 2 loops of bowel or bowel/skin

Question 10

deep fishering ulcers form in

Answer 10

Crohns’ cause it can go all the way through bowel wall

Question 11

UC is a superficial mucosa disease-

Answer 11

generally confined to bowel surface

Question 12

in UC neutrophils form in the

Answer 12

crypt abscesses

Question 13

IBD has variable….

Answer 13

age of onset and behaviour

Question 14

UC- _ will have one or more relapse after first attack

Answer 14

90%

Question 15

UC- early relapse in first 2 years associated with

Answer 15

worse disease course later

Question 16

Cd- _ will undergo surgery within 10 years of diagnosis

Answer 16

50%

Question 17

CD- at 20 years only _ will have experienced long term remission

Answer 17

10%

Question 18

CD- steroids within 3 months of diagnosis predictive for…

Answer 18

need of surgery

Question 19

CD behaviour varies over time:

Answer 19

inflammation -> stricturing ( narrowing down of blood lumen)/penetrating

Question 20

IBD is prevalent in…

Answer 20

industrial countries/ ones with westernised food habits

Question 21

we known that iBD is an _ response to _ or _ in a genetically pre-disposed individual

Answer 21

aberrant inflammatory
host microbial
environmental factors

Question 22

have many genes have been associated with IBD

Answer 22

around 300

Question 23

smoking makes _ worse but _ less likely

Answer 23

Crohn’s worse but UC less likely

Question 24

medications could mimic IBD- e.g., ….

Answer 24

non-steroidal anti-inflammatory drugs (ibroprofen) can cause ulceration internally

Question 25

having an appendicectomy is more common in people who develop _ but protective in _

Answer 25

Crohn’s
UC

Question 26

IBD- there are defects in the _- loss of _ and do there is translocation of microbes through tissue- activating immune cells

Answer 26

barrier function
loss of mucus

Question 27

genetic architecture sub-stratifies and defines relationship of IBD location (,,,)

Answer 27

NOD2, MHC, MST1, 3p21

Question 28

NOD2 is particularly associated with

Answer 28

Crohn’s at ileum

Question 29

strong genetic distinction between _ and _

Answer 29

colonic and ileal Crohn’s

Question 30

invasive investigations remain gold standards for diagnosis/ongoing assessment:

Answer 30

• ileo-colonoscopy
• MRI/CT/US
• others: capsule endoscopy/MRCP/ERCP

Question 31

in IBD white speckles seen in branching blood vessels =

Answer 31

mucus

Question 32

in severe colitis there is loss of the _ and there are _. also loss of _ and bleeding

Answer 32

vessels
erosions
epithelium

Question 33

_ and _ are predominant in IBD

Answer 33

Th17 and Th1

Question 34

top-down approach use the…

Answer 34

powerful medications first

Question 35

azathioprine suppresses the…

Answer 35

immune response

Question 36

step up approach starts with….

Answer 36

gentle anti-inflammatories

Question 37

what therapy coats the lining of the colon

Answer 37

5-ASA

Question 38

NOD2 gene drives the highest…

Answer 38

risk of IBD-its a bacterial sensing gene