Path IBD Flashcards
2 major forms of IBD
ulcerative colitis
Crohn’s disease
Cigarette smoking effect on CD & UC
CD increased
UC decreased!
Appendectomy effect on CD & UC
CD increased
UC decreased
high sanitation level in childhood effect on CD & UC
CD increase
UC no effect
High intake of refined carbohydrates effect on CD & UC
CD increase
UC no effect
description of UC and CD affected GI areas
UC always rectum, retrograde continuous spread
CD anywhere, including ilium and colon. big diversity
broad based ulcerations
UC
skip lesions
CD
toxic megacolon as potential sequelae
UC
pseudopolyp
UC
bloody diarrhea
UC
gross pathology of UC
hemorrhagic, edematous, mucosa with superficial ulceration, loss of folding pattern. pseuopolyps.
microscopic pathology of UC
inflammatory cells, superficial ulceration (mucosa +/- submucosa) crypt abscesses
crypt abscess
UC (even when no necrosis)
granulomas in UC?
no
inflammatory cells in UC
lymphocytes, plasma cells, eosinophils, macrophages, but no granulomas
ulcerative proctitis
UC limited to rectum
rectal bleeding, pain, urgency, tenesmus
mildest form of UC
proctosigmoiditis
UC of rectum and sigmoid
bloody diarrhea, abdominal cramps, pain, tenesmus.
continuous
left-sided colitis
bloody diarrhea, abdominal cramps, pain, unintended weight loss.
continuous
pancolitis
all colon. bloody diarrhea, abdominal cramps, pain, fatigue
fulminant colitis
uncommon, life-threatening
entire colon - pain, diarrhea, dehydration/shock, SIRS. Deep colonic injury
most sensitive test for free air (as in toxic megacolon with perforation)
CT
What imaging for detail of mucosa?
barium contrast. CT is poor at this
CD location
any part of GI tract mouth to anus.
small bowel & proximal colon most common
CD age
peak at 20-29
aphthous ulcers association?
CD
rectal sparing?
CD
skip lesions
CD
deep ulcerations
CD
stricture formation
CD
fistulas
CD
CD:
small intestine alone %
small intestine & colon %
colon alone %
small intestine alone 30%
small intestine & colon 40%
colon alone 30%
noncaseating granuloma
CD
cobblestone mucosa
CD
inflammatory cells in CD
neutrophils, lymphs, plasma cells, eosinophils, macrophages w/granulomas (35%)
extra-intestinal manifestations of IBD (9)
enterocutaneous fistula apthoid ulcer erythema nodosum pyoderma gangrenosum scleritis, episcleritis, uveitis gallstones uric acid & oxalate stones hypercoagulable state peripheral neuropaty
IBD risk factors for colorectal CA (6)
extensive IBD long term IBD young age of onset IBD backwash ileitis (UC) family history of colorectal ca hx of sclerosing cholangitis
etiology of CD & UC
CD - disordered response to intestinal bacteria
UC - autoimmune
creeping fat, bowel wall thickening
CD
lead pipe appearance on imaging
UC
