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GI (Y1) > Pathology IBD - Week 5 > Flashcards

Pathology IBD - Week 5 Flashcards

1
Q

What is Crohn’s disease?

A

Chronic inflammatory and ulcerating condition of the GI tract that can affect anywhere from the mouth to the anus

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2
Q

In which part of the GI is most affected by Crohn’s disease?

A

Terminal ileum and colon

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3
Q

What is the most common age for Crohn’s diagnosis?

A

20-30 years old

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4
Q

Give some symptoms of Crohn’s disease.

A 
Abdominal pain
Small bowel obstruction
Diarrhoea
PR Bleeding
Anaemia
Weight loss
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5
Q

How is Crohn’s disease diagnosed?

A

History
Endoscopy
Mucosal biopsy

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6
Q

What histological findings may be found in Crohn’s disease?

A

Increased chronic inflammatory cells

Granuloma formation

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7
Q

Which structures may develop in Crohn’s disease?

A

Strictures, fistulae or abscesses

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8
Q

Deep fissuring in Crohn’s disease is called…

A

Cobblestoning

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9
Q

What kind of inflammation occurs in Crohn’s disease?

A

Transmural

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10
Q

Give some complications of Crohn’s disease.

A

Malabsorption, Short bowel syndrome (iatrogenic), Deficiencies/Anaemia, Gallstones, Fistulae, Bowel obstruction, Perforation, Malignancy, Amyloidosis

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11
Q

Give examples of fistulae which may form in Crohn’s disease.

A

VesicoColic
Enterocolic
Gastrocolic
Recto vaginal

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12
Q

Give examples of anal disease which may occur as a result of Crohn’s disease.

A 
Sinuses
Fissures
Skin tags
Abscesses
Perineum falls apart
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13
Q

Crohn’s disease has a high incidence in…

A

North America & Northern Europe

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14
Q

What is the effect of smoking on Crohn’s disease?

A

Increases risk of flare

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15
Q

Which aspects of the immune system are altered in Crohn’s disease?

A

Persistent activation of T-cells and macrophages (failure to switch off)
Excess proinflammatory cytokine production

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16
Q

What is meant by Ulcerative Colitis?

A

Chronic inflammatory disorder starting in the rectum, spreading proximally

17
Q

What kind of inflammation is found in Ulcerative Colitis?

A

Mucosal and submucosal

18
Q

Peak incidence of Ulcerative Colitis occurs in…

A

30s

19
Q

What is the clinical presentation of Ulcerative Colitis?

A

Diarrhoea, mucus and blood PR

20
Q

Which changes occur histologically in patients with Ulcerative Colitis?

A

Massive influx of inflammatory cells
Irregular shaped branching crypts
Severe ulceration with fibrinopurulent exudate

21
Q

Which operation may be performed in severe UC?

A

Colectomy

22
Q

What is toxic megacolon?

A

Complication of Crohn’s/UC. Acute or acute on chronic fulminant colitis. Colon swells up to massive size - will rupture unless removed.

23
Q

How can UC lead to colorectal carcinoma?

A

Chronic inflammation leads to epithelial dysplasia and then carcinoma

24
Q

Risk of colorectal carcinoma in UC is increased when…

A

Disease has lasted longer than 10 years or pancolitis

25
Q

Give some complications of Crohn’s disease.

A

Blood loss
Electrolyte disturbance (hypokalemia)
Anal fissures
Extra GI manifestations

26
Q

Which extra-GI manifestations may be found in IBD?

A

Eyes: Uveitis
Liver: Primary sclerosing cholangitis
Joints: Arthritis, Ank Spondylitis
Skin: Pyoderma gangrenosum, erythema nodusum

27
Q

Which aspects of the immune system are altered in UC?

A

Persistent activation of T-cells and macrophages
Autoantibodies eg ANCA present
Excess proinflammatory cytokine production and bystander damage due to neutrophillic inflammation

28
Q

What is the effect of smoking on UC?

A

Thought to have a protective effect

29
Q

Is stricturing more common in Crohn’s or UC?

A

Crohn’s

30
Q

Are fistulae more common in Crohn’s or UC?

A

Crohn’s

31
Q

Is the cancer risk higher in Crohn’s or UC?

A

Crohn’s

GI (Y1) (79 decks)

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