Pathology of GIT: UC and Crohn's disease Flashcards
Crohn’s disease is thought to go through the ______ pathway and cause the activation of ______ (inflammatory cell) leading to the formation of histolytic components such as granulomas
TNF pathway leading to the activation of macrophages = Crohn’s
(TH1)
what IBD is associated with liver abnormalities?
UC because it is associated with primary sclerosing cholangitis (P-ANCA)
in addition to necrotizing, large granulomas in TB caused colitis, you will also see longitudinal/transverse (direction) ulcers
transverse; Transverse = Tb
will see longitudinal ulcers in Crohn’s
What is the HLA association in Crohn’s disease
HLA DR7 and DQ4
what is the HLA association in UC
HLA DRB1
OCP’s is a risk factor for which occlusive cause of ischemic bowel disease
venous thrombosis
circumferential ulcers are seen in _______ caused colitis
NSAID related colitis
_________ is a toxigenic organism that can cause acute ischemic colitis
EHEC/STEC which will have pain, bloody diarrhea and hemolysis and renal failure (HUS)
which fluoroquinolone is associated with C. difficile colitis?
ciprofloxacin
mucosal and submucosal involvement with
UC; starts at rectum and has diffuse pattern of involvement (NOT FULL THICKNESS)
describe the ulcers seen in typhoid (enteric fever) in the GI
longitudinal ulcers typically over Peyer’s patches
a patient presents with weight loss and chronic diarrhea. she also has symptoms of intestinal obstruction. what is the most likely IBD
IBD's present with chronic diarrhea and weight loss intestinal obstruction (and malabsorption because Crohn's involves the ileum more commonly than UC) is more commonly seen with Crohn's due to the structures and ↑ wall thickening
_______ (IBD) will have granulomas
Crohn’s
granulomas are seen in ________
Crohn’s
what is the preferred method of diagnosing C. difficile caused pseudomembranous colitis/
stool tests:
- enzyme immunoassay for toxin A/B
- PCR for tcdB gene
stool culture takes 2-4 days so not often used
“string sign” on radiography is seen with ____
Crohn’s due to the wall thickening and strictures
subserosal infiltrating fat (creeping fat) is seen in ________ (IBD)
Crohn’s; it is serosal reaction to the transmural inflammation
pharmacologic administration of _______ (drugs) is associated with pseudomembranous colitis
↓ gastric acid secretion:
- PPI’s and H2 receptor inhibitors
bacteria that triggers dendritic cells and a activates the T helper and _____ pathway ultimately leading to activation of neutrophils is the proposed mechanism of _____ (IBD)
T helper (TH2) and IL-8 pathway causing activation of neutrophils is the proposed mechanism of Ulcerative Colitis
what are some associations of collagenous and lymphocytic colitis (microscopic colitis)
- NSAIDs
- celiac disease
- autoimmune: SLE, RA
what layers are affected in TB caused colitis?
superficial as opposed to in Crohn’s, it is transmural
pseudopolyps are seen in _____
UC; due to isolated islands of intervening regenerating mucosa bulge
______ (inflammatory cell) is seen in the epithelium of the crypt (cryptitis) or in the lumen (crypt abscess) and is associated with ____ (IBD)
neutrophils; UC
erythema nodosum is more commonly seen before/after the onset of GI symptoms and is seen more commonly in what IBD
erythema nodosum seen before the GI symptoms and more common in UC
plasmacytosis and crypt abscesses are seen in _______
UC
thinning of the luminal wall is seen in ____ (IBD)
UC
pseudomembrane is a mixture of neutrophils, fibrin, and _____
necrosis; have damaged crypts that are distended with mucopurulent exudate
endoscopy of ________ colitis is usually normal
microscopic; older women with watery diarrhea is the typical presentation with microscopic colitis
while both UC and Crohn’s disease can have extra intestinal manifestations, which IBD are they more commonly seen?
UC
______ (IBD) is associated with HLA DRB1
UC
fistula and strictures are seen with _____ (IBD)
Crohn’s
transmural inflammation is seen in _______ (IBD)
Crohn’s
in addition to C. difficile, what is another cause of pseudomembranous colitis?
ischemia
mucosa that is red, granular and friable is seen in _____
UC
what type of granuloma is seen in Crohn’s
non caseating epithelioid granulomas
______ is a histological feature seen in both Crohn’s and UC
crypt architectural distortion
but crypt abscesses is seen in UC
