Pathology of Idiopathic Inflammatory Bowel Disease

Question 1

Define Chron’s

Answer 1

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

Question 2

Where is Crohn’s disease most common

Answer 2

In the terminal ileum and colon

Question 3

Who is most commonly affected by Crohn’s disease

Answer 3

Young patients 10-40

Males most commonly

Question 4

What are 6 common presentations of Crohn’s disease

Answer 4

Abdominal pain 
Small bowel obstruction 
Diarrhoea
Bleeding PR
Anaemia
Weight loss

Question 5

Describe the clinical course of Crohn’s Disease

Answer 5

Chronic
Exacerbations and remissions
Unpredictable response to therapy

Question 6

What are significant features of crohn’s disease in histology

Answer 6

Granuloma formation

Increased inflammatory cells in the lamina propria

Question 7

What are the appearance of deep fissures in Crohns disease (histology)

Answer 7

Knife like in appearance

Question 8

What are complications of malabsorption in Crohn’s disease

Answer 8

Malabsorption
Latrogenic due to repeated resections
Hypoproteinemia, Vtiamin deficiency, anaemia
Gallstones

Question 9

What are other complications of crohns disease

Answer 9

Fistulas
Anal Disease
Intractable disease
Bowel obstruction
Perforation
Malignancy 
Amyloidosis

Question 10

What causes Crohn’s disease

Answer 10

Genetic susceptibility and environmental agents

Question 11

Define Ulcerative colitis

Answer 11

Chronic inflammation idsorder confined to colon and rectum with mucosal and submucosal inflammation

Question 12

Who is most likely to have ulcerative colitis

Answer 12

Young patients mostly male

but can present in children and elderly

Question 13

What part of the GI tract is affected by Ulcerative colitis

Answer 13

Colon and rectum (usually the rectum)

Question 14

What are the common clinical presentations of Ulcerative colitis

Answer 14

Diarrhoea, mucus and blood PR

Question 15

What are 4 aspects of the clinical course of ulcerative colitis

Answer 15

Chronic course with exacerbation and remission
Continous low grade activity
A single attack
Acute fulminatn colitis

Question 16

What are some common observations (histology)

Answer 16

Massive influx of inflammatory cells
Basal lymphoplasmacytic infiltrate with irregular shaped branching crypts
Acute cryptitis
Crypt abscesses
Sever ulceration
Pseudopolyps 
No granulomas
Rarely fistulae

Question 17

Where is the inflammation confined to in Ulcerative colitis

Answer 17

The mucosa and submucosa (superficial)

Question 18

What are some common complications of Ulcerative colitis

Answer 18

Intractable disease - continuous diarrhoea and total colectomy
Toxic megacolon
Colorectal carcinoma
Blood loss
Electrolyte disturbnace
Anal fissures
Extra GI manifestations (eyes, liver, joints, skin)