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GINME > Week 3: Inflammatory Bowel Disease > Flashcards

Week 3: Inflammatory Bowel Disease Flashcards

1
Q

Case 1 history

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2
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Case 1 additional history

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3
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Case 1 Labs

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4
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Case 1 colonoscopy

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5
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Case 2 history

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6
Q

Case 2 additional history

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7
Q

Case 2 labs

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8
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Case 2 contrast

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9
Q

Case 2 Colonoscopy

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10
Q

What is IBD?

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11
Q

What types of IBD are there?

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Crohn’s Disease

Ulcerative Colitis

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12
Q

Other causes of intestinal inflammation

A
  • Infections
  • Medications (NSAIDs, Antibiotics)
  • Ischemia
  • Radiation
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13
Q

Proposed etiologies of IBD

A
  • Genetic
  • Infection (dysbiosis)
  • immune dysfunction
  • Environmental factors
  • Intestinal barrier defect
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14
Q

Pathogenesis of IBD

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15
Q

IBD pathways

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16
Q

Genetic factors of IBD

A
  • Genetic mutation in NOD-2 gene in 10-15% of patients with Crohn’s disease most common in Jews
    *
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17
Q

Role of microbes

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18
Q

Epidemiology of IBD

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19
Q

Risk factors for IBD

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20
Q

A broad overview of how Ulcerative colitis and Crohn’s disease

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21
Q

Ulcerative colitis location of inflammation

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Inflammation in the colonic mucosa where only the colon is involved

inflammation affects the rectum and extends proximally to affect a variable extent of colon

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22
Q

Ulcerative colitis duration of inflammation

A

Continuous inflammation

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23
Q

Forms of IBD that are associated with extraintestinal complications

A

Both

  • Crohn’s Disease
  • Ulcerative colitis
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24
Q

Way to remember ulcerative colitis

A

ULCCCERS

  • Ulcers
  • Large intestine
  • Continuous/Colon cancer/ Crypt abscesses
  • extends proximally, red diarrhea, sclerosing cholangitis
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25
Q

Crohns disease location

A
  • chronic transmural inflammation
  • may involve any part of the GI tract from oral to anus
  • Typically affects the ileum and colon
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26
Q

Most common Crohn’s disease location

A

Typically affects the ileum and colon

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27
Q

Describe the distribution of Crohn’s Disease

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  • distribution tends to be focal, asymmetric or segmental (skipped lesions)
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28
Q

Crohn’s disease complications

A

frequently complicated by fistulas and perianal disease

Also

Associated with extraintestinal complications

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29
Q

Anatomic distribution of ulcerative colitis

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30
Q

Anatomic distribution of Crohn’s Disease

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31
Q

Gross histology of non-universal ulcerative coliiis

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32
Q

Crohn’s disease anatomic distribution frequency

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33
Q

Ulcerative colitis clinical presentation

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  • Diarrhea (small frequent BM)
  • Blood stools
  • Abdominal pain
34
Q

Crohn’s Disease clinical presentation

A
  • Diarrhea (less freq)
  • Blood stools (less)
  • Right lower quadrant abdominal pain and mass
  • Obstructive sxs (decrease in bm)
  • Intestinal fistulas and fissures
35
Q

What is the most common extraintestinal manifestation of ulcerative colitis?

A

Skeletal (osteoarthritis, ankylosing spondylitis, sacroiliitis)

36
Q

What are the skeletal extraintestinal manifestations of ulcerative colitis?

A

Skeletal (osteoarthritis, ankylosing spondylitis, sacroiliitis)

37
Q

What are the ocular extraintestinal manifestations of ulcerative colitis?

A
  • Uveitis
  • episcleritis
  • iritis
38
Q

What are the biliary extraintestinal manifestations of ulcerative colitis?

A
  • primary sclerosing cholangitis (PSC)
  • It is rare for patients with UC to develop PSC but up to 90% of all patients affected by PSC will also be affected by UC
39
Q

What are the cutaneous extraintestinal manifestations of ulcerative colitis?

A
  • erythema nodosum
  • pyoderma gangrenosum
  • aphthous stomatitis
40
Q

What are the general extraintestinal manifestations of ulcerative colitis?

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  • fatigue
  • Fever
41
Q

What are the adolescent or seen in children extraintestinal manifestations of ulcerative colitis?

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  • growth retardation
  • delayed puberty
42
Q

What is this?

A
  • Left is pyoderma gangrenosum
  • Right is erythema nodosum
43
Q

Ulcerative colitis Dx is based on?

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44
Q

Labs for Ulcerative colitis

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45
Q

Endoscopy of UC

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46
Q

Endoscopy of Crohn’s Disease

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47
Q

Endoscopic spectrum of proctocolitis

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48
Q

Describe the appearances of Crohn’s Disease endoscopic feature

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49
Q

Histology of UC

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Mucosal inflammation

50
Q
A
51
Q

Gross histology and histology of mild UC

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52
Q

Gross histology and histology of severe UC

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53
Q

Histology of Crohn’s disease

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  • Transmural inflammation
  • Non-caseating granulomas
  • Giant cells
  • NEutrophilic inflammation of the crypts
54
Q

Describe Crohn’s Disease histology granuloma

A
55
Q

Describe Crohn’s Disease histology cross-section

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56
Q

Describe Crohn’s Disease histology

A

transmural process

57
Q

Describe Crohn’s Disease histology fistula

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58
Q

Describe Crohn’s Disease histology enteric fistulae

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59
Q

Describe Crohn’s Disease histology enterocutaneous fistulae

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60
Q

Describe Crohn’s Disease histology perianal fistulae and abscess

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61
Q

Describe Crohn’s Disease histology perineal complications of Crohn’s disease

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62
Q

Describe how radiology can be used to identify IBD

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63
Q

UC radiology

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64
Q

Crohn’s radiology

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65
Q

What is this?

A

String sign in Crohn’s disease

66
Q

What is this?

A

ileitis in Crohn’s Disease

67
Q

What is this?

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Gastro-duodenitis in Crohn’s Disease

68
Q

Treatment of Crohn’s disease

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69
Q

Describe step-up therapy for Crohn’s disease

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70
Q

Describe surgical options for UC

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Colectomy is curative for UC

71
Q

Crohn’s Disease surgical options

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  • Surgery is to be avoided if possible
  • High-rate of postoperative recurrence at the site of the resection
72
Q

Summary of Crohns to UC

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73
Q

Case 2 recap

A

Ulcerative colitis

74
Q

Case 1 recap

A

Crohn’s Disease

GINME (63 decks)

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