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31 Cards in this Set
- Front
- Back
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What is the definition of idiopathic Inflammatory Bowel Disease?
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A chronic relapsing inflammatory disorder caused by persistent activation of the mucosal immune system.
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What are the 2 IBDs?
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-Ulcerative colitis
-Crohn disease |
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What portion of the gut is affected in Crohn's disease?
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From lips to anus
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What portion of the gut is affected in Ulcerative colitis?
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The colon and rectum
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Where is IBD most common?
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In developed countries
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What are the 2 KEY PATHOGENIC ABNORMALITIES in IBD?
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1. Strong immune responses to normal flora
2. Defects in epithelial barrier function |
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What are 3 contributors to the pathogenesis of IBD?
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1. Immune dysregulation
2. Genetic susceptibility 3. Environmental triggers (normal gut flora) |
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What is the immune response in IBD primarily mediated by?
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CD4+ Tcells
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What key mediator is elevated in patients with Crohn's?
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TNF-a
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What antibody binds and neutralizes the effects of TNF-a?
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Infliximab
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When is Infliximab used to treat Crohn's disease?
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In mod-severe cases that do not respond to normal therapies
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At what age is the peak detection of Crohn's disease?
What is its annual incidence? What patients are more common to get it? |
20-30
1/300,000 Females, Whites |
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What is a strong exogenous risk factor for Crohn's disease?
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Smoking!!
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What are 4 clinical manifestations of Crohn's?
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-Intermittent abdominal pain
-Fever -Diarrhea -Occult bloodloss leading to anemia |
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What are the more common sites of the GI tract involved in CD?
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-Terminal ileum
-Colon |
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What does the serosa look like in diseased bowel segments with CD?
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Gray, dull and granular
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What is Creeping fat?
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When the mesenteric fat wraps around the bowel surface (gross)
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Why does the intestinal wall get rubbery and thick in Crohn's disease?
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Because of the inflammation causing edema, fibrosis and hypertrophy of the muscularis propria.
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What is the String sign?
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The rubbery thick wall makes the lumen smaller; so when barium is given it shows a thin stream through diseased segments.
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What is the CLASSIC feature of Crohn's disease presentation in the bowel?
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Segments of normal intestine between affected regions
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What is it called when multiple bowel segments are involved and intervening bowel is essentially normal?
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Skip lesions
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What is an early characteristic sign of Crohn's disease?
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Aphthous ulcers
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What are apthous ulcers?
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Focal mucosal ulcers that look like canker sores
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What happens to the aphthous ulcers as Crohn's disease progresses?
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They elongate into serpentine linear ulcers
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What is the final gross change seen in CD pathology?
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Fissures and fistulas
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Why are fistulas and fissures bad?
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Theyc an end up in adhesions and sinus tracts leading to the outside environment
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So what are the 6 main complications that could result from Crohn's disease?
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FPSGPS
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What does FPSGPS stand for?
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-Fistulas
-Protein losing enteropathy -Strictures -General malabsorption -Pernicious anemia -Steatorrhea |
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How is Crohn disease related to cancer?
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There is a 5-6X increased risk for developing GI cancer
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What are 6 extraintestinal manifestations of Crohn's disease?
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MAUSES
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What is PUSSAS?
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-Polyarthritis
-Uveitis -Sacroiliitis -Skin manifestations - Erythema nodosum -Ankylosing spondylitis -Systemic amyloidosis |
