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42 Cards in this Set
- Front
- Back
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What is the US incidence of Ulcerative Colitis?
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4-12/100,000
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At what age is the peak onset of ulcerative colitis?
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20-25
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What age and race is UC more commonly seen in?
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White women
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What is an exogenous risk factor for UC?
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NONsmoking
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What type of CD4+ Tcells are thought to be more associated w/
-Crohn's disease -Ulcerative colitis |
CD = Th1
UC = Th2 |
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The 3 big pathologic hallmarks of Crohn's disease are:
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-Skip lesions
-Noncaseating granulomas -Fissuring w/ fistula formation |
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Where does Ulcerative Colitis develop in the gut?
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-Rectum
-Radiates up proximally |
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What are the 3 main ways that UC is different from CD?
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-Continuous; no skip lesions
-No granulomas -Not transmural - affects only the mucosa and submucosa |
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What extraintestinal complications are seen in UC as well as in CD?
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-Polyarthritis
-Uveitis -Sclerosing cholangitis -Sacroiliitis -Ankylosing spondylitis -Skin lesions (erythema nodosum) |
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What TYPE of nonsmokers are at a higher risk of getting UC?
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Smokers that stop smoking (more than smokers that never smoked before)
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What is pancolitis? When is it seen?
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UC involving the entire colon - seen in more severe cases
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What is Backwash Ileitis?
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Involvement of the distal ileum due to incompetence of the ileocecal valve
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If you see UC involvement of the terminal ileum, how can it be distinguished from Crohn's?
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It will be diffuse and only in the last 25 cm of the small intestine; not skip lesions.
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What are the 4 key gross morphology features of UC?
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1. Red, granular friable mucosa
2. Ulceration 3. Pseudopolyps 4. Nonthickened wall |
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What are the 5 main microscopic features of UC?
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-Cryptitis
-Crypt abscesses -No granulomas -Not transmural -Architectural distortion |
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What is the early appearance of the mucosa in UC?
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Red, granular, friable, easily bleeds
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What is the later appearance of mucosa in fully developed UC?
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Extensive broad-based ulcers in the distal colon or along its entire length
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What do isolated islands of regenerating mucosa in UC create?
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Pseudopolyps
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How do the ulcers in UC compare to those in CD?
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UC - linear, but not serpentine
CD - serpentine |
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What happens to the mucosal surface in UC as a result of chronic indolent disease?
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It becomes atrophic, flattened, and attenuated.
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What 2 things do NOT occur to the colon wall in UC?
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-No thickening
-No change in serosal appearance |
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What develops in most severe cases of IBD when there is complete shutdown of neuromuscular function?
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Toxic megacolon
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What is the appearance of Toxic Megacolon like?
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Swollen and black-green gangrenous
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What is toxic megacolon at risk for causing?
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Rupture
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So what are the 4 bad complications of UC?
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TBUG
-Toxic megacolon -Bowel perforation -Uncontrollable C diff infection -GI carcinoma |
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What is UC at a much higher risk for than CD?
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Developing into cancer
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What are the 2 stages in progression from UC to cancer?
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1. Dysplasia
2. Carcinoma |
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Does UC have to be active inflammation for dysplasia to develop?
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No; it can be inflamed or quiescent
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What are the 2 classes of epithelial dysplasia that can be seen in UC?
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-Low grade
-High grade |
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Why is it difficult to identify dysplasia sometimes?
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Because there is often a lot of Reactive dysplasia too - normal regeneration from inflammation
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What 2 pathologic features distinguish Carcinoma?
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-Infiltrative
-Without exophytic masses |
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How much is the risk for developing cancer increased in patients with pancolitis for 10 yrs or more?
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20-30X
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What extraintestinal manifestation is more associated with UC than CD?
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Primary sclerosing cholangitis
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In which IBD are strictures more common? When do they develop?
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Crohn's - early
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In what 2 scenarios can pseudopolyps develop?
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-Crohn's in the colon
-UC |
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Do pseudopolyps develop in Crohn's in the terminal ileum?
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Rarely
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What are the ulcers like in
-Crohn's -UC |
Crohn's: deep and linear
UC: superficial |
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Which disease has lymphoid reaction, fibrosis, and serositis?
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Crohn's
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Which disease has granuloma's and fistulae/sinuses?
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Crohn's
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Which disease is associated with fat and vitamin malabsorption?
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Crohn's
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Which disease has malignant potential?
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Crohn's AND UC
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Which disease responds best to surgery?
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Ulcerative colitis
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