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26 Cards in this Set
- Front
- Back
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What are the features of ulcerative colitis?
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Limited to colon (except backwash into the ileum)
Limited to mucosa Begins at rectum, progresses continuously and proximally |
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Acute viral hepatitis
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What is this process?
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Coagulative necrosis (from toxic injury)
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What process is this?
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What are the intestinal manifestations of UC?
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Blood and mucus in stool
Cramping is WORSE with passage of stool Pain more common in LLQ Tenesmus while there isn't anything in rectum (feeling is from inflammation) |
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What is cirrhosis?
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A diffuse process throughout the liver in which nodules of regenerating hepatocytes are surrounded by bands of fibrosis
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What are the intestinal manifestations of UC?
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Blood and mucus in stool
Cramping is WORSE with passage of stool Pain more common in LLQ Tenesmus while there isn't anything in rectum (feeling is from inflammation) |
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What are the biopsy findings of UC?
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Crypt distortion (not unique to UC), Acute and chronic infiltrate of PMN’s and lymphocytes
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Cirrhosis
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What condition of the liver is this?
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Ulcerative colitis - notice the inflammatory cells in the mucosa.
Crypts are sparse and branching. Crypt abscesses |
What disease is this?
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What is mallory hyaline?
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A dense condensation of cytoskeletal proteins in the cytoplasm of hepatocytes
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What are the systemic complications of UC?
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episcleritis, uveitis, eythema nodosum, pyoderma gangrenosum, peripheral arthritis (seronegative), ankylosing spondylitis and sacro-iliits, sclerosing cholangitis, cholangiocarcinoma
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Steatosis
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What liver pathology is this?
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What are the features of Crohn's disease?
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Involves any part of the GI tract
May be skip lesions Can be transmural GRANULOMA is pathognomonic, but not sine qua non |
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Mallory hyaline
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What liver pathology is represented by the cell in the center?
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What are the intestinal manifestations of Crohn's Disease?
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Depend on location, extent, and severity
Pain may be periumbilical or RLQ Inflammatory mass may be palpated Nausea/vomiting if in stomach or duodenum, also early satiety, epigastric pain, dysphagia Perianal skin tags, fissures, fistulae Increased pain, distension, borboyrgmi are signs of stenosis and obstruction |
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Acidophils - apoptotic hepatocytes
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What type of cells are these?
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What are linear ulcers indicative of?
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Crohn's
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Ballooning degeneration
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What are the big, pale cells?
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Crohn's (see granuloma, significant inflammation of all layers
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What disease is this?
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What are systemic complications of small bowel syndrome?
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Gallstones, malabsorption, fatty diarrhea, oxalate stones in kidney
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Dysplasia (big, disorganized nuclei)
And frank cancer |
What does this slide show?
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What is the potential pathogenesis of IBD?
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Inappropriate activation of mucosal immune system
Caused by autoimmunity to luminal or mucosal antigen? Response to normal flora? Dysfunctional suppressor T cells Inability to mount reciprocal cytokine response Infection Genetic and environmental contributants |
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What are the specific aspects of the pathogenesis of Crohn's disease?
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Cell-mediated! -Macrophages and dendritic cells
Induced by Th1 cells --> IFN-g, TNF-a, IL-12 |
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What are the specific aspects of the pathogenesis of ulcerative colitis?
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Humoral! Autoantigens cross-react with bacterial Ags from normal flora
Lack of regulatory cells Excess CD4 effector cells Th2 response pANCA in 70% |
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What is the stepwise approach for treatment of IBD?
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1. Aminosalicylates (5-ASA)
2. Corticosteroids 3. Immunomodulatory (6-MP + azothiaprine) 4. Infliximab (for CD) 5. Other agents that sometimes work (methotrexate, cyclosporine) |
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there is no question here
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Thank God.
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