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34 Cards in this Set
- Front
- Back
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what causes IBD?
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a dysfunctional immune resonse to antigerns in the intestine
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what age groups have the highest rate of incididence for uc and crohns?
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20-40, peak of onset in late teens, and other peak in middle age
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what part of the gi tract is most often affected by crohns?
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the colon; although it can affect anywhere;
typically will affect both SI and colon |
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what disease is associated with fat that encases the ouside of the bowel? (creeping fat)
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Crohn;s
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which disease produces full thickness inflamation? transmural
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crohns
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what are symptoms of crohns?
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bleeding diarrhea wt loss fever fatigue
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what are three phenotypes of CD?
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Inflammatory: majority, constitutional diarrhea pain wt loss
fistulizing: not uncommon dilation of bowle obstructing: fibrostenotic, strictures wo much inflammation treat w/ antiinflam, and/or surgery; can cause n/v |
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what phenotype will younger pts often have?
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stricture
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how can you dx crohns?
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seeing non caseating granulomas on histology confrms Dx
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abscess is a normal result of what kind of inflammation?
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transmural
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how can CD affect peds pops?
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inflammation malnutirion and drugs can cause closure of long bone prominesc and limit skeletal growth
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are most crohns pts healed for good?
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no 70% chronically relapse
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where do you see UC inflammation?
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only the the colon, and only in the mucosa
always rectal, sometime left, left+right |
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is it possible to distinguish UC and CD by history alone?
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NO, they have similar symptoms, unless UC has proctitits
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what are the symptoms of rectal inflamation? what dseas is it associ with?
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urgency of defecation, incmoplete evacuation (tenesmus)
UC |
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what are extra intestinal maifestations of UC and CD?
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eye and joint inflammation, skin diseases
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what is primary sclerosing colangitsi and what is it related to?
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inflammation of extrahepatic and intra hepatic biliary tree; associated with UC, not frequent complication
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how does smoking affect uc and cd?
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protective for Uc
increase risk of complications for cd |
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what predisposes UC pts to toxic megacolon?
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use of narcotics for pain.
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classic beaded appearance of billiary tree
can cause jaundice bacterial cholangitits many pts require liver transplants |
PSC--- associate with UC
tx: can try to stent strictures open, doesn't respond to immunosuppression |
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pyoderma gangrenosum; ulcerating full thikcness rashes on legs
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correlated with UC
can respond by treating bowel diseas may need primary tx |
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episcleritis
eye inflammation tender to touch |
associated with UC
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do you see fistualats and stictures in UC?
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no, rare,
common in CD |
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how do you tellt he diff in UC and CD?
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us anatomical location (rectum uc, SI CD), granulomata on Bx (CD), complications
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disscontinuous inflammation vs
continuous inflamation |
CD
UC |
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ASCA anitibodies
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50-75% of Crohsn have a response
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p-ANCA
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60-70 UC have rxn
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will UC recurr after surgery?
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NO but CD WILL
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what is the first line tx for crohns?
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oral 5ASA, abx, orally active corticosteroids
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Induction of remission for moderate CD:
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corticosteriods, biologic drugs
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Mintenance for moderate CD:
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AZA, MTX, Anti tnfa
(can't use 5ASA or cortico for maintence) |
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what med is good at inducing and maintaining mild UC?
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5ASA- preention of dysplasia
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tx for moderate/severe UC:
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induciton: coticosteroids and infliximab
maintenance: immunosuppresen |
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which one (uc or cd) has a greater genetic componend?
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CD
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