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58 Cards in this Set
- Front
- Back
What is a group of chronic inflammatory conditions of the colon and small intestine? |
IBD |
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What is characterized by a tendency for chronic or relapsing immune activation and inflammation within the GI tract (also as a dysregulation of the immune respond to GI luminal bacteria)? What are the two major forms? |
Idiopathic inflammatory bowel disease
Crohn disease and ulcerative colitis |
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Name three gene mutations associated with each component of IBD: Innate immunity, adaptive immunity, and epithelial immunity |
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Describe whether each has an increased incidence, decreased incidence, or no effect on UC and CD:
Cigarette smoking, appendectomy, high-sanitation level in childhood, high-intake refined carbohydrates. |
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What is the hygiene hypothesis? What is the conflicting data on IBD between the Manitoba case-control and the Montreal case-control? |
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Draw the pathogenesis of inflammatory bowel disease. Use bacterial components, macrophage, dendritic cell, neutrophils, CD4 T cell, and the associated cytokines release by each. |
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What is a chronic inflammatory disorder of the GI tract affecting the large bowel? |
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Where does ulcerative colitis usually begin? Where does it extend? Any skip lesions?
Endoscopically: hyperemia, ____ , granularity with friability, easy bleeding, broad based ulceration, _____, tunnels with mucosal bridges, rarely perforation Toxic megacolon: shutdown of _____ function secondary to exposure of fecal material to _____ and neural plexus Rarely pericolonic abscess Indolent, relapsing disease |
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What is shown here? Describe it. |
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What is the condition? Describe: extensive |
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What is a characteristic feature of ulcerative colitis (where layer is the disease limited to)? |
Muscularis and serosa are NOT affected. |
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What is this characteristic finding in ulcerative colitis? What are they filled with? |
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What is this condition called that is associated with UC? |
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Identify Proctitis, left-sided, and pancolitis. |
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UC: Up to 30% with disease limited to proctitis or proctosigmoiditis present with what?
Is abdominal pain usually a prominent feature? Are fistulization, stricture, skip areas, and abscess formation characteristic? |
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What percent of patients have rectal sparing? What is this called? If the rectum is normal, what is the disease? Does Crohn's disease typically have skip areas? |
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What is the condition? |
Ulcerative proctitis |
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What is the condition? |
Proctosigmoiditis |
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What is the condition? |
Left-sided colitis |
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What is the condition? |
Pancolitis |
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What is the condition? |
Fulminant colitis |
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Which is normal? Which is abnormal? What is the condition? |
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Again, what is the condition? |
UC |
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Condition? |
UC |
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What is shown in each image? |
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Which is normal? Which is UC (toxic megacolon)? |
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What study can you use to observe fine mucosal detail in UC? |
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Identity severe UC and chronic UC with fibrosis (rigidity and shortening of colon). |
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What study is most sensitive for evaluation of free air (which condition would this be useful for)? Does it demonstrate mucosal detail well? |
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What is shown here? |
Thickened mucosa with edema and pericolonic fluid |
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What is the condition? |
Crohn's disease |
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At what age does Crohn's disease peak in incidence (diagnosis)? |
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Crohn's Colitis:
1. _____ (symmetrical or asymmetrical) disease where there is involvement |
Asymmetrical disease where there is involvement |
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Crohn's Disease: What percent involves small intestine alone, small intestine and colon alone, colon alone? What are four uncommon sites?
What layers of the wall are involved? Do you often see non-caseating granulomas? Fissuring with fistula? What types of lesions? |
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What is the incidence of Crohn's disease? At what ages does it peak (bimodal)? What race?
What are three recurrent symptoms? What will you see in 50% of cases (mild)? |
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What is characteristic of Crohn's disease (in terms of wall involvement)? |
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What is the descriptive term for the mucosa in Crohn's disease? |
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What are "skip lesions" in Crohn's disease?
What are areas on the serosa extending to seal off areas of transmural inflammation? |
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What is the disease? What is characteristic of the disease that is shown here (branching on the right side)? |
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What is the disease? |
Crohn's disease |
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What is the arrow pointing to? What disease is this characteristic of? In what layer is this typically present? What other cells do you see? |
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What is shown and what is the condition? What cell type is present (like in TB)? Is it usually necrotizing? |
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What are the three patterns of Crohn disease? |
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What do you see in this endoscopy? What could this? |
Ulcerations => Crohn's disease |
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What two things do you see here? What condition could this be? |
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What do the white arrows and black arrows show? What disease? |
White arrow = mural stratification (mesenteric hypervascularity?) of the terminal ileum
Black arrow = mucosal hyperenhancement |
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What is this tender subcutaneous nodule with an erythematous or dusky appearance that tends to parallel the activity of IBD (may also see it in Crohn's)? |
Erythema nodosum |
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Fibrosis What is this?
Description: Swollen venules
What cells are involved? |
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Appears first as a papule or nodule usually on the anterior aspect of the shin. May occur anywhere. Progresses to an ulcer with undermined borders. Not usually painful
What is this? |
Pyoderma gangrenosum (mild) |
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What is this? |
Pyoderma gangrenosum (severe) |
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What is episcleritis? What percent of Crohn's disease? It is an emergency? |
Infection of the sclera and conjunctiva => parallels activity of UC and Crohn's (6% of Crohn's). Involves deeper structures of eye => requires urgent care. |
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What are all these? |
Extra-intestinal manifestations of Crohn's |
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What is the current theory of IBD? What three things does the pathogenesis involve? |
Chronic relapsing, and remitting inflammatory disorder(s) of unknown etiologies: |
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St. Mark’s London followed 600 patients with extensive UC for 5932 patient years |
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What are all of these patients with IBD at risk for?
Do patients with Crohn's disease respond to TNF antagonists? |
Colorectal cancer, yes |