Crohn Disease Versus Ulcerative Colitis Quiz

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Questions and Answers

Which blood test result is more likely to be positive in Crohn's disease?

  • Positive p-ANCA
  • Mild anemia
  • Elevated ESR (correct)
  • Hypokalemia

What is a common characteristic of Ulcerative Colitis based on stool analysis?

  • Low RBC count
  • Elevated WBCs (correct)
  • Presence of ova
  • Negative for blood

What is a distinguishing radiological sign that may be seen in Crohn's disease?

  • String sign (correct)
  • CT scan shows cobblestoning
  • Lead pipe appearance
  • MRI showing no structural abnormalities

Which is a complication more commonly associated with Ulcerative Colitis?

<p>Thromboembolic phenomena (C)</p> Signup and view all the answers

What is a common feature of Crohn's disease endoscopic appearance?

<p>Rectal sparing (C)</p> Signup and view all the answers

Which laboratory test result is more indicative of Ulcerative Colitis?

<p>Positive p-ANCA (C)</p> Signup and view all the answers

What is a potential complication specific to Crohn's disease?

<p>Sclerosing cholangitis (B)</p> Signup and view all the answers

What is a characteristic feature of Ulcerative Colitis endoscopic findings?

<p>Superficial ulcerations (B)</p> Signup and view all the answers

Which complication would NOT be typically seen in Ulcerative Colitis?

<p>Fistulas involving other segments (C)</p> Signup and view all the answers

What treatment option is commonly used for both Ulcerative Colitis and Crohn's disease?

<p>Immunosuppressors: azathioprine, 6-MP, methotrexate (A)</p> Signup and view all the answers

Flashcards

Ulcerative Colitis (UC)

Inflammation of the mucosa and submucosa of the colon and rectum.

Crohn's Disease (CD)

Transmural inflammation that can affect any part of the GI tract.

Fecal Leukocytes in IBD

Used to help rule out infectious causes of diarrhea in IBD.

Colonoscopy in IBD

A procedure to visualize the extent of disease and complications in IBD.

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Transmural Involvement

Involves the entire intestinal wall; from mucosa to serosa.

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Skip Lesions

Areas of disease separated by healthy tissue.

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Crohn's Disease Presentation

RLQ pain, watery diarrhea, and possible palpable mass.

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Skin Manifestations of IBD

Erythema nodosum and pyoderma gangrenosum.

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Hepatobiliary Complications of IBD

Gallstones and Primary Sclerosing Cholangitis (PSC).

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Crohn's Disease Activity Index Components

Liquid stools, abdominal pain, extraintestinal issues, complications, mass, meds, hematocrit, weight.

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Study Notes

Inflammatory Bowel Disease (IBD)

  • IBD includes Ulcerative Colitis (UC) and Crohn's Disease (CD)
  • UC: inflammation of the mucosa and submucosa of the colon and rectum
  • CD: transmural inflammation that can affect any part of the GI tract

Diagnostics

  • Fecal leukocytes: to rule out infectious diarrhea
  • Colonoscopy: to assess the extent of disease and the presence of any complications

Complications

  • Iron deficiency anemia
  • Hemorrhage

Crohn Disease vs Ulcerative Colitis

  • Crohn Disease:
    • Transmural involvement (intestinal wall from mucosa to serosa)
    • Discontinuous involvement (skip lesions)
    • Can involve any part of the GI tract
    • Colectomy is not curative (recurrences occur)
    • Complications: fistulae and abscesses are more common than in UC
    • Extraintestinal manifestation: more common than in UC
  • Ulcerative Colitis:
    • Mucosa and submucosa involvement
    • Confined to colon and rectum
    • Colectomy is curative
    • Continuous involvement (no skip lesions)

Crohn's Disease

  • Anatomic distribution:
    • Ileocolic (45%)
    • Small bowel alone (33%)
    • Colon alone (20%)
    • Rectal sparing
  • Clinical presentation:
    • RLQ pain (postprandial) and palpable mass
    • Diarrhea (watery)
    • Rectal bleeding
    • Malabsorption and weight loss
    • Fever
    • Growth retardation in children
    • Perirectal fistula
  • Extraintestinal manifestations:
    • Skin: erythema nodosum, pyoderma gangrenosum
    • Joints: peripheral arthritis, sacroiliitis, AS
    • Eye: uveitis, episcleritis, iritis
    • Hepatobiliary complications: gallstones, PSC
    • Renal complications: nephrolithiasis, recurrent UTIs

Crohn's Disease Activity Index

  • Liquid or very soft stools/day
  • Abdominal pain and cramping
  • Extraintestinal manifestations
  • Complications
  • Abdominal mass
  • Use of anti-diarrheal medications
  • Hematocrit
  • Body weight

Extraintestinal Manifestations of IBD

  • Eye lesions:
    • Episcleritis: parallels bowel disease activity
    • Anterior uveitis: independent course
  • Skin lesions:
    • Erythema nodosum: especially in Crohn disease; parallels bowel disease activity
    • Pyoderma gangrenosum: especially in UC; parallels bowel disease activity in 50% of cases
  • Arthritis:
    • Migratory monoarticular arthritis: parallels bowel disease activity
    • Ankylosing spondylitis: patients with UC have a 30 times greater incidence of ankylosing spondylitis than the general population; the course is independent of the colitis
    • Sacroiliitis: does not parallel bowel disease activity
  • Thromboembolic-hypercoagulable state: can lead to deep venous thrombosis (DVT), pulmonary embolism (PE), or a cardiovascular accident (CVA)
  • Idiopathic thrombocytopenic purpura
  • Osteoporosis
  • Gallstones in Crohn disease (ileal involvement)
  • Sclerosing cholangitis in UC

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