Inflammatory Bowel Disease

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Questions and Answers

Which of the following is a characteristic feature of ulcerative colitis?

The primary lesion begins with inflammation in the small intestine

The primary lesion begins with inflammation at the base of the crypt of Lieberkühn (correct)

The primary lesion begins with inflamed granulomas in the colon

Manifests with alternating periods of constipation and diarrhea

What is a common extraintestinal manifestation of ulcerative colitis?

Hepatic adenomas

Renal calculi

Pulmonary embolism

Cutaneous lesions (correct)

Which complication is associated with long-standing ulcerative colitis?

Risk of esophageal varices

Increased risk of acute pancreatitis

Development of neuroendocrine tumors in the colon

Increased risk of colon cancer (correct)

What is the recommended approach for detecting dysplasia and colorectal cancer in long-standing ulcerative colitis?

Chromoendoscopy Signup and view all the answers

What is the primary location of ulceration in ulcerative colitis?

Colonic mucosa, most commonly in the rectum and sigmoid colon Signup and view all the answers

Which of the following is a symptom of severe ulcerative colitis?

Frequent diarrhea Signup and view all the answers

What is the primary factor leading to damage of the epithelial mucosal barrier in ulcerative colitis?

Release of inflammatory cytokines Signup and view all the answers

In which type of UC does the disease involve less mucosa and may be limited to proctitis?

Mild UC Signup and view all the answers

What is the basis for the diagnosis of ulcerative colitis?

Medical history, clinical manifestations, imaging procedures, and biopsy findings Signup and view all the answers

Which gene mutation has the strongest association with Crohn disease?

CARD15/NOD2 Signup and view all the answers

What is the most common site of Crohn disease?

Ascending colon Signup and view all the answers

Which cytokines are associated with Th1-mediated inflammation in Crohn disease?

TNF-α and IFN-γ Signup and view all the answers

What is a risk factor for Crohn disease?

Cigarette smoking Signup and view all the answers

Which type of lesions are characteristic of Crohn disease?

Skip lesions Signup and view all the answers

What is a potential extraintestinal manifestation of Crohn disease?

Arthropathies Signup and view all the answers

What is a common clinical manifestation of Crohn disease?

Diarrhea and rectal bleeding Signup and view all the answers

What can surgical resection of small intestinal segments for Crohn disease lead to?

Short bowel syndrome Signup and view all the answers

What is a component of Crohn disease therapy?

Smoking cessation Signup and view all the answers

What should be performed for long-standing Crohn disease?

Cancer screening Signup and view all the answers

Which of the following is a potential consequence of unknown environmental factors or infections in inflammatory bowel disease?

Promotion of loss of immune tolerance to normal intestinal antigens Signup and view all the answers

Which proinflammatory molecule is involved in damaging the intestinal epithelium in inflammatory bowel disease?

Tumor necrosis factor Signup and view all the answers

After how many years of inflammatory bowel disease does the risk of colon cancer significantly increase?

30 to 35 years Signup and view all the answers

What is the estimated prevalence of inflammatory bowel disease in the United States?

3 million people Signup and view all the answers

Which population shows a higher prevalence of inflammatory bowel disease?

White populations Signup and view all the answers

What is thought to activate dendritic cells in response to inflammatory bowel disease?

Loss of immune tolerance to normal intestinal antigens Signup and view all the answers

Which type of cells are triggered to transport to mesenteric lymph nodes in response to inflammatory bowel disease?

Dendritic cells Signup and view all the answers

What is the primary factor thought to lead to damage of the epithelial mucosal barrier in inflammatory bowel disease?

Altered immune response to intestinal microflora Signup and view all the answers

Which immune response cells are involved in damaging the intestinal epithelium in inflammatory bowel disease?

All of the above Signup and view all the answers

Study Notes

Crohn Disease Overview and Management

Crohn disease is an idiopathic inflammatory disorder affecting any part of the gastrointestinal tract and involves "skip lesions" with inflamed areas mixed with uninflamed areas, noncaseating granulomas, fistulas, and deep penetrating ulcers.
Risk factors for Crohn disease include family history, cigarette smoking, Jewish ethnicity, urban residency, age less than 40 years, and an altered gut microbiome.
The CARD15/NOD2 gene mutations have the strongest association with Crohn disease, although many other genes have been identified, and their mutation may promote dysbiosis and reduced levels of defensins.
Th1-mediated inflammation with activation of TNF-α, IFN-γ, IL-12, and Th17-associated cytokines causes mucosal injury in Crohn disease.
Inflammatory lesions begin in the intestinal submucosa and spread with discontinuous transmural involvement, and the ascending colon and the transverse colon are the most common sites of the disease.
Clinical manifestations of Crohn disease include diarrhea, rectal bleeding, anemia, malabsorption of vitamin B12, deficiencies in folic acid, vitamin D absorption, and calcium, weight loss, and anal manifestations.
Individuals with Crohn disease are at risk for intestinal adenocarcinoma and extraintestinal manifestations such as arthropathies, skin, oral, and ocular lesions.
Diagnosis and treatment of Crohn disease involve imaging of the small intestine, corticosteroids, 5-aminosalicylates, immunomodulatory agents, and new biologic agents under development.
Smoking cessation is a component of Crohn disease therapy, and surgery is generally performed to manage complications or to relieve obstruction.
Surgical resection of small intestinal segments for Crohn disease can lead to complications related to short bowel syndrome, including malabsorption, diarrhea, and nutritional deficiencies.
Cancer screening should be performed for long-standing Crohn disease.
Crohn Disease can be evaluated through endoscopic imaging techniques to detect dysplasia and colorectal cancer with long-standing disease.

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Description

Test your knowledge of Inflammatory Bowel disease with this overview and management quiz. Explore the risk factors, genetic associations, clinical manifestations, diagnostic imaging, treatment options, and potential complications associated with this inflammatory disorder of the gastrointestinal tract.