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Nutrition > 142: IBD - Crohn's and Ulcerative Colitis > Flashcards

142: IBD - Crohn's and Ulcerative Colitis Flashcards

1
Q

abnormal immune response to gut flora (T2 cells and CD4).

A

Ulcerative Colitis

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2
Q

uniform, diffuse inflammation of the mucosa

A

UC

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3
Q

distorted crypts and loss of mucin production

A

UC

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4
Q

bloody mucoid diarrhoea

A

UC

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5
Q

UC affects which other parts of the body?

A

Liver: primary sclerosing cholangitis and cirrhosis
Joints: ankylosing spondylitis, arthritis, sacro-illitis
Eye: Uvitis and Episcleritis
Skin: Erythema nodosum, and pyoderma gangrenosum

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6
Q

what is primary sclerosing cholangitis

A

inflammation of the bile ducts

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7
Q

what is ankylosing spondylitis

A

inflammation of the spine

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8
Q

NOD2 gene mutation

A

Crohn’s Disease

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9
Q

Tissue damage following cell mediated immune response (granuloma - t1 cells surround macrophage)

A

CD

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10
Q

pain, fever, diarrhoea, raised ESR and C-reactive protein, strictures causing obstruction,

A

CD

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11
Q

Smoking and OCPill worsens

A

CD

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12
Q

Smoking protects

A

UC

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13
Q

skip lesions, fissures, fistula, cobble stoning

A

CD

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14
Q

what is Meckel’s Diverticulum?

A

embryological remnant causing an out pouch of the distal ileum.

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15
Q

what is Hirschsprung’s Disease?

A

ganglion cells migrate to the gut from the neural crest - i.e. lack of nerve bodies in the colon. collapsed rectum

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16
Q

what is cystic fibrosis?

A

autosomal recessive disease = viscous secretions

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17
Q

what is coeliac disease?

A

sensitivity to gluten, positive tissue transeglutaminase (TTG), villous atrophy, intra-epithelial lymphocytes.

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18
Q

what is a volvulus?

A

twisting of sigmoid colon on its mesentery causing mass in the left iliac fossa, coffee bean sign.

19
Q

what is diverticulosis?

A

high luminal pressure leads to folds of mucosa pushed out through weaknesses in muscle.

20
Q

first line treatment for UC?

A

Aminosalicyltes e.g. Mesalazine

21
Q

name an aminosalicylate…

A

mesalazine

22
Q

aminosalicylate mechanism of action…

A

inhibits infllammatory mediators: prostaglindins, thromboxane, platlet activiating factor. scavenger of oxygen-radicals

23
Q

adverse effects of mesalazine.

A

diarrhoea, headache, nausea, rash. ( monitor renal function)

24
Q

what do mineralocorticoids do?

A

affect water and electrolyte balance

25
Q

what do glucocorticoids do?

A

affect proteins and carbohydrate metabolism, anti-inflammatory and immunosupressive activity

26
Q

what are NF-KB ad AP-1

A

Nuclear Factor Kappa light chain enhancer of activated B cells and Activator Protein 1

DNA transcription of cytokines

27
Q

what act on NF-KB and AP-1 ?

A

corticosteroids

28
Q

adverse effects of cortocosteroids?

A

buffalo hump, thinning of skin, thin arms with increased abdofat, osteoporosis, poor wound ehaling and easy bruising, moonfaced, cataracts.

29
Q

name some oral corticosteroids…

A

prednisolone, budesonide, beclometasone

30
Q

IV corticosteroid…

A

Hydrocortisone

31
Q

topical corticosteroid…

A

hydrocortisone and predisolone.

32
Q

what do thiopurines do?

A

Immunosuppressive drugs, deactivating key processes in T lymphocytes that lead to inflammation.

33
Q

name some thiopurines…

A

azathipprine, 6-mercaptopurine

34
Q

when do you use thiopurines?

A

severe or frequent relapses

35
Q

adverse effect of azathioprine…

A

bone marrow suppression, leukopenia and hepatotoxicity.

36
Q

What is ciclosporin?

A

immunosuppressant ( via T cells)

37
Q

what is methotrexate?

A

antifolate, antimetabolite. inhibit cytokine and eicosanoid ( prostaglandin, leukotrines, thromboxanes)) synthesis

38
Q

adverse effects of ciclosporin…

A

hypertension, renal impairments, increased seizure risk, gum hypertrophy.

39
Q

what is eicosanoid?

A

local hormones such as prostaglandin

40
Q

adverse effects of methotrexate…

A

Nausea, vomiting, diarrhoea.

hepatotoxicity

41
Q

what is infliximab?

A

anti TNF antibody.

42
Q

which tnf alpha inhibitor is used in crown’s only?

A

adalimumab - subcut injection.

43
Q

first choice in Crohn’s initially

A

corticosteroids - predisolone.

then move to azathioprine or monoclonal antibodies

Nutrition (16 decks)

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