24. Inflammatory Bowel Disease Flashcards
What are the clinical features of UC?
Bloody diarrhoea
Fever and crampy abdominal pain
Frequency and urgency, tenesmus
General malaise and extra-intestinal symptoms
What are the True Love and Witt criteria?
Assessment of whether a patient with UC should be admitted to hospital due to risk of perforation
What are the components of the True Love and Witt criteria?
>6 stools >90BPM Temp >37.8C Hb< 10.5 High CRP
What are the clinical features of CD?
Abdominal pain Diarrhoea Weight loss Perianal disease General malaise and extra-intestinal symptoms
What scoring system is used in Crohn’s disease?
Harvey Bradshaw index
What are the extra-intestinal symptoms of inflammatory bowel disease?
Erythema nodosum Pyoderma gangrenosum Unilateral arthritis PSC Uveitis, iritis Kidney stones Amyloidosis
What can be seen on general inspection of a patient with IBD?
Low BMI
Short stature if paediatric patient
What can be seen on the hands of a patient with IBD?
Clubbing
Palmar crease pallor and koilonychia if anaemic
What can be seen on the face of a patient with IBD?
Angular stomatitis (B12 deficiency) Conjunctival pallor Scleritis Mouth ulcers Puffy lips and inflamed gums
What is the differential for IBD if the patient is older than 60?
Diverticulitis Ischaemia Tumour NSAID induced Microscopic colitis Cholangitis
What blood results may be seen in IBD?
FBC: low Hb, raised WCC
U&E: high urea, low K+
High CRP and ESR
Low B12 and folate
What does faecal calprotectin show?
Migration of neutrophils into mucosa
What is faecal elastase used for?
Shows disease is not of pancreatic origin
What basic imaging in used in IBD?
Abdominal x-ray: toxic megacolon
Erect CXR: air under diaphragm
What advanced imaging is used in IBD?
CT of abdomen and pelvis in suspected perforation
Barium follow through
MRE (MRI of intestines)
Gastro/sigmoid/colon-oscopy
