crohn's & ulcerative colitis

Question 1

what is the main difference between crohn’s and ulcerative colitis?

Answer 1

crohn’s is both large and small bowel, colitis is only large

Question 2

what age are IBD common?

Answer 2

15-25y/o

50-80 y/o

Question 3

what is the gender risk for IBD?

Answer 3

crohn's = male>female
colitis= female>male

Question 4

what are the risk factors for IBD?

Answer 4

food intolerance
persisting viral infection/immune activation
smoking
genetic

Question 5

what are the crohn’s disease sites

Answer 5

any part of GIT and mouth
ileo-caecal region common
-causes vitB12 malabsorption

Question 6

what are the colitis sites?

Answer 6

always in rectum, extends up large bowel
continuous
only colon

Question 7

which is more likely to extend onto skin? (fissures)

Answer 7

crohns

Question 8

which is superficial?

Answer 8

colitis, crohns entire wall of intestine

Question 9

which is vascular?

Answer 9

colitis

Question 10

what are the microscopic features of colitis?

Answer 10

mucosal
vascular
mucosal abcesses

Question 11

what are the microscopic features of crohns?

Answer 11

transmural
granulomas
oedematous
-blockage of lymphatics occupying drainage channels

Question 12

what causes lymphatic obstruction in crohns?

Answer 12

inflammatory changes
lymphocytes
large multinucleated giant cells

Question 13

where does the inflammatory change occur in ulcerative colitis?

Answer 13

submucosa

Question 14

what are the symptoms of ulcerative colitis?

Answer 14

darrhoea
abdominal pain
PR bleeding

Question 15

what are the symptoms of crohns?

Answer 15

diarrhoea
abdominal pain
PR bleeding
small bowel disease
-pain-obstruction
-malabsorption - anal disease
mouth
-orofacial granulomatosis

Question 16

what are the investigations for IBD?

Answer 16

blood tests
-anaemia, CRP, ESR
faecal calprotectin
endoscopy

Question 17

what can be used if endoscopy no possible?

Answer 17

leukocyte scan
barium studies
bullet endoscopy

Question 18

what are the complications of UC?

Answer 18

carcinoma
risk increases w/ time
judgement if colectomy justified

Question 19

what tx is available to IBD?

Answer 19

medical-immunosuppressive
systemic steroids- prednisolone
local steroids
anti-inflammatories
-pentasa, mesalazine, sulphalazine
non steroid immunosuppressants
-azathioprine
-methotrexate
anti TNF-a therapy
-infliximab
-adalimumab

Question 20

when is surgery used?

Answer 20

when obstruction/blockage
colectomy cures UC
crohns-palliate symptoms
-remove obstructed segment
-drain abcesses
-close fistulae
usually results in stoma

Question 21

what is orofacial granulomatosis?

Answer 21

separate from crohns
not single condition
can present before crohn's in children
granuloma formation blocks lymphatics
lip & oral swelling 
-trigger can be food preservatives/additives