CT 1.1 IBD Flashcards
What are the characteristics of UC
Begins in the rectum and never occurs past the ileocecal valve. It is continuous
Disease is limited to mucosa and submucosa layers of the bowel wall
There is distorted crypt architecture and crypt abscesses form
Slight female predominance
Associated with primary sclerosing cholangitis
What investigations for IBD
Stool microscopy or culture to rule out t other things like salmonella
Faecal calprotectin
Colonoscopy
FBC - anaemia and elevated WCC
CRP and ESR
LFTs – UC can result in liver complications such primary sclerosing cholangitis
which condition has the following features
bowel wall thickening, abscesses or strictures
In UC muscularis propria is only involved in which kind of disease
fulminant disease
what are the symptoms of UC
diarrhoea
PR bleeding
fatigue
weight loss
fever
tachycardia * compensatory due to diarrhoea and anaemia
what is primary sclerosing cholangitis
condition in which the bile ducts become scarred and narrowed which may lead to bile stasis and therefore bacterial cholangitis. strictures eventually form
may present with jaundice. pruritus, ruq pain
diagnosed via MRCP
can be managed by putting stents into ducts
UDCA meds but dont slow disease progression
what are the three forms of crohns
ileocaecal disease *most common
small bowel disease
colonic disease
in crohns what layer of the bw do granulomas mostly form
submucosa so will be identified on surgical samples biopsies
what are complications of crohns
uveitis
erythema nodosum
pyoderma gangrenosum
aphthous ulcers
anal fissures
fistula
amyloidosis
what is the lead pipe sign
on barium enema colon looks like a pipe due to loss of haustra
mostly seen in UC
examples of aminosalicyclates
mesalazine
sulphasalazine
what are the side effects of aminosalicyclates
rashes
headaches
diarrhoea
interstitial nephritis
reversible infertility
what other therapies are considered as a step up to aminosalicylates
corticosteroids
eg pred
budesonide
beclomethasone
hydrocortisone
what immunomodulators can be used for more severe disease
azathioprine (affects A+G synthesis)
mercaptopurine
methotrexate (anti-folate)
ciclosporin (calcineurin inhibitor)
mycophenolate (affects purine synthesis in B+T cells)
examples of TNF alpha inhibitors
infliximab
adalimumab
are monoclonal antibodies which inactivate cytokines
what is the last resort for treatment for IBD
surgery but recurrence of disease is v high for crohns
for UC it is curative but reserved for severe instances like toxic megacolon
complications of UC
toxic megacolon
primary sclerosing cholangitis
colorectal cancer
