GI 10 - IBD Flashcards

1
Q

Name some triggers of IBD:

A
  • Infection
  • Diet
  • Smoking
  • Antibiotics
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2
Q

What is the typical presentation of ulcerative colitis?

A
  • Young adult
  • Urgent diarrhoea
  • Mucous/bloody stools

May also have problems with:

  • Skin
  • Liver/biliary tree
  • Eye
  • MSK pain
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3
Q

What is the typical presentation of Crohn’s disease?

A
  • Either 15-30yrs or 60+yrs

If ileum affected:

  • Colicky abdominal pain
  • Diarrhoea
  • Malabsorption
  • Weight loss

If colon affected:

  • Bloody/mucous diarrhoea
  • Malaise
  • Anorexia
  • Weight loss
  • Perianal disease
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4
Q

What part of the GI tract is affected by ulcerative colitis?

A
  • Continuous proximally from rectum, can affect whole colon

- Mucosa only

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5
Q

What part of the GI tract is affected by Crohn’s disease?

A
  • Can affect any part of GI tract (with skip lesions)

- Transmural

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6
Q

Is there a higher risk of strictures with UC or Crohn’s? Why?

A

Crohn’s

Transmural disease leading to thickening of wall and narrowing of the lumen, whereas UC only affects mucosa

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7
Q

What skin conditions are commonly seen with IBD?

A
  • Erythema nodosum
  • Pyoderma gangrenosum
  • Psoriasis
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8
Q

Which of IBD may be managed by dietary changes?

A

Crohn’s

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9
Q

What methods are commonly used to investigate IBD?

A
  • Blood test
  • Stool cultures
  • Abdominal XRay
  • CT scan
  • MRI scan
  • Colonoscopy
  • Barium enema
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10
Q

Which IBD can cause perianal disease?

A

Crohn’s disease

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11
Q

What are the macroscopic changes associated with UC?

A
  • Loss of haustra
  • Pseudopolyps
  • Loss of typical vascular pattern
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12
Q

What are the microscopic changes associated with UC?

A
  • Crypt abscesses/distortion
  • Decreased no. goblet cells
  • Inflammatory infiltrate into lamina propria
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13
Q

What are the macroscopic changes associated with Crohn’s disease?

A
  • Cobblestone appearance
  • Fistulae of bowel + bowel/bladder/vagina/skin
  • Ulcers
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14
Q

What are the microscopic changes associated with Crohn’s disease?

A

Granuloma formation

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15
Q

Which sign from a barium enema is associated with UC?

A

Lead pipe sign

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16
Q

Which sign from a barium enema is associated with Crohn’s disease?

A

String sign of Kantour

17
Q

Name some medications which are available for IBD:

A
  • Aminosalicylates ie Sulfasalazine
  • Corticosteroids ie Prednisolone
  • Immune system suppressors ie Azathioprine
  • Antibiotics
  • Anti-diarrhoea med
  • Pain relief
  • Iron/vit B12/Ca2+/vit D supplements
18
Q

What is the surgical option for UC? IS it curative?

A

Proctocolectomy +/- Ileoanal anastamosis

Curative

19
Q

What are the surgical options for Crohn’s disease?

Are they curative?

A
  • Strictureplasty
  • Resection +/- colostomy
  • Abscess drain

Not curative

20
Q

What is toxic megacolon, and with which IBD does it typically appear?

A
  • Dilation of colon due to inflammation extending into smooth muscle layer, causing paralysis
  • Neutrophils and macrophages produce NO = dilatation

Usually seen in ulcerative colitis