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Year 1: Gastrointestinal > GI: IBD > Flashcards

GI: IBD Flashcards

1
Q

What are the two types of IBD?

A

Crohn’s disease

Ulcerative Colitis

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2
Q

Which interacting co-factors result in IBD?

A

Genetics
Environment
Host immune response

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3
Q

Which type of IBD has a greater associated genetic link?

A

Crohn’s

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4
Q

Mutations in which gene predisposes IBD?

A

NOD2 gene on chromosome 16

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5
Q

How does smoking affect the two types of IBD?

A

Aggravates Crohn’s

Protective effect in UC

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6
Q

Which cells mediate Crohn’s disease?

A

TH1 cells

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7
Q

Which cells mediate UC?

A

TH1 + TH2 cells

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8
Q

At what age does IBD typically present?

A

Teens- twenties

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9
Q

Which part of the GI tract is affected in Crohn’s disease?

A

ANY!

Most common in the terminal ileum and colon

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10
Q

Which part of the GI tract is affected in UC?

A

Inflammation begins in the rectum and extends proximally. Affects the colon only

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11
Q

What are the 2 main differences between the inflammation in Crohn’s and UC?

A

Crohns- discontinuous ‘skip lesion’ + transmural

UC- Continuous + confined to the mucosa

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12
Q

What would a mucosal biopsy of a Crohn’s patient show?

A

Deep ulcers and fissures

Cobblestoned mucosal appearance

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13
Q

What would a mucosal biopsy of a UC patient show?

A

Red mucosa which bleeds easily

Pseudopolyps + ulcers in severe disease

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14
Q

Which form of IBD is associated with granulomas?

A

Crohn’s disease

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15
Q

Which form of IBD is associated with crypt abscesses?

A

Ulcerative Colitis

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16
Q

How does UC typically present?

A

Diarrhoea which often contains blood and mucus

17
Q

How many bloody stools per day indicates mild UC?

A

Less than 4

18
Q

How many bloody stools indicates severe UC?

A

Greater than 6

19
Q

How does Crohn’s disease affecting the ileum present?

A

Abdominal pain + weight loss

20
Q

How does Crohn’s disease affecting the colon present?

A

Diarrhoea, bleeding, pain on defecation

21
Q

What features are associated with perianal disease due to Crohn’s?

A

Anal tags
fissures
fistulae
abscess formation

22
Q

What blood test results might be expected in a patient with acute Crohn’s disease?

A

Increased platelet count
Increased ESR
Increased CRP

23
Q

Which investigations undertaken to diagnose IBD?

A

Sigmoidoscopy + biopsy

Colonoscopy + biopsy

24
Q

Which drugs are given for mild-moderate UC?

A

First line: Oral 5-ASA, e.g. mesalazine

Second line if response poor: Oral prednisolone

25
Q

Which drug is given for severe UC?

A

Oral prednisolone

26
Q

Which drugs are given for severe UC with systemic features?

A

Hydrocortisone
Infliximab (anti-TNF)
Ciclosporin

27
Q

Which drugs are given to maintain remission in UC?

A

5-ASA

Azathioprine (immunosuppressant)

28
Q

Which drug is given in mild Crohn’s only?

A

Oral 5-ASA

29
Q

Which drug is given in moderate-severe Crohn’s?

A

Oral prednisolone

30
Q

Which drugs are given to maintain remission in Crohn’s?

A

Azathioprine

Infliximab

31
Q

Which drug is given in severe perianal disease?

A

Metronidazole

32
Q

How do 5-ASA drugs work? What are the side effects?

A

Anti-inflammatory

Diarrhoea

33
Q

How do corticosteroids work? What are the side effects?

A

Anti-inflammatory

Weight gain, hypertension, osteoporosis, growth failure in children

34
Q

What are the side effects of immunosuppressant drugs such as Azathioprine?

A

Bone marrow suppression
Pancreatitis
Hepatitis
Allergic reaction

35
Q

Which drug should azathioprine never be taken with?

A

Allopurinol (used to treat gout)

36
Q

How do Anti-tNF drugs work? What are the side effects?

A

Promote apoptosis of activated T lymphocytes

Increased risk of infection and cancer

37
Q

When is surgery for IBD indicated?

A

Failure to respond to medications
Complications, e.g. obstruction, abscess/fistulae (crohn’s)
Dysplasia of colon mucosa (cancer)

Year 1: Gastrointestinal (14 decks)

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