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Alimentry > IBD > Flashcards

IBD Flashcards

1
Q

What affects only the colon, UC or CD

A

UC

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2
Q

What develops in patches, UC or Crohn’s disease

A

Crohns

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3
Q

For patients who have features of both, what are they classed as x

A

IBD-U

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4
Q

What is microscopic colitis

A

Inflammation that can only be seen under microscope

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5
Q

What are the two forms of microscopic colitis

A

Collagenous: thickening of subepithelial collegen band

Lymphocytic colitis

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6
Q

How does microscopic colitis present

A

Chronic, non bloody, watery diarrhoea with no macroscopic abnormalities

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7
Q

What is associated with microscopic colitis

A

Autoimmune disease, rheumatoid, thyroid, coeliac

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8
Q

What are risk factors for IBD

A 
Smoking 
Stoping smoking in UC 
Young Asian men coming west
Genetics: snp (nod2) 
Heritiary
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9
Q

Describe the microbial communities in IBD

A

Dysbiosis

Increase in actionbacteria, proteobscteria and decrease in bacteroides species

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10
Q

Describe clinical profile of someone with UC

A

Peak 20-40
Makes = females
Bloody diarrhoea, abdominal pain, Weight loss and fatigue

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11
Q 
In UC where does
Procitis 
Procitisigmoidtisi 
Left side colitis 
Extensive 
Pancolitis 
Effect
A 
Procolitis effects rectum only 
Rectum to sigmoid 
Left sided up to splenic flexure
Extensive up to hepatic flexure
Pancolitis whole colon
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12
Q

For proctitis what has to be check to make sure it is IBD

A

STI, Chlymydia and ghonorea

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13
Q

In someone suffering from UC procolitis what symptoms may they experience

A

Frequency and urgency to go
Small volume mucous and blood
Constipation
Responds to topical therapy

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14
Q

How is UC severity, what score is used

A

True love and witts

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15
Q

What are the categories in true love and witts criteria

A

Mi,d
Moderate
Sever
Fulminant

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16
Q

If I have 10 stools a day +bleeding , toxicity is this sever or fulminant

A

Fuliminant

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17
Q

In UC what investigations are conducted

A

Bloods - CRP increase, albumin decrease
Stool culture to rule out infection
Faecal calprotectin
Colonoscopy

18
Q

What is considered a normal level of faecal calprotectin in the stool

A

0-50 normal
59-200 equivocal
>200 elevates

19
Q

What is faecal calprotectin a measure of

A

Any inflammation in the gut, not just UC or Cd

20
Q

What is the name of the poo chart

A

Bristol

21
Q

In acute sever colitis, how is it treated in first 24 hours

A 
4 stools for C diff
Blood tests
Stool chart
Avoid specific drugs, NSAIDs, opiates,anti-diarrhoea’s 
IV conticosterioids, methyl pred twice daly 
IV hydration 
Lmwh 
Axr for toxic diliation
22
Q

What are complications of crohns

A

Inflammation
Stricture
Fistula

23
Q

In symptoms with Crohn’s disease what do symptoms depend on

A

Where in GI is it occurring

24
Q

What are the investigations for cd

A

Same as UC
+ small bowel mri
Only occasionally do you do CT to rule out abscess

25
Q

Histologically what is the diff betweeen CD and UC

A

Cd causes granulomatous, transmural

UC limited to muscosa, globet cells lost, crypt abscesses

26
Q

What are the complications of CD

A

Inflammation
Stricture
Fistula
Abscess

27
Q

What symptoms does perianal CD cause

A

Pain in anus
Inability to sit
Plus

28
Q

What is the investigations used for someone with perianal Crohn’s disease

A

MRI of pelvis

Examination under anasthetic

29
Q

What treatment is given to someone with perianal Crohn’s disease

A

Surgery to drain abbesses and seton stitch

Medical antibiotics and biological therapy

30
Q

What are the extra intestinal manifestations of IBD

A 
Mouth ulcers 
Skin rashes
Musculoskeletal 
Eyes
Primary sclerosing cholangitis
31
Q

What factors determine risk to carinoma from IBD

A

Extent

Duration.

32
Q

When is someone first colitis survaliienced

A

10 years

33
Q

What is 1 st line treatment for both during and induction of remission

A

5-ASA
ONLY in UC mile - moderat
No more than 3 g per day orally or suppository in rectal disease

34
Q

What is second line of tresatment

A

Prednisolone (40mg per day) tapering it down with calcium and vit D to reduce side effect of bone density
Budesonide which though less effective, less side effects
INDUCE REMISION IN BOH UC AND CROHNS

35
Q

What is the 3rd line of treatment

A

Immunomodulation in both UC and crohns
Azathioptine/ 6 MP: requires monitoring of blood due to hepatoxicity, pancreatitis, lymphoma risk and skin cancer, 28% intolerant

Methotrexate : crohns only, is teratogenic

36
Q

What is the 4th line of treatment

A

Monoclonal antibodies

See slide

37
Q

What has been found to be equally effective as steroids

A

Elemental feeding

Though hard to comply, for children

38
Q

In someone acutely I’ll, what is the surgery called

A

Subtotal colectomy, leaving only recital remaining

39
Q

After someone who has had subtotal colectmy what are their two options regarding the rectum

A

Pouch

Removal

40
Q

Can someone with CD get a pouch

A

No only UC

Alimentry (9 decks)

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