IBD Flashcards
What is IBD?
Umbrella term forCrohn’s disease and Ulcerative colitis
Which part of the GI tract does Crohn’s disease affect?
Any part but most commonly the terminal ileum and colon
Which one has granuloma formation: Crohn’s or ulcerative colitis?
Crohn’s
Which has skip lesions: Crohn’s or ulcerative colitis?
Crohn’s
Which one does smoking improve symptoms of: Crohn’s or ulcerative colitis?
Ulcerative colitis
What are the risk factors for Crohn’s disease?
Smoking, stress, depression, NSAIDs, oral contraceptives, appendectomy
What are some non-specific symptoms of Crohn’s disease?
Weight loss, lethargy, bloating, flatulance
What are some GI-specific symptoms of Crohn’s disease (specify which part of the GI tract these symptoms come from)
Perianal - discomfort, pain and itchiness around anus, anal fissure/fistulae/abscesses/tags
Small bowel - pain, weight loss, steatorrhoea
Terminal ileum - abdo pain especially in right iliac fossa
Colon - diarrhoea accompanies bleeding and abdominal pain
Name some extra-intestinal symptoms of Cronh’s disease
Recurrent ulcers in mouth, erythema nodosum, pyoderma gangrenosum
What is diagnostic of Crohn’s disease?
Colonoscopy with biopsy
What conditions is faecal calprotectin raised in?
IBD (distinguishes it from IBS)
What is the lifestyle management for Crohn’s disease?
Smoking cessation
What is the pharmacological management of Crohn’s disease?
Corticosteroids (prednisolone)
Immunosuppressants (methotrexate, infliximab, azathioprine, sulfasalazine)
Is ulcerative colitis associated with granulomas?
No
What part of the GI tract does ulcerative colitis affect?
Colon and rectum only
Which one of Crohn’s and ulcerative colitis is blood and mucus secretion seen?
Ulcerative colitis
How do you induce remission in mild/moderate ulcerative colitis?
- first line: aminosalicylate (e.g. mesalazine)
- second line: corticosteroids (e.g. prednisolone)
How do you induce remission in severe ulcerative colitis?
- first line: IV corticosteroids (e.g. hydrocortisone)
- second line: IV ciclosporin
How do you maintain remission in ulcerative colitis?
- aminosalicylate (mesalazine)
- azathioprine
- mercaptopurine
What are the complications of ulcerative colitis?
Toxic megacolon
Increased incidence of colon cancer
Primary sclerosing cholangitis
Osteoporosis due to steroid use
What mnemonic is used for clinical features of ulcerative colitis?
5 Ps
Pyrexia, pseudopolyps, lead pipe radiological appearance, poo (blood diarhoea), proctitis
Name two complications of ulcerative colitis
Anterior uveitis
Enteropathic arthritis
Describe the classical microscopic features of UC
Crypt abscesses, and pseudopolyps
What is non-caseating granulomas and transmural inflammation a classical histological features of?
Crohn’s disease
