IBD

Question 1

What is IBD?

Answer 1

Umbrella term forCrohn’s disease and Ulcerative colitis

Question 2

Which part of the GI tract does Crohn’s disease affect?

Answer 2

Any part but most commonly the terminal ileum and colon

Question 3

Which one has granuloma formation: Crohn’s or ulcerative colitis?

Answer 3

Crohn’s

Question 4

Which has skip lesions: Crohn’s or ulcerative colitis?

Answer 4

Crohn’s

Question 5

Which one does smoking improve symptoms of: Crohn’s or ulcerative colitis?

Answer 5

Ulcerative colitis

Question 6

What are the risk factors for Crohn’s disease?

Answer 6

Smoking, stress, depression, NSAIDs, oral contraceptives, appendectomy

Question 7

What are some non-specific symptoms of Crohn’s disease?

Answer 7

Weight loss, lethargy, bloating, flatulance

Question 8

What are some GI-specific symptoms of Crohn’s disease (specify which part of the GI tract these symptoms come from)

Answer 8

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

Question 9

Name some extra-intestinal symptoms of Cronh’s disease

Answer 9

Recurrent ulcers in mouth, erythema nodosum, pyoderma gangrenosum

Question 10

What is diagnostic of Crohn’s disease?

Answer 10

Colonoscopy with biopsy

Question 11

What conditions is faecal calprotectin raised in?

Answer 11

IBD (distinguishes it from IBS)

Question 12

What is the lifestyle management for Crohn’s disease?

Answer 12

Smoking cessation

Question 13

What is the pharmacological management of Crohn’s disease?

Answer 13

Corticosteroids (prednisolone)

Immunosuppressants (methotrexate, infliximab, azathioprine, sulfasalazine)

Question 14

Is ulcerative colitis associated with granulomas?

Answer 14

No

Question 15

What part of the GI tract does ulcerative colitis affect?

Answer 15

Colon and rectum only

Question 16

Which one of Crohn’s and ulcerative colitis is blood and mucus secretion seen?

Answer 16

Ulcerative colitis

Question 17

How do you induce remission in mild/moderate ulcerative colitis?

Answer 17

• first line: aminosalicylate (e.g. mesalazine)

- second line: corticosteroids (e.g. prednisolone)

Question 18

How do you induce remission in severe ulcerative colitis?

Answer 18

• first line: IV corticosteroids (e.g. hydrocortisone)

- second line: IV ciclosporin

Question 19

How do you maintain remission in ulcerative colitis?

Answer 19

• aminosalicylate (mesalazine)
• azathioprine
• mercaptopurine

Question 20

What are the complications of ulcerative colitis?

Answer 20

Toxic megacolon
Increased incidence of colon cancer
Primary sclerosing cholangitis
Osteoporosis due to steroid use

Question 21

What mnemonic is used for clinical features of ulcerative colitis?

Answer 21

5 Ps

Pyrexia, pseudopolyps, lead pipe radiological appearance, poo (blood diarhoea), proctitis

Question 22

Name two complications of ulcerative colitis

Answer 22

Anterior uveitis

Enteropathic arthritis

Question 23

Describe the classical microscopic features of UC

Answer 23

Crypt abscesses, and pseudopolyps

Question 24

What is non-caseating granulomas and transmural inflammation a classical histological features of?

Answer 24

Crohn’s disease