IBD Flashcards
why are TPMT levels checked before azothioprine?
some people have a defective enzyme which can lead to azothiorpine causing bone marrow toxicity in them as it is not being properly metabolised
what is the investigation of choice for a suspected perianal fistula?
MRI is the investigation of choice for suspected perianal fistulae - can be used to determine if there (is an abscess and if the fistula is simple (low fistula) or complex (high fistula that passes through or above muscle layers)
what are complications of crohs?
- small bowel cancer (standard incidence ratio = 40)
- colorectal cancer (standard incidence ratio = 2, i.e. less than the risk associated with ulcerative colitis)
- osteoporosis
which drug used to treat UC and RA causes haemolytic anaemia?
sulfasalezine
- cause haemolytic anaemia with Heinz bodies.
- blood tests show low haemoglobin, increased reticulocytes and the peripheral smear shows multiple Heinz bodies, confirming the diagnosis.
what is left Lower quadrant pain more typical of?
UC
which causes more weight loss?
chrons- due to loss of absorption by the small intestines
in which is bloody stool more common?
UC
which affects the RLQ?
crohns
what are features of UC?
always involves rectum
- confined to colon
- continuous
- superficial
what are features of crohs?
- transmural (causing fistulation and luminal stenosis)
- discontinuous (skip lesions - rose thorn ulcers)
- mouth to anus (terminal ileum most common)
which is more likely to cause bowel obstruction?
crohns
what is the difference in extra intestinal features present in CD vs UC?
Arthritis is the most common extra-intestinal feature in both CD and UC
- Episcleritis is more common in CD
- Primary sclerosing cholangitis is much more common in UC
- Uveitis is more common in UC
in which is gallstones more common?
CD
secondary to reduced bile acid reabsorption
Oxalate renal stones*
what is the difference in histology between the two?
CD:
increased goblet cells
granulomas
UC:
neutrophils migrate through the walls of glands to form crypt abscesses
depletion of goblet cells and mucin from gland epithelium
granulomas are infrequent
how does CD appear on endoscopy?
cobblestone appearance