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General, Upper GI, Hepatobiliary + Colorectal/Lower GI Surgery > IBD > Flashcards

IBD Flashcards

1
Q

Differential diagnosis of colitis

A

Infectious - bacterial i.e. E. coli, diverticulitis
Inflammatory - IBD, Ischaemic
Cancer?

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2
Q

What is pancolitis?

A

Inflammation of the whole colon

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3
Q

What is the most common cause of pancolitis?

A

Ulcerative colitis

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4
Q

Pancolitis is usually caused by UC, what are other causes?

A

C. difficile, rheumatoid arthritis

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5
Q

Ulcerative colitis VS Crohn’s disease

Which one has ‘skip’ lesions?

A

Crohn’s disease

UC has continuous segments

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6
Q

Ulcerative colitis VS Crohn’s disease

Which one has ‘mucosal inflammation’

A

UC

Crohn’s has transmural inflammation

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7
Q

Ulcerative colitis VS Crohn’s disease

Which one has ‘granulomas?’

A

Crohn’s - UC does not have granulomas

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8
Q

Ulcerative colitis VS Crohn’s disease

Which one has ‘fistulae’?

A

Crohn’s has fistulae

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9
Q

Ulcerative colitis VS Crohn’s disease

Which one is in colon only?

A

UC - Crohn’s disease is anywhere in GIT

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10
Q

Fistulae is a common complication of what IBD?

A

Crohn’s

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11
Q

How to treat a fistulae associated with Crohn’s

A

Treat any infection
Remove distal obstruction
Reduce flow
(Rehydrate)

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12
Q

Management of Fistula mnemonic - SNAP

A

S = Sepsis - identify whether there is sepsis and it’s source, manage appropriately
N = Nutrition - optimise oral and/or enteral intake
Initiate parenteral nutrition if appropriate
A = Anatomical Mapping
P = Plan for potential surgical intervention

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13
Q

Extraintestinal manifestations - aphthous ulcers - which IBD?

A

Crohn’s

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14
Q

Pyoderma gangrenosum is a potential complication of both IBD types (more common in UC) - what is it?

A

Lesions in skin filled with pus, ulcer has indistinct edges and a unique purplish colour
Painful and slow to heal

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15
Q

Erythema nodosum is a skin condition that most often affects people with …

A

Crohn’s disease

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16
Q

What is this showing?

A

Erythema nodosum - an inflammatory condition characterised by inflammation of the fat cells under the skin, resulting in tender red nodules or lumps that are usually seen on both shins. Typically seen in Crohn’s (15% develop this), also idiopathic causes and some infections, medications, autoimmune disorders and potentially pregnancy

17
Q

What is episcleritis?

A

Persistent irritated red eye - discomfort, not severe pain
No visual change
Vessels mobile over sclera
Usually localised

18
Q

What is the most common eye manifestation of IBD?

A

Episcleritis - persistent red irritated eye, no vision loss, usually localised

19
Q

What is neutropenic sepsis?

A

Potentially life-threatening complication of neutropenia (low neutrophil count)
Complication of anti cancer or immunosuppressive drug treatment
Temp of greater than 38 and any symptoms/signs of sepsis, in a person with a neutrophil count of 0.5 x 10^9/L or lower

20
Q

Neutropenic sepsis is a complication of what treatments?

A

Immunosuppressive drugs and anti cancer treatment

21
Q

Define septic shock

A

Sepsis with hypotension not responsive to 20ml/kg or requiring vasopressors

22
Q

Define sepsis

A

Life-threatening organ dysfunction (medical emergency) caused by a dysregulated host response to infection

23
Q

Severe sepsis - define

A

Sepsis with Organ dysfunction or high lactate

24
Q

Sepsis 6

A

Take - blood cultures, lactate and Hb, urine output

Give - oxygen, antibiotics, fluid challenge

25
Q

Types of shock:

A

Cardio genie, hypovolaemic, obstructive, distributive (septic, anaphylactic, neurogenic)

26
Q

3 types of distributive shock

A

Septic, anaphylactic, neurogenic shock

27
Q

Neutropenic sepsis - what bacteria is it? And how do we treat?

A

Gram + or negative bacteria
Broad spectrum antibiotics
Anti-fungals +/-

28
Q

Primary sclerosing cholangitis is associated with …

A

Ulcerative colitis

29
Q

Someone that is thin, but not cachectic is less likely to have what?

A

Crohn’s with ileitis and malabsorption

30
Q

Neutrophil count of 0.1 is suggestive of …

A

Agranulocytosis- can be due to side effects of immunosuppressive drugs or anti cancer therapy

31
Q

Tender brushes on skin - usually shins indicates …

A

Erythema nodosum

32
Q

‘Skip lesions’ on colonoscopy and transmural inflammation with granulomas =

A

Crohn’s disease

33
Q

Abdominal distension in acute colitis - important to do an abdominal X-ray to look for what?

A

Toxic mega colon - dilated transverse colon - it is life-threatening

General, Upper GI, Hepatobiliary + Colorectal/Lower GI Surgery (39 decks)

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