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FINALS - GI > IBD > Flashcards

IBD Flashcards

1
Q

where are UC legions found in the bowel

A

rectum

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2
Q

where does UC never extend past

A

ileocaecal valve

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3
Q

what is the peak incidence for UC

A

15-25 and 55-65

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4
Q

what are common GI symptoms of UC

A

bloody diarrhoea // urgency // tenesmus // left lower Q pain

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5
Q

what extraintestinal symptoms are common in UC only (2)

A

primary sclerosing cholangitis!! // uveitis

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6
Q

what extraintestinal symptoms are common in both UC and chrons (5)

A

arthritis // erythema nodosum // osteoporosis // pyoderma gangreosum // clubbing

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7
Q

what is the most common extraintestinal symptoms in IBD

A

arthritis

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8
Q

how is UC usually diagnosed

A

endoscopy/ colonscopy + biopsy

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9
Q

when is colonscopy in UC contraindicated and what is done instead

A

severe colitis incase of perforation –> flexible sigmoidoscopy

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10
Q

what is seen on colonscopy of UC

A

no inflamm beyond submucosa // pseudopolyps

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11
Q

what is seen on biopsy of UC

A

crypt absecc and low goblet cells

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12
Q

what is seen on barium enema of UC

A

loss of haustrations // pseudopolys // drainpipe colon

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13
Q

what classifies mild UC

A

<4 stools/ day and small blood

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14
Q

what classifies moderate UC

A

4-6 stools/ days // some blood

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15
Q

what classifies severe UC

A

> 6 bloody stools // systemic upset eg fever

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16
Q

how is remission initially achieved in mild UC (proctitis)

A

topical 5asa

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17
Q

what is 1st line mx to induce remission mild UC (proctitis)

A

topical 5 ASA’s (mesalazine)

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18
Q

if 1st line mx fails in mild UC proctitis what is offered next (2)

A

2nd = + oral 5ASA // 3rd = + oral or topical steroid

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19
Q

what what is 1st line mx to induce remission in proctosidmoiditis and left sided UC

A

topical 5ASA

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20
Q

what what is 2nd line mx to induce remission in proctosidmoiditis and left sided UC

A

oral 5ASA + top steroid/ ASA

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21
Q

what what is 3rd line mx to induce remission in proctosidmoiditis and left sided UC

A

stop topical treatments –> oral 5ASA and steroid

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22
Q

what what is 1st line mx to induce remission in extensive UC

A

topical 5ASA and oral 5ASA

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23
Q

what what is 2nd line mx to induce remission in extensive UC

A

stop topical –> 5ASA and steroids

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24
Q

what is given first line for severe colitis in UC

A

admission and IV steroids

25
what 2nd line treatment for severe colitis UC
(IV steroids) + ciclopsorin // surgery
26
how is remission maintained in proctitis and proctosigmoiditis (UC)
topical 5ASA +/- oral 5ASA
27
how is remission maintained in left sided and severe (UC)
low dose daily 5ASA
28
following a severe UC relapse or >2 exacerbations in a year what is given
oral azathioprine or mercaptpurine
29
what mx is NOT recommended in UC
methotrexate
30
what are common triggers of UC flares
stress // NSAIDs // abx // stopping smoking!
31
what are common triggers of UC flares
stress // NSAIDs // abx // stopping smoking!
32
what is toxic megacolon
total and non-obstrucive dilation of colon
33
how is toxic megacolon diagnosed
AXR --> thumbprinting
34
when does crohns usually present
late adolescence or early adult
35
what are symptoms of crohns
non specific // diarrgoea // abdo pain // perianal skin tags
36
what extraintestinal symtpoms are common in crohns (2)
arthritis // episcleritis
37
what blood tests support dx of crohns
raised CRP // raised faecal calprotectin // aneamia // low B12 and vit D
38
what marker correlates to crohns disease activity
CRP
39
which part of bowel does crohns usually affect
terminal ileum and colon but can be anywhere
40
what is seen on endocsopy of crohns
deep ulcers and skip legions and cobble stone
41
what is seen on biopsy of crohns (3)
inflamm from mucosa --> serosa // goblet cells // granulomas!!!
42
what is seen on enema of crohns
strictures // proximal bowel dilation // rose thorn ulcers // fistulae
43
why are crohns patients more prone to fistulas/ strictures and adhesions
inflammation in all layers down to serosa
44
1st mx to induce remission in crohns
glucocorticoids eg prednisolone (some patients use budesonide)
45
2nd mx to induce remission in crohns
5ASA eg mesalazine
46
what add on therapies can be used in crohns inducing remission
1. azathioprine or mercaptopurine // methotraxate if cant have 2. infliximab
47
what treatment can be given in isolated perianal disease
metronidazole
48
what is 1st line in maintaining crohns remission
azathrioprine or mercapropurine
49
what activity needs to be checked before starting azathrioprine or mercapropurine
TPMT
50
what is 2nd line in maintaining crohns remission
methotrexate
51
how are perianal fistulas diagnosed in crohns
MRI
52
how can perianal fistulas in crohns be managed medically
1. oral metro 2. infliximab
53
how can perianal fistulas in crohns be managed surgically
draining seton
54
how are perianal abscess managed in crohns
incisiion, drainage, abx
55
what are complications of crohns
small bowel cancer // colorectal cancer!!! // osteoporosis
56
in UC, how is poorly controlled/ unresponsive colitis treated surgically
sub total colectomy
57
in UC, how is poorly controlled/ unresponsive colitis treated surgically
sub total colectomy
58
what does terminal ileal crohns increase risk of
gallstones

FINALS - GI (18 decks)

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