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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
Q

what 2nd line treatment for severe colitis UC

A

(IV steroids) + ciclopsorin // surgery

26
Q

how is remission maintained in proctitis and proctosigmoiditis (UC)

A

topical 5ASA +/- oral 5ASA

27
Q

how is remission maintained in left sided and severe (UC)

A

low dose daily 5ASA

28
Q

following a severe UC relapse or >2 exacerbations in a year what is given

A

oral azathioprine or mercaptpurine

29
Q

what mx is NOT recommended in UC

A

methotrexate

30
Q

what are common triggers of UC flares

A

stress // NSAIDs // abx // stopping smoking!

31
Q

what are common triggers of UC flares

A

stress // NSAIDs // abx // stopping smoking!

32
Q

what is toxic megacolon

A

total and non-obstrucive dilation of colon

33
Q

how is toxic megacolon diagnosed

A

AXR –> thumbprinting

34
Q

when does crohns usually present

A

late adolescence or early adult

35
Q

what are symptoms of crohns

A

non specific // diarrgoea // abdo pain // perianal skin tags

36
Q

what extraintestinal symtpoms are common in crohns (2)

A

arthritis // episcleritis

37
Q

what blood tests support dx of crohns

A

raised CRP // raised faecal calprotectin // aneamia // low B12 and vit D

38
Q

what marker correlates to crohns disease activity

A

CRP

39
Q

which part of bowel does crohns usually affect

A

terminal ileum and colon but can be anywhere

40
Q

what is seen on endocsopy of crohns

A

deep ulcers and skip legions and cobble stone

41
Q

what is seen on biopsy of crohns (3)

A

inflamm from mucosa –> serosa // goblet cells // granulomas!!!

42
Q

what is seen on enema of crohns

A

strictures // proximal bowel dilation // rose thorn ulcers // fistulae

43
Q

why are crohns patients more prone to fistulas/ strictures and adhesions

A

inflammation in all layers down to serosa

44
Q

1st mx to induce remission in crohns

A

glucocorticoids eg prednisolone (some patients use budesonide)

45
Q

2nd mx to induce remission in crohns

A

5ASA eg mesalazine

46
Q

what add on therapies can be used in crohns inducing remission

A
  1. azathioprine or mercaptopurine // methotraxate if cant have 2. infliximab
47
Q

what treatment can be given in isolated perianal disease

A

metronidazole

48
Q

what is 1st line in maintaining crohns remission

A

azathrioprine or mercapropurine

49
Q

what activity needs to be checked before starting azathrioprine or mercapropurine

A

TPMT

50
Q

what is 2nd line in maintaining crohns remission

A

methotrexate

51
Q

how are perianal fistulas diagnosed in crohns

A

MRI

52
Q

how can perianal fistulas in crohns be managed medically

A
  1. oral metro 2. infliximab
53
Q

how can perianal fistulas in crohns be managed surgically

A

draining seton

54
Q

how are perianal abscess managed in crohns

A

incisiion, drainage, abx

55
Q

what are complications of crohns

A

small bowel cancer // colorectal cancer!!! // osteoporosis

56
Q

in UC, how is poorly controlled/ unresponsive colitis treated surgically

A

sub total colectomy

57
Q

in UC, how is poorly controlled/ unresponsive colitis treated surgically

A

sub total colectomy

58
Q

what does terminal ileal crohns increase risk of

A

gallstones

FINALS - GI (18 decks)

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