IBD

Question 1

Crohns Features?

Answer 1

CROWS NESTS
No Blood or Mucus
Entire GI Tract
Skip Lesions on endoscopy
Terminal Ileum most affected and transmural (full thickness) inflammation
Smoke is risk factor
strictures and fistulas
weight loss

Question 2

Ulcerative Colitis features

Answer 2

CLOSE UP
Continous Inflammation
Limited to Colon and Rectum
Only Superficial mucosa affected
smoking is protective
excrete blood and mucus
use aminosalicylates
primary sclerosing cholangitis

Question 3

Tests for IBD

Answer 3

CRP, ESR and WBC
Faecal Calproectin
Endoscopy (OGD and Colonoscopy)

Question 4

Treating Crohns

Answer 4

Remission: Steroids eg Oral Pred or IV Hydrocortisone

Can add
- Azathioprine
- Mercaptopurine
- methotrexate
-infiliximab
-adalimuab

Maintain remission
- First line: Azathioprine, Mercaptopurine
-Alt: methotrexate, infliximab, adalimumab

Surgery: when only distal ileum can remove this area

Question 5

Treating Ulcerative Colitis

Answer 5

Induce Remission
Mild to Mod
- 1: Aminosalicylate eg Mesalazine oral or rectal
- 2: corticosteroid eg pred

Severe
1: IV Corticosteroid eg hydrocortisone
2: iv ciclosporin

Maintain remission
- aminosalicylate
-azathioprine
-mercaptopurine

Surgery
- Panproctocolectomy with Ileostomy or ileo-anal astomosis