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Nutrition > IBD > Flashcards

IBD Flashcards

1
Q

how does cyclosporin work

A

it is an immunosuppressant
it works by inhibiting calcineurin
it also has approximately 34982743928743987239 drug interactions as it is a p450 inhibitor
it is also nephrotoxic

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2
Q

which IBD is ciclosporin used for

A

ulcerative colitis

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3
Q

how does methotrexate work

A

antimetabolite - it inhibits dihydrofolate reductase - used in the synthesis of purines and pyrimidines
it is contra indicated in patients with renal and hepatic impairment
it should always be given with folic acid to reduce toxiticity

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4
Q

which IBD is methotrexate used in the treatment of

A

Crohn’s disease
used for the induction and remission of disease
2nd line to AZAs or 6MP

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5
Q

What must be measured before starting azathioprine

A

TPMT

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6
Q

How does azathioprine work?

A

metabolised to 6-mercaptopurine
has a steroid sparing effect
used in Crohn’s and UC
cytotoxic - important for women of childbearing age

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7
Q

how are corticosteroids used n IBD

A

to induce remission
NOT for maintenance
UC –> Beclometasone
CD –> Budesonide

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8
Q

what is important to illicit from a patient history before giving infliximab

A

previous history of TB - can reactivate

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9
Q

how do infliximab and adalimumab work and which IBDs are they used in

A

anti-TNF alpha
Inflix –> CD and UC
Adal –> CD only

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10
Q

Aminosalicylates are first line for which IBD

A

UC

inhibits synthesis of inflammatory mediators

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11
Q

how does lactulosee interact with ASAs

A

alters pH so will affect absorption

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12
Q

in which IBD is surgery curative

A

UC

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13
Q

what are the features of UC

A

symmetrical continous, non-interrupted inflammation of the mucosal layer of the colon
usually involving the recturm

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14
Q

what are the features of CD

A

asymmetrical transmural inflammation with skip lesions affecting anywhere along the GI tract leading to fibrosis and formation of fistulae/abscesses

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15
Q

in which ethnic group is UC and CD more prevalent

A

those of jewish descent

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16
Q

what effect does smoking have on IBD

A

protective UC

more likely to develop CD

17
Q

which antibodies are found in the circulation of IBD patietns

A

PANCA - UC

ASCA - CD

18
Q

what might be the endoscopic findings in UC

A

diffuse continuous erythematous pinpoint ulcerations almost always with rectal involvemnt

19
Q

what might be the endoscopic findings in CD

A

large ulcerations, skip lesions, cobblestone appearance

rectum usually spared

20
Q

what might be the histological findings on biopsy for UC

A

cryptitis and crypt abscesses
branching of crypts
atrophy of glands (goblet cells)

21
Q

what might be the histological findings on biopsy for CD

A

transmural inflammation

granulomas

22
Q

what might be the radiological findings for UC

A 
loss of haustra
shortening of the colon
pinpoint ulcers
collar button ulcers
thumb printing
pseudopolyps
no fistulae

chronic:
halo sign - inflammation of fat around rectum

23
Q

what might be the radiological findings for CD

A 
deep ulcerations
nodular or stenotic terminal ileum (string sign)
comb sign (stranding of mesentery)
inflammed pseudopolyps
fistulae may be visible
24
Q

what is the presentation of UC

A 
tends to have relapsing course:
frequent small stools (tenesmus from proctitis)
lower ado cramping
joint pain (HLA27)
erythema nudism
pyoderma gangrenosum
25
Q

which infective agents are important to exclude in a Ddx of UC

A

shigella

campylobactor

26
Q

what does defective bile salt reabsorption lead to

A

irritation of the colon –> diarrhoea

27
Q

which infections are implicated in the aetiology of Crohn’s disease

A

M paratuberculosis
measles
paramyxovirus

28
Q

which mucocutaneous lesions are associated with Crohn’s disease

A

apthous ulcers
orofacial granulomatosis
erythema nodosum

29
Q

which infective agents are important to exclude in a Ddx of CD

A 
yersinia
m tuberculosis (Johne's disease)

Nutrition (11 decks)

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