IBD

Question 1

what is a history of crohn’s disease described as

Answer 1

may be unrecognised for years

recurring periods of flare ups and remission

Question 2

what is a history of UC described as

Answer 2

history of weeks

gradual onset of diarrhoea with blood and mucus +/- weight loss and blood on rectal examination

Question 3

where does crohns disease affect

Answer 3

any part of the Gi tract including the mouth

Question 4

where does UC affect

Answer 4

colon

Question 5

what are the three parts of the colon that UC can affect

Answer 5

rectum alone (proctitis)
extend proximally form the rectum to involve the sigmoid and descending colon (distal colitis/left-sided colitis)
whole colon (extensive colitis)
(also inflammation of distal ileum (backwash ileitits))

Question 6

what happens to the part of the bowel affect by Crohn’s disease

Answer 6

bowel is thickened and narrowed
deep ulcers and fissures in the mucosa
fistulae and abcesses may be seen which reflect penetrating disease

Question 7

how is the colon affect by UC

Answer 7

mucosa looks reddened, inflamed and bleeds easily

in severe disease there is an extensive ulceration with the adjacent mucosa appearing as inflammatory (pseudo) polyps

Question 8

which layers of tissue are affected by crohn’s disease

Answer 8

al inflammation extends through all layers (transmural)

Question 9

what layers of tissue are affected by UC

Answer 9

superficial inflammation is seen
mucosa shows chronic inflammation cell infiltrate in the lamina propria
crypt abscesses and goblet cell depletion also seen

Question 10

what chronic inflammatory cells are seen in crohns

Answer 10

increase in chronic inflammatory cells and lymphoid hyperplasia in 50-60% of patients granulomas present
granulomas are non-caseating epitheliod cell aggregates with Langhans’ giant cells

Question 11

what is CUTE

Answer 11

colitis of undetermined type and aetiology

Question 12

what is the difference in the inflammation in crohn’s disease and UC

Answer 12

crohn’s disease deep-transmural and patchy

UC mucosal and continuous

Question 13

are granulomas present in crohns disease or ulcerative colitis

Answer 13

crohn’s disease

Question 14

how are goblet cells affected in crohns and UC

Answer 14

present in crohns disease but depleted in UC

Question 15

what should always be performed if a diagnosis of IBD is suspected

Answer 15

stool cultures including clostridium difficile if diarrhoea is present

Question 16

how is crohns disease managed

Answer 16

aim to induce and then maintain clinical remission and achieve mucosal healing to prevent complications

Question 17

how is remission induced in crohns disease

Answer 17

oral of IV glutocorticoids (if moderate to severe Prednisolone if less sever then budesonide)
enteral nutrition
anti-TNF nutrition

Question 18

what are extraintesitnal symptoms of BD

Answer 18

spondylartyropathy 
apthous ulcers 
pyoderma gangrenosum 
uveitis 
anaemia

Question 19

what are some of the oral presentations of crohns disease

Answer 19

mucosal tags
cobblestone mucosa
swollen lips
angular cheilitis

Question 20

how should you treat severe colitis

Answer 20

in hospital start with IV steroids

Question 21

benefits of suppositories

Answer 21

better mucosal adherence then enemas

Question 22

what is more common with gallstones UC or crohns

Answer 22

crohns

Question 23

where does the inflammation extend to in UC

Answer 23

no inflammation beyond submucosa, inflammatory cell infiltrate in lamina propria

Question 24

what cells are involved in forming crypt abscesses

Answer 24

neutrophils migrate through walls of glands to form crypt abscesses

Question 25

when do you get cobblestoning

Answer 25

crohns

Question 26

what are psuedopolys formed from

Answer 26

theses are surviving normal mucosa in UC