IBD Flashcards
What is the main histological difference between UC and CD?
CD - presence of granulomas
UC - absence of granulomas
What type of pattern does inflammation follow in CD?
Skip lesions
In a non-continous way
What layers of the gut wall are generally affected in CD?
Generally all the layers
What layer/s of the gut wall are affected in UC?
Generally only the mucosa
What type of pattern does inflammation follow in UC?
Continous manner
No Skip lesions
What part of the GIT does UC affect?
The colon only
What part of the GIT does crohn’s affect?
Can affect any part of the gut tube
What are the main symptoms in UC?
Rectal bleeding
Blood in stools
Mucus stools
What do the symptoms of CD depend on?
The location of the inflammation
What would be possible symptom in Crohn’s colitis?
Bloody diarrhoea
Loss of mucus
What type of Crohn’s could lead to malabsorption?
Ileal Crohn’s
What are the investigations for UC?
Endoscopy
Colonoscopy
Sigmoidoscopy
Tissue biopsy for pathology
What are the investigations for CD?
Lab tests Anaemia CRP LFTs Endoscopy AXR Barium studies Endoscopy Colonoscopy Sigmoidoscopy
What is the treatment for IBD?
Aminosalicylates – (anti-inflammatory) Oral or rectal admission depending on where is closer to the site of main inflammation Corticosteroids Immunosuppressant’s Biologics Infliximab - form of immune suppressor
What is the action of aminosalicylates?
Anti-inflammatory
What is infliximab a form of?
Immune suppressor
What is the risk with infliximab?
Malignancy 1-2%
What is required to put a patient on immunosuppressants?
Specialist care and close monitoring
What type of appearance is Crohn’s said to have on endoscopy?
Cobblestone
What is IBD?
Chronic relapsing inflammatory
What are the two types of IBD?
Ulcerative Colitis
Crohn’s
Where does UC affect?
Only the colon
Does Crohn’s demonstrate continous or skipping inflammation?
Skipping
Does UC demonstrate continous or skipping inflammation?
Continous
Which age does UC peak at?
20-40
Who is UC more common in M or F?
F
What are the symptoms of UC?
Bloody diarrhoea
Abdo pain
Weight loss
Where does inflammation always start in UC?
In the rectum
Where does the inflammation in UC spread?
Rectum proximally
What is classified as a severe attack of UC?
Stool frequency >6 stools a day with blood AND Fever >37.5 >90bp (tachycardia) ESR raised Anaemia Hb <10g/dl Albumin <30g/l
Are M or F more affected with Crohn’s Disease?
Equal
Where does Crohn’s disease affect?
Anywhere from mouth to anus
What type of lesions are present in CD?
Skip lesions
What are the clinical features of CD?
Depends on which region is affected
What are the signs and symptoms of CD?
Diarrhoea Abdo pain Weight loss Malaise Lethargy Anorexia Malabsorption (anemia, vitamin deficient ect..)
What signs in the blood can suggest IBD?
High ESR High CRP High platelet High WCC Low Hb Low albumin
What can be present in a stool sample suggesting IBD?
Calcprotectin
In which IBD are granulomas present?
CD
In which IBD are goblet cells depleted?
UC
In which IBD can fistulae be present?
CD
What are differential diagnoses for IBD?
Chronic diarrhoea
Ileo-caecal TB
Infective, amoebic and ischaemic colitis
What is a potential long term complication of UC?
Colonic carcinoma
What are the surgical indications for Crohn’s disease?
Failure of medical management Relief of obstructive symptoms Management of fistulae Management of intra-abdominal abscess Management of anal conditions Failure to thrive
Is CD curative?
No
Rx for IBD
5ASA
Corticosteroids e.g prednisolone
Immunosuppressants e.g azathioprine
Biologics e.g infliximab
Surgery if unable to manage
