IBD

Question 1

what does IBD stand for

Answer 1

Inflammatory bowel disease

Question 2

what two conditions are involved in IBD

Answer 2

UC

Crohn’s

Question 3

what is Crohn’s

Answer 3

chronic inflammatory condition of the GI tract

Question 4

what areas of the GI tract does Crohn’s affect

Answer 4

ANYWHERE from mouth to anus

Question 5

describe the pathology of Crohn’s disease

Answer 5

patchy, segmental disease anywhere in the GI tract

Question 6

what are the causes of Crohn’s disease

Answer 6

smoking

failure of the immune system

Question 7

what is the link between the immune system and Crohn’s

Answer 7

Th1 CD4+ T cells and macrophages are constantly activated meaning excess pro-inflammatory cytokines are produced

Question 8

what are the general symptoms of Crohn’s

Answer 8

anaemia
weight loss
bleeding PR

Question 9

what are the symptoms of Crohn’s associated with the small intestine

Answer 9

abdominal cramps (pri-umbilical)
diarrhoea
obstruction

Question 10

what are the symptoms of Crohn’s associated with the colon

Answer 10

abdominal cramps (lower abdomen)
bloody diarrhoea

Question 11

what are the symptoms of Crohn’s associated with the mouth

Answer 11

painful ulcers
swollen lips
angular chielitis

Question 12

what are the symptoms of Crohn’s associated with the anus

Answer 12

peri-anal pain

anal abscess

Question 13

what clinical investigations should be done for Crohn’s

Answer 13

PR exam
GI exam
Oral exam
Bloods

Question 14

what other investigations should be done for Crohn’s

Answer 14

colonoscopy + mucosal biopsy

small bowel MRI

Question 15

what is the treatment of Crohn’s (in order of what should be done first)

Answer 15

stop smoking
steroids
imunnosupressive drugs
anti-TNF alpha

Question 16

what does anti-TNF alpha do

Answer 16

promotes apoptosis of activated T-lymphocytes

Question 17

give examples of immunosuppressive drugs

Answer 17

azathioprine
meracaptopurine
methotrexate

Question 18

what is UC

Answer 18

chronic inflammatory disorder

Question 19

where is UC found

Answer 19

rectum and colon, starts at the rectum and moves proximally

Question 20

what is the genetic cause of UC

Answer 20

HLA-DR2

NOD-2

Question 21

what is the link between the immune system and UC

Answer 21

persistent activation of T-cells and macrophages causes excess pro-inflammatory cytokine production leading to bystander damage

Question 22

what are the symptoms of UC

Answer 22

Diarrhoea 
Increased bowel frequency
Urgency and tenesmus
Incontinence 
Night rising 
Mucus and blood PR
Lower abdominal Pain/ cramps

Question 23

what are the non-GI symptoms of UC

Answer 23

Eyes: Uveitis
Liver: Primary sclerosing cholangitis
Joints: Arthritis, Ank Spondylitis
Skin: Pyoderma gangrenosum, erythema nodusum

Question 24

what is the criteria for SEVERE UC

Answer 24

> 6 bloody stool in 24hrs + 1 of the following:

fever
tachycardia
anaemia
elevated ESR

Question 25

what is the treatment of UC (in the order in which they would be given)

Answer 25

``` 5ASA steroids immunosuppressive drugs anti-TNF alpha surgery = curative ```

Question 26

give an example of 5ASA

Answer 26

mesalazine

Question 27

what are skip lesions associated with

Answer 27

Crohn's

Question 28

what are skip lesions

Answer 28

Normal tissue interspersed between inflammation

Question 29

what is transmural inflammation associated with

Answer 29

Crohn's

Question 30

what is toxic megacolon associated with

Answer 30

UC

Question 31

what is primary sclerosing cholangitis associated with

Answer 31

UC

Question 32

what is granulomas associated with

Answer 32

Crohn's

Question 33

high cancer risk is associated with what

Answer 33

UC

Question 34

superficial inflammation only is associated with what

Answer 34

UC

Question 35

strictures are common in what

Answer 35

Crohn's

Question 36

fistulae are common in what

Answer 36

Crohn's

Question 37

thicken bowel is associated with what

Answer 37

Crohn's

Question 38

mucosal ulceration is associated with what

Answer 38

UC

Question 39

moderate cancer risk is associated with what

Answer 39

Crohn's

Question 40

"thumb-printing" on AXR is caused by what

Answer 40

UC

Question 41

how big does the transverse colon have to be to be considered a toxic megacolon

Answer 41

>5.5cm

Question 42

how big does the caecum have to be to be considered a toxic megacolon

Answer 42

>9cm

Question 43

what are pseudopolyps associated with

Answer 43

UC

Question 44

what IBD can be cured by surgery

Answer 44

UC

Question 45

which IBD can be treated with 5ASA

Answer 45

UC

Question 46

which IBD can be treated with smoking cessation

Answer 46

Crohn's

Question 47

what is deep/knife-like inflammation associated with

Answer 47

Crohn's

Question 48

what is eroding fissure associated with

Answer 48

Crohn's

Question 49

"cobble-stone mucosa" is caused by what

Answer 49

Crohn's

Question 50

"crypt abscess" are caused by what

Answer 50

UC

Question 51

"goblet cell depletion" is caused by what

Answer 51

UC