IBD Flashcards
what does IBD stand for
Inflammatory bowel disease
what two conditions are involved in IBD
UC
Crohn’s
what is Crohn’s
chronic inflammatory condition of the GI tract
what areas of the GI tract does Crohn’s affect
ANYWHERE from mouth to anus
describe the pathology of Crohn’s disease
patchy, segmental disease anywhere in the GI tract
what are the causes of Crohn’s disease
smoking
failure of the immune system
what is the link between the immune system and Crohn’s
Th1 CD4+ T cells and macrophages are constantly activated meaning excess pro-inflammatory cytokines are produced
what are the general symptoms of Crohn’s
anaemia
weight loss
bleeding PR
what are the symptoms of Crohn’s associated with the small intestine
abdominal cramps (pri-umbilical) diarrhoea obstruction
what are the symptoms of Crohn’s associated with the colon
abdominal cramps (lower abdomen) bloody diarrhoea
what are the symptoms of Crohn’s associated with the mouth
painful ulcers
swollen lips
angular chielitis
what are the symptoms of Crohn’s associated with the anus
peri-anal pain
anal abscess
what clinical investigations should be done for Crohn’s
PR exam
GI exam
Oral exam
Bloods
what other investigations should be done for Crohn’s
colonoscopy + mucosal biopsy
small bowel MRI
what is the treatment of Crohn’s (in order of what should be done first)
stop smoking
steroids
imunnosupressive drugs
anti-TNF alpha
what does anti-TNF alpha do
promotes apoptosis of activated T-lymphocytes
give examples of immunosuppressive drugs
azathioprine
meracaptopurine
methotrexate
what is UC
chronic inflammatory disorder
where is UC found
rectum and colon, starts at the rectum and moves proximally
what is the genetic cause of UC
HLA-DR2
NOD-2
what is the link between the immune system and UC
persistent activation of T-cells and macrophages causes excess pro-inflammatory cytokine production leading to bystander damage
what are the symptoms of UC
Diarrhoea Increased bowel frequency Urgency and tenesmus Incontinence Night rising Mucus and blood PR Lower abdominal Pain/ cramps
what are the non-GI symptoms of UC
Eyes: Uveitis
Liver: Primary sclerosing cholangitis
Joints: Arthritis, Ank Spondylitis
Skin: Pyoderma gangrenosum, erythema nodusum
what is the criteria for SEVERE UC
> 6 bloody stool in 24hrs + 1 of the following:
fever
tachycardia
anaemia
elevated ESR
what is the treatment of UC (in the order in which they would be given)
5ASA steroids immunosuppressive drugs anti-TNF alpha surgery = curative
give an example of 5ASA
mesalazine
what are skip lesions associated with
Crohn’s
what are skip lesions
Normal tissue interspersed between inflammation
what is transmural inflammation associated with
Crohn’s
what is toxic megacolon associated with
UC
what is primary sclerosing cholangitis associated with
UC
what is granulomas associated with
Crohn’s
high cancer risk is associated with what
UC
superficial inflammation only is associated with what
UC
strictures are common in what
Crohn’s
fistulae are common in what
Crohn’s
thicken bowel is associated with what
Crohn’s
mucosal ulceration is associated with what
UC
moderate cancer risk is associated with what
Crohn’s
“thumb-printing” on AXR is caused by what
UC
how big does the transverse colon have to be to be considered a toxic megacolon
> 5.5cm
how big does the caecum have to be to be considered a toxic megacolon
> 9cm
what are pseudopolyps associated with
UC
what IBD can be cured by surgery
UC
which IBD can be treated with 5ASA
UC
which IBD can be treated with smoking cessation
Crohn’s
what is deep/knife-like inflammation associated with
Crohn’s
what is eroding fissure associated with
Crohn’s
“cobble-stone mucosa” is caused by what
Crohn’s
“crypt abscess” are caused by what
UC
“goblet cell depletion” is caused by what
UC
