IBD

Question 1

Give 3 eye problems associated with IBD.

Answer 1

Episcleritis
Uveitis
Scleritis

Question 2

What is pancolitis?

Answer 2

When UC involves both the rectum and colon

Question 3

What is the cause of backwash ileitis?

Answer 3

Incompetent ileocaecal valve

Question 4

What is the risk of concordance between identical twins in IBD?

Answer 4

70%

Question 5

Give two broad causes of IBD

Answer 5

Autoimmune dysfunction in response to a trigger such as smoking ABx smoking and diet

Altered interaction between gut microbiota

Question 6

What may the typical presentation of Crohn’s disease be?

Answer 6

Young 
Loose stool - non bloody 
RLQ pain 
Weight loss
Joint pains
Smoker

Question 7

What can be used to visualise strictures and fistula in Crohn’s?

Answer 7

Barium enema/ follow through

Question 8

In which UC or crohns are you more likely to have a low grade fever?

Answer 8

Crohn’s

Question 9

What are some histopathological changes that can be seen in UC?

Answer 9

Crypt abscesses
Crypt distortion (irregular shaved glands with dysplasia (darker crowded nuclei)
Reduced goblet cell number

Question 10

What is indeterminate colitis?

Answer 10

10% post-diagnostic evaluation of crohns that can not be classified

Question 11

What imaging method is used to visualise lead pipe colon?

Answer 11

Double contrast enema

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Question 12

Why do you get a granular appearance on radiography in UC?

Answer 12

Contrast settling int he superficial ulcers

Question 13

Name a immunomodulator and why it may be given in the context of IBD

Answer 13

Azathioprine

Maintenance of remissions
Fistulas

Question 14

Why is there is a risk of perforation in UC when performing an endoscopy?

Answer 14

Mucosa is extremely friable

Question 15

Outline the treatment for IBD?

Answer 15

Flares and remission - aminosalicylates - 5-ASA preparations

Flares - steroids - prednisolone

Maintenance of remission and fistulas - immunomodulators such as azathioprine