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My1 GI > IBD > Flashcards

IBD Flashcards

1
Q

Inflammatory bowel disease mainly comprises of two idiopathic chronic inflammatory diseases - what are they?

A

crohn’s disease and ulcerative colitis (UC)

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2
Q

what 3 things predispose IDB

A

Genes, impaired mucosal immunity, environmental triggers

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3
Q

what gene impacts IBD and which disease is more affected

A

crohn’s more affected, NOD2 on chromosome 16

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4
Q

smoking worsens which disease

A

crohn’s

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5
Q

Both diseases are TH1 mediated, but which one also has TH2

A

UC

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6
Q

what is UC

A

mucosal and submucosal inflammation of the rectum, extending proximally with no skip legions

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7
Q

what age group is normally affected by UC

A

20’s-30’s

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8
Q

what are the symptoms of UC

A

diarrhoea + blood,

increased bowel frequency and urgency, incontinence, night rising, LIF pain

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9
Q

what are the symptoms of severe UC

A

6> bloody stool per day plus one of: tachycardia, anaemia, elevated ESR, fever

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10
Q

what are the microscopic investigations of UC

A

endoscopy and biopsy: neutrophils NO granulomas, crypt abscesses, superficial in mucosa and submucosa

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11
Q

what would you see on an AXR for UC

A

thumbprinting

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12
Q

what is crohn’s disease

A

chronic inflammation and ulceration of GI tract, most common in terminal ileum and colon, skip legions, is transmural

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13
Q

what are symptoms of crohn’s disease

A

abdominal pain, small bowel obstruction, diarrhoea + blood, weight loss, ulcers, abscesses

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14
Q

what are the investigations of crohn’s

A

colonoscopy mucosal biopsy: granulomas (50%), knife-like fissues, bloods, stools, QFIT

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15
Q

what are the complications of crohn’s

A

malabsorption, short bowel syndrome, fistulas

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16
Q

what are the complications of UC

A

toxic megacolon, colorectal cancer, fistulas

17
Q

what is toxic megacolon

A

loss of muscle tone due to chronic inflammation - can be fatal

18
Q

what blood could be done for UC

A

CRP and albumin

19
Q

what can extra-intestinal symptoms of IBD can develop

A

joints, eyes, skin and primary sclerosing cholangitis (inflammation of biliary tree)

20
Q

what are the therapy options for UC in order

A

5-ASA, steroids, immunosuppressants and anti TNFa

21
Q

what are the therapy options chrons in order

A

steroids, immunosuppressants and anti TNFa

22
Q

what is 5-ASA and give an example

A

anti-inflammatory, mesalazine

23
Q

what 2 ways can 5ASA be taken

A

orally or topically

24
Q

what type is pH dependent release

A

orally

25
Q

what 2 ways can topical be administered and the advantages of both

A 
enema = goes more proximal towards sigmoid.
suppositories = better mucosal adherence but don't travel as far
26
Q

give an example of a steroid and how it is taken

A

prednisolone - orally/ topically, very short course

27
Q

give examples of immunosuppressants

A

azathioprine or methotrexate

28
Q

give examples of anti TNFa and what it does

A

infliximab, adalimumab. apoptosis of activates T lymphocytes.

29
Q

when should anti TNFa not be used

A

TB

30
Q

what are the emergency procedures for IBD

A

subtotal colectomy in UC (leaves rectum) and resection in crohn’s

31
Q

what are indications for elective surgery in UC

A

medically unresponsive, malignancy, child growth retardation

32
Q

what are the 3 types of elective UC proctocolectomy

A

end ileostomy, pouch, ileorectal anastomosis

33
Q

what is end ileostomy proctocolectomy

A

small intestine feeds into soma bag

34
Q

what is a pouch proctocolectomy

A

loop intestine to create reservoir, ‘normally’ functionin rectum - can become impotent especially in women

35
Q

what set of criteria can assess severity of IBD

A

Trueman and witt’s

36
Q

what surgery is more curative

A

UC, stomas often remove symptoms and improve QoL

37
Q

what is the purpose of crohn’s disease surgery

A

temporary symptom relief, often need further surgeries where bowel is removed

My1 GI (26 decks)

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