IBD

Question 1

What are the 2 types of IBD?

Differentiate them.

Answer 1

1) ulcerative colitis = large colon only / inner 1/3 / continuous inflammation
2) crohns = mouth to anus / transmural (all layers of colon) / skip lesions

Question 2

What is the M:F ratio of crohns and UC?

Answer 2

1:1 for both

Question 3

What is the onset age for UC?

Answer 3

Bi-modal = 20’s and 50’s

Question 4

Which IBD condition has a larger genetic component?

Answer 4

Crohns

Question 5

What would bloods for IBD show?

Answer 5

Raised inflammatory markers (CRP/ESR)

Low albumin

Anaemia (iron deficiency due to malabsorption)

Low LFT’s

Faecal calprotectin raised

Question 6

What is faecal calprotectin?

Answer 6

Like ‘CRP’ for the bowel

Question 7

What is the gold standard for UC diagnosis?

Answer 7

Endoscopy

Question 8

Where does UC start and where does it progress to?

Answer 8

Rectum = start

Can travel whole length of colon progressively:

• proctitis
• left-sided colitis
• pan-colitis

Question 9

What is the treatment for UC?

Answer 9

Steroids
Aminosalicyates 
Immunosuppressants (methotrexate/azathioprine)
Biologics
Surgery

Question 10

What is another name for the aminosalicylate drug group?

Answer 10

5-ASA (Mesalazine)

Topical

Question 11

Where would each of these stomas be located?

1) colostomy
2) iliostomy
3) urostomy

Answer 11

1) colostomy = LIF
2) iliostomy = RIF
3) urostomy = RIF

Question 12

What is a loop versus an end colostomy?

Answer 12

End = one opening

Loop = 2 (to allow a anastomoses distally to heal post-surgery)

Question 13

What is the onset age for crohns?

Answer 13

20-30

Question 14

Which race is at greater risk of crohns?

Answer 14

White

Question 15

What is the genetic concordance of crohns?

Answer 15

58% monozygotic twins

Question 16

What added sign/symptom is seen in crohns compared to UC?

Answer 16

Oral ulceration

Perianal abscess

Question 17

What can faecal calprotectin indicate?

Answer 17

IBD over IBS but NOT between crohns or UC

Question 18

What can RIF pain indicate?

Answer 18

IBD over IBS

Question 19

Which IBD condition can give you nutritional deficiencies?

Answer 19

Crohns

Question 20

Which IBD can give you fistula and strictures?

Answer 20

Crohns

Question 21

What histological findings are seen in UC?

Answer 21

Crypt abscesses

Mucosal lining inflammation only

Question 22

What histological findings are seen in UC?

Answer 22

Granulomas

Transmural full thickness inflammation

Question 23

Is smoking detrimental to both IBD diseases?

Answer 23

Yes to crohns

Protective for UC!