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IBD Flashcards

1
Q

What is it

A

Relapsing and remitting inflammatory disorder of the colonic mucosa

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2
Q

Where does UC affect

A

rectum and may extend part of the colon (L sided) or entire colon (pan colitis)
never spreads beyond ileocaecal valve

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3
Q

What is peak incidence of UC

A

15-25

55-65

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4
Q

What is a RF of UC ?

A

non-smoker

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5
Q

What are the symptoms of UC

A

episodic or chronic diarrhoea +/- blood + mucus (prominent)
Crampy abdo pain
Urgency/ tenesmus
Systemic sx in attacks: fever, malaise, anorexia, WL

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6
Q

What would you find endoscopically in US

A

continuous inflamed mucosa from rectum proximally

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7
Q

What would you find histologically in UC

A

Mucosal and submucosal inflammation
Crypt abscesses
Reduced goblet cells

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8
Q

What is the treatment of UC?

A

Fluids
Oral/IV steroids if a flare
Mild-moderate UC – oral/rectal mesalazine (aminosalicylate)
Immunosuppressants – mercaptopurines, anti-TNF – be aware of infection!

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9
Q

What tests would yo carry out in UC?

A
  1. Raised WCC and CRP
  2. Faecal calprotectin
  3. Stool cultures to rule out bacterial cause
  4. AXR, CT/MRI
  5. Sigmoidoscopy, colonoscopy
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10
Q

What are the complications of UC? Give acute and chronic

A

Acute: toxic megacolon -> perforation
VTE - give proph
hypokalaemia
Chronic: colon cancer - monitor!

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11
Q

When is surgery indicated in US?

A

failure of medical therapy

fulminant colitis w toxic dilation or perforation

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12
Q

What are the sx of crohns?

A

Diarrhoea
Abdo pain
Weight loss prominent

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13
Q

What is the GI involvement in Crohns?

A

Anywhere along GI tract

most commonly terminal ileum

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14
Q

What is peak age of crohns?

A

20-40

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15
Q

What is crohns associated w ?

A

smoking

NSAIDs may exacerbate

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16
Q

What is seen endoscopically in Crohns?

A

inflamed thickened mucosa
aphthous ulcers
skip lesions

17
Q

What is seen histologically in Crohns?

A

inflammation extending beyond the submucosa

granulomas present

18
Q

What are the complications of Crohns?

A 
SBO
Toxic megacolon 
Abscesses
Fistulae 
Colon cancer + small bowel cancer 
Malnutrition
Primary sclerosing cholangitis
19
Q

what tests would u do in crohns?

A

same as UC
Small bowel enema - strictures - Kantors string sign
proximal bowel dilatation
‘rose thorn’ ulcers

20
Q

What is the management of inducing remission in Crohns?

A
  1. Glucocorticoids - pred, methylpred IV hydrocortisone
  2. Mesalazine
  3. +/- azathioprine or mercaptopurine
21
Q

What is given to maintain remission in Crohns?

A

Azathioprine or mercaptopurine

Methotrexate is second lin

22
Q

What is the most common surgery to have in Crogns?

A

ileocaecal resection

23
Q

What is the treatment of perianal disease in Crohns?

A

§oral abx

immunosuppressant therapy +/- anti-TNF + local surgery

GI (16 decks)

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