IBD Flashcards
1
Q
Define Crohn’s disease
A
Intermittent chronic inflammatory disease of the entire GI tract. Particularly affects terminal ileum.
2
Q
Epidemiology of Crohn’s
A
- Usually presents in teens - 20s
2. Northern Europe, America, UK
3
Q
Pathology of Crohn’s (GALS)
A
- GRANULOMAS
- ALL layers and LEVELS
- SKIP lesions
(deep fissures and ulcers -> cobblestone appearance)
4
Q
RF Crohn’s
A
- Genetic link
- Smoking
- Stress + depression bring on attacks
5
Q
Symptoms of Crohn’s
A
- Small bowel - abdominal pain and weight loss
- Terminal ileum - RIF pain
- Colonic - mucus and blood with diarrhoea, pain
- Systemic: anorexia, malaise, fatigue, fever
6
Q
Signs of Crohn’s
A
- Mouth ulcers
- Anaemia
- Bowel ulceration
- Abdominal tenderness
- Perianal fistulae, abscess, skin tags
- Anal strictures
- Clubbing, skin, eye, joint problems
7
Q
Investigations for Crohn’s
A
- Colonoscopy/sigmoidoscopy + biopsy
- Bloods - raised ESR, CRP, WCC, reduced Hb
- Stool sample - check for infection
8
Q
Management of Crohn’s
A
- Optimise lifestyle: no smoking, good nutrition
- Mild attacks : prednisolone
- Severe attacks: IV hydrocortisone
- Immunosuppressants: infliximab
- Surgery - bowel resection
9
Q
Complications of Crohn’s disease
A
- Small bowel obstruction
- Toxic dilatation
- Abscess formation
- Fistulae
- Perforation
- Colon cancer
- Malnutrition
- Osteoporosis
10
Q
Define ulcerative colitis
A
Relapsing and remitting continuous inflammatory disorder of the colonic mucosa
11
Q
Cause of UC
A
Inappropriate mucosal immune response to luminal bacteria. Smoking reduces risk.
12
Q
Pathology of UC
A
Hyperaemic/haemorrhagic mucosa +/- pseudopolyps formed by inflammation
- Continuous inflammation - no skip lesions
- Goblet cell depletion and crypt abscesses
- No granulomas
- Only affects colonic mucosa (no deeper)
13
Q
Symptoms of UC
A
- Episodic/chronic bloody diarrhoea
- Crampy abdominal discomfort
- Urgency/tenesmus
- Bowel frequency - relates to severity
- Systemic features: malaise, fever, anorexia, weight loss
14
Q
Signs of UC
A
- May be none
- Acute severe UC: fever, tachycardia, tender+distended abdomen
- Extraintestinal signs: clubbing, aphthous oral ulcers, erythema nodosum, arthritis, conjunctivitis
15
Q
Investigations for UC
A
- Bloods - raised WCC, ESR, CRP
- Stool sample
- Faecal calprotein - GI inflammation check
- Sigmoidoscopy/colonoscopy
- AXR - no faecal shadows, mucosal islands/thickening
16
Q
Management of UC
A
- Mild: 5-amino salicylates - mesalazine - remission inducer and maintenance
- Moderate (>6 motions/day) : prednisolone
- Immunosuppressants: azathioprine - risk of anaemia
- Severe flare up : infliximab/ciclosporin
- Surgery
17
Q
Complications of UC
A
- Osteoporosis
- Toxic megacolon
- Bowel cancer
- PSC
- Poor growth and development
