IBD Flashcards
what are the two inflammatory bowel conditions?
crohns disease and ulcerative colitis
which type of IBD can affect the mouth to anus?
crohns disease is a pan-GI condition. it can affect anywhere from mouth to anus. usually affects the terminal ilium.
presenting features of crohns disease?
weight loss, lethargy, mucus in stool, diarrhoea (no blood), RIF pain (terminal ilium), oral ulcers, peri-anal disease (skin tags)
what are some extra-intestinal features of crohns disease?
finger clubbing, erythema nodosum, uveitis, inflammatory reactive arthritis
crohns disease is associated with high risk of colorectal cancer? T/F
false!
crohns - low risk colorectal cancer
UC - high risk colorectal cancer
pathological features in crohns disease
which type of IBD has skip lesions, transmural inflammation, cobble-stoning of the mucosa, non-caseating granulomas and deep fissures, increased number of goblet cells
investigations for crohns?
blood test (anaemia, raised CRP/ESR), endoscopy and biopsy, stool samply
what stool investigations should be perfromed?
culture - if you suspect C.diff toxin
microscopy - if you suspect parasite
what are two stool markers found in active intestinal disease?
raised calprotectin/lactoferrin
treatment for crohns disease?
steroids to induce remission
immunosuppression with azathioprine
B12 supplementation
iv methylprednisolone and bowel resection if severe
bowel resection is curative in crohns? T/F
false
surgery is curative in Ulcerative Colitis, not crohns
what is procitis and what condition is it seen in?
inflammation of the rectum
seen in US
which parts of the GI tract does UC affect?
colon and rectum
which age does UC typically present
young and elderly people
pathological features of UC?
continuous lesions ascending from the rectum to the iliocecal valve
no inflammation beyond the submucosa
goblet cell depletion
no granulomas
clinical features of UC
bloody diarrhoea
night rising
procitis (urgency and tenesmus)
LIF abdominal pain
investigations for UC
bloods (raised WBC/CRP/ESR, iron deficiency)
stool test (raised fecal calprotectin)
barium enema (loss of haustrations= drain pipe colon)
AXR (toxic megacolon)
colonoscopy and biopsy
how wide does the colon need to be for diagnosis of toxic megacolon?
> 6cm
when should you never do a colonoscopy?
during flare up - risk of perforation
treatment for UC?
induce remission (5-ASA, Mesalazine) maintain remission surgery (protectomy with end iliostomy)
is surgery curative in UC?
yes - protectomy with iliostomy
primary sclerosing cholangitis is associated with which type of IBD?
80% of PBS cases are associated with ulcerative colitis
what is primary sclerosing cholangitis?
fibrotic stricture of the common bile duct. risk of cholangiocarcinoma.
‘drain/lead pipe colon’ is seen in which IBD?
ulcerative colitis. Lead pipe colon is seen due to loss of bowel haustrations.
