IBD

Question 1

Types of IBD?

Answer 1

Ulcerative Colitis or Crohn’s.

Question 2

Common presentation of IBD?

Answer 2

Diarrhoea, abdominal pain + weight loss

Question 3

Distinguishing Signs of Ulcerative Colitis?

Answer 3

UC CLOSE UP
Continuous
Limited 
Only superficial
Smoking = protective
Excretion - blood and mucus
Use aminosalicylates
Primary sclerosing cholangitis (associated)

Question 4

Distinguishing Signs of Crohn’s?

Answer 4

Crow's NESTS
No blood/mucus 
Entire GI Tract
Skip Lesions
Terminal Ileum origin
Smoking = exacerbation

Question 5

Differences: UC vs Crohn’s?

Answer 5

UC: Superficial, Limited to colon/rectum, smoking = protective
Crohn’s: Deep, Entire GI tract, smoking = risk factor.

Question 6

Investigations for IBD?

Answer 6

Same for both

1) FBC, U&Es, LFTs, TFTs + CRP
2) Faecal calprotectin
3) Endoscopy (e.g. colonscopy) + Biopsy

Question 7

Managing UC?

Answer 7

Mild - Oral/rectal: 1) Aminosalicylate 2) Prednisolone
Severe - 1) IV hydrocortisone 2) IV ciclosporin

Aminosalicylate = maintain remission
Surgery: ileostomy/Colectomy

Question 8

Managing Crohn’s

Answer 8

1) Remission: Oral prednisolone OR IV hydrocortisone
2) Aazathioprine/methotrexate + mercaptopurine

Maintenance: NONE or azathioprine/mercaptopurine
Surgery: stricture/fistula formation OR isolated to terminal ileum