IBD

Question 1

What are the features of Crohn’s disease compared to UC? (5)

Answer 1

crows NESTS

N-No blood or mucus
E-Entire GI tract
S-Skip lesions 
T-Terminal ileum most affected and Transmural inflammation 
S-Smoking IS a risk factor

Question 2

What are the features of UC in comparison to crohns? (7)

Answer 2

CLOSEUP

C-Continuous inflammation 
L-Limited to rectum and colon
O-Only superficial mucosa affected 
S-Smoking is protective
E-Excrete blood and mucus
U-Use aminosalicylates
P-Primary sclerosant cholangitis (PSC)

Question 3

What is the presentation for IBD? (4)

Answer 3

Diarrhoea

Abdo pain

Passing blood

Weight loss

Question 4

What are the tests for IBD? (8)

Answer 4

Routine bloods (anaemia, thyroid, kidney, liver)

CRP

Faecal calprotectin

Endoscopy OGD with biopsy

US

CT

MRI

Question 5

What is the first line drug to induce remission in crohns?

Answer 5

Steroids (oral pred or IV hydrocortisone)

Question 6

What drugs are used to maintain remission in crohns? (2)

Answer 6

Azothioprine

Mercaptopurine

Question 7

When is surgery indicated for Crohns? (2)

Answer 7

When it only affects the distal ileum

To treat fistulas and strictures

Question 8

What drug is first line to induce remission in mild to moderate UC and what drug is second line?

Answer 8

Aminosalicylate (mesalazine)

Corticosteroids (pred)

Question 9

What medication is first line to induce remission in severe UC and what drug is second line?

Answer 9

IV Corticosteroids (hydrocortisone)

IV ciclosporin

Question 10

What drugs are used to maintain remission in UC? (3)

Answer 10

Aminosalicylate (mesalazine)

Azothioprine

Mercaptopurine

Question 11

What is the surgical procedure used in UC to remove the colon and rectum?

Answer 11

Panproctocolectomy

Question 12

What is a patient potentially left with after having their colon and rectum removed (1 bag and 1 non-bag)

Answer 12

Permanent ileostomy

J-shaped pouch (ileum functions as the rectum)