IBD- Clinical Flashcards
What two diseases come under IBD?
- Ulcerative colitis
- Crohns
What 3 factors contribute to the epidemiology of IBD?
- Genetics
- Environmental factors
- Mucosal immune system
What effect does the NOD2/CARD15 mutation have in people?
Encodes a defective protein involved in bacterial recognition
Crohn’s disease is mediated by which adaptive immune cell?
Th1 mediated
Smoking aggrevates ulcerative colitis is prevenatitve against Crohns? T/F
False- opp
Can NSAID’s trigger IBD?
Yes
UC symptoms?
- Diarrhoea & Bleeding
- Lower abdo pain- esp in LIF
- Tenesmus
- Incontinence
- increased bowel frequency (how often?)
Important things to think about in history of UC?
- •Recent travel
- •Antibiotics
- •NSAID’s
- •Family history
- •Smoking
- •Skin, eyes, joints
What factors in symptoms and signs can be used to classify a diagnosis of UC as Severe?
- >6 Stools in 24 hrs
- 1 or more of
- tachycardia > 90bpm
- fever > 37.8
- anaemia- Hb < 10.5
- elevated ESR > 30mm/hr
What investigations would one do for UC?
- FBC
- CRP, Albumin
- Plain AXR
- Endoscopy
- Histology
What is the skip lesion pattern in Crohns?
Inflammed area follwed by normal mucosa, followed by more inflammation.
Whereas in UC, inflammation is continuos
What is peri-anal disease?
Recurrent abscess formation in the anal-rectal area
Painful, can damage sphincters, or lead to fistulas with persistence leakage
What are the 3 pathological effects of Crohn’s?
- Stenosis
- Inflammation
- Fistulas
Symptoms of Crohn’s?
Depends on SITE
- Small I- abdo cramps, doarrhoea, weight loss
- Colon- abdo cramps, diarrhoea with blood, weight loss
- Mouth- swellng, ulcers, angular chielitis
- Anus- perianal pain, absscess
What assessments would you do for Crohn’s?
- Bloods- CRP, Albumin, B12, Platelets
- Colonoscopy
- Small Bowel- Barium follow through, small bowel MRI, Technetium labelled white cell scan
