IBD - UC and Crohn's Flashcards

1
Q

which one is known for bloody diarrhoea?

A

UC

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2
Q

which one is weight loss a more prominent feature?

A

Crohns

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3
Q

in which one is tenesmus a feature?

A

UC

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4
Q

mouth ulcers, perianal disease?

A

Crohns

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5
Q

abdominal mass palpable in RIF?

A

Crohns

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6
Q

skip lesions may be present?

what do skip lesions look like on AXR?

A

Crohns

cobblestone appearance

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7
Q

abdominal pain in LLQ?

A

UC

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8
Q

extra-intestinal features of UC?

A

primary sclerosing cholangitis

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9
Q

widespread ulceration with pseudopolyps?

A

UC

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10
Q

inflammation through all layers from mucosa to serosa?

A

Crohns

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11
Q

On AXR looks like drainpipe colon with loss of haustrations?

A

UC

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12
Q

In UC - inflammation starts where and can end where?

A

starts at rectum and ends at ileo-caecal valve

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13
Q

peak incidence of UC is between which ages?

2 peaks

A

15-25

55-65

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14
Q

which one is HLA-B27 +ve?

A

UC

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15
Q

RF for UC

A

not smoking
NSAIDs
FHx
Infection

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16
Q

Features of UC?

Extra-intestinal features of UC?

A

urgenyc, tenesmus
LLQ pain
bloody discharge with mucus
cramping

uveitis
primary sclerosing cholangitis
arthritis

17
Q

what stool study can you do to show increase in bowel inflammation?

why is this good?

A

faecal calprotectin (increases)

correlates to disease severity

18
Q

UC

if acute - what imaging would you do?

if not responding to tx - what imaging would you do?

A

flexible sigmoidoscopy

colonoscopy

19
Q

acute complications of UC?

chronic complication of UC?

A

Toxic megacolon (dilatation of >6cm) with risk of perforation.

colon cancer (x6 risk)

20
Q

UC Tx - mild and moderate

if severe (systemically unwell)?

A

5-ASA (mesalazine) PO or oral steroids

IV steroids
if CRP >45 for 3 days: give infliximab or ciclosporin

if that fails - urgent colectomy

21
Q

where does disease lie in 70% of crohn’s patients?

A

terminal ileum

22
Q

RF for crohn’s disease

A
white 
FHx 
Smoking 
NSAIDs
OCP (x1.7)
23
Q

Features of Crohn’s

Extra-intestinal Features of Crohn’s?

A

weight loss/failure to thrive
RLQ pain if terminal ileum
cramping and constipation
perianal disease and mouth ulcers

uveitis
arthritis
episcleritis

24
Q

which one is ASCA +VE

25
which one is ANCA +ve
UC
26
complications of Crohn's
small bowel obstruction | small bowel cancer
27
what will blood tests show in Crohn's?
anaemic low ferritin serum folate is low CRP/ESR raised
28
Imaging of choice for Crohns
Colonoscopy
29
whats imaging of choice for terminal ileum in crohns? what sign would you find?
small bowel enema AXR Kantor's string sign (narrowed terminal ileum)
30
Tx of Crohns would you tell them to quit smoking? what medication would you give? what medication do you give in refractory disease? if they have isolated perianal disease?
YES but in UC - it will make it worse 1st line oral steroids 5ASA as 2nd line if they aren't as effective. Infliximab Metronidazole
31
surgical Tx of UC
sub total colectomy is usually successful as UC is only
32
what is hartmann's procedure?
done in emergency end colostomy + a stumped rectum