IBD - UC and Crohn's Flashcards
which one is known for bloody diarrhoea?
UC
which one is weight loss a more prominent feature?
Crohns
in which one is tenesmus a feature?
UC
mouth ulcers, perianal disease?
Crohns
abdominal mass palpable in RIF?
Crohns
skip lesions may be present?
what do skip lesions look like on AXR?
Crohns
cobblestone appearance
abdominal pain in LLQ?
UC
extra-intestinal features of UC?
primary sclerosing cholangitis
widespread ulceration with pseudopolyps?
UC
inflammation through all layers from mucosa to serosa?
Crohns
On AXR looks like drainpipe colon with loss of haustrations?
UC
In UC - inflammation starts where and can end where?
starts at rectum and ends at ileo-caecal valve
peak incidence of UC is between which ages?
2 peaks
15-25
55-65
which one is HLA-B27 +ve?
UC
RF for UC
not smoking
NSAIDs
FHx
Infection
Features of UC?
Extra-intestinal features of UC?
urgenyc, tenesmus
LLQ pain
bloody discharge with mucus
cramping
uveitis
primary sclerosing cholangitis
arthritis
what stool study can you do to show increase in bowel inflammation?
why is this good?
faecal calprotectin (increases)
correlates to disease severity
UC
if acute - what imaging would you do?
if not responding to tx - what imaging would you do?
flexible sigmoidoscopy
colonoscopy
acute complications of UC?
chronic complication of UC?
Toxic megacolon (dilatation of >6cm) with risk of perforation.
colon cancer (x6 risk)
UC Tx - mild and moderate
if severe (systemically unwell)?
5-ASA (mesalazine) PO or oral steroids
IV steroids
if CRP >45 for 3 days: give infliximab or ciclosporin
if that fails - urgent colectomy
where does disease lie in 70% of crohn’s patients?
terminal ileum
RF for crohn’s disease
white FHx Smoking NSAIDs OCP (x1.7)
Features of Crohn’s
Extra-intestinal Features of Crohn’s?
weight loss/failure to thrive
RLQ pain if terminal ileum
cramping and constipation
perianal disease and mouth ulcers
uveitis
arthritis
episcleritis
which one is ASCA +VE
Crohns
which one is ANCA +ve
UC
complications of Crohn’s
small bowel obstruction
small bowel cancer
what will blood tests show in Crohn’s?
anaemic
low ferritin
serum folate is low
CRP/ESR raised
Imaging of choice for Crohns
Colonoscopy
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)
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
surgical Tx of UC
sub total colectomy
is usually successful as UC is only
what is hartmann’s procedure?
done in emergency
end colostomy + a stumped rectum
