IBD (UC vs Crohn's) Flashcards
What is more common, UC or Crohn’s
UC
What part of the GI tract do UC and Crohn’s affect
UC affects the rectum, extending proximally
Crohn’s can affect any region of GI tract from mouth to anus
Which IBD has skip lesions
Crohn’s
Which IBD can give the symptom of Tenesmus
UC
Which IBD can give the symptom of urgency
UC
What are small intestinal symptoms in Crohn’s
Umbilical abdominal cramps
Diarrhoea
Weight loss
What are symptoms associated with the colon in Crohn’s
Lower abdominal cramps
diarrhoea with blood
weight loss
What symptoms of UC present in the mouth
None, UC doesn’t affect the mouth
What symptoms of Crohn’s present in the mouth
Painful Ulcers
Angluar Chielitis
Swollen lips
What are the symptoms of the anus with Crohn’s
Peri-anal pain
Abscess
Smoking aggravates UC and Crohn’s, true or false
False
Smoking aggravates Crohn’s but not UC
fuck knows why
What are some features characteristic of UC that can be seen on an AXR
Stool absent in inflamed colon
Mucosal Oedema
Toxic Megacolon
What is the buzzword for Mucosal Oedema
Thumb printing (similar to epiglottitis on a head X-ray)
Cobblestoning presents in which IBD
Crohn’s
Granular Mucosa presents in which IBD
UC
Which IBD can have pseudo-polyps in its advanced stage
UC
In Crohn’s, the inflammation only affects the mucosal layer, true or false
False
Inflammation only affects the mucosal layer in UC
Fissures occur in which IBD
Crohn’s
Which layers are affected by inflammation in Crohn’s
All of them
Transmural inflammation
Granuloma can present in which IBD
Crohn’s
in 30-50% of people
Goblet cells are absent in which IBD
UC
in UC, the crypts of lieberkuhn are distorted and abscesses can form
True or False
True
this doesn’t happen in Crohn’s
Which IBD gives you a higher risk of colorectal cancer
UC
Think about it, it affects the RECTUM extending proximally
Fistula’s can form in which IBD
Crohn’s
Malabsorption is more common in UC than in Crohn’s
True or False
False
More common in Crohn’s
Strictures and perforations can occur in which IBD
Crohn’s
What are the 3 treatment aspects in both IBD’s
Lifestyle advice
Drugs
Surgery
Which drugs are used in UC but not in Crohn’s and give an example
5ASA’s
Mesalazine
Which 3 classes of drugs can be used for both UC and Crohn’s
Steroids
Immunosuppressants
Anti-TNF therapy
What is a nickname for Immunosuppressants
‘Steroid-sparing agents’
Which IBD can surgery be curative for
UC
What can repeated resection of the small bowel, in Crohn’s, result in
Short Bowel Syndrome
What is the length of bowel you need to be diagnosed with Short Bowel Syndrome
<200cm
What is the treatment for Short Bowel Syndrome
Lifelong Parenteral nutrition
What does PSC stand for and what is it
Primary Sclerosing Cholangitis
Chronic inflammation of the biliary tree
Is PSC more common in males or females
Males
unlucky lads
What does PBC stand for and what is it
Primary Biliary Cirrhosis
Autoimmune disease with unknown aetiology
Is PBC more common in males or females
Females
90% females unlucky gals
Name 3 pathologies which can occur in peri-anal disease
Recurrent abscess formation
Fistula formation with permanent leakage
Sphincter damage leading to incontinence
What is ESR
The rate at which red blood cells settle out in a tube of unclotted blood, expressed in millimeters per hour
What does an elevated ESR suggest
The presence of inflammation
What are the side effects of 5ASA’s
Diarrhoea, idiosyncratic nephritis
What are the MSK side effects of corticosteroids
Avascular necrosis
Osteoporosis
What are the cutaneous side effects of corticosteroids
Acne
Skin thinning
What are the metabolic side effects of corticosteroids
Weight gain
Diabetes
Hypertension
Growth failure
What ophthalmological side effects can corticosteroids have
Cataract
What is the onset of action of Immunosuppressants
V slow
16weeks
What can u not co-prescribe immunosuppressants with
allopurinol
Lol no idea ?
What are side effects of immunosuppressants
Hepatitis
Pancreatitis
Leucopaenia – Low WCC
Small risk of lymphoma, skin cancer
What is the onset of action of Anti-TNF therapy
Rapid
What are the two types of Anti-TNF therapy and give an example of each
Chimeric (infliximab; IV infusion)
Humanised (adalimumab; S/C injection)
How does Anti-TNF therapy work
Promotes apoptosis of activated T- lymphocytes
What is the major side effect of Anti-TNF therapy
think about it
Cancer