Inflammatory bowel disease Flashcards

1
Q

Characteristic features of Crohn’s (crow’s NESTS)

A
  • no bleeding
  • entire GI tract can be affected
  • skip lesions on endoscopy
  • terminal ileum most common/transmural inflam
  • smoking is a RF
  • weight loss
  • stricture & fistulas
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2
Q

characteristic features of UC (U-C-CLOSEUP)

A
  • continuous inflammation
  • limited to colon & rectum
  • only superficial mucosa affected
  • smoking is protective
  • excrete blood & mucus
  • use aminosalicylates
  • primary sclerosis cholangitis
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3
Q

Presentation (typical of bowel inflammation)

A
  • diarrhoea
  • abdominal
  • blood
  • weight loss
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4
Q

When is faecal calprotectin released

A

Inflamed intestines

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5
Q

1st line inducing remission crohn’s

A

Steroids

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6
Q

Additive to 1st line inducing remission Crohn’s if 1st line on its own doesn’t work

A
  • azathioprine
  • mercaptopurine
  • methotrexate
  • infliximab
  • adalimumab
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7
Q

1st line immunosuppressants maintaining remission Crohn’s

A
  • azathioprine

- mercaptopurine

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8
Q

2nd line maintaining remission Crohn’s (chemotherapeutic immunosuppressant & 2 monoclonal Abs)

A
  • methotrexate
  • infliximab
  • adalimumab
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9
Q

When to perform surgery in Crohn’s

A

If only ileum is affected

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10
Q

1st line mild-moderate UC inducing remission

A
  • aminosalicylate
  • mesalazine
  • oral/rectal
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11
Q

2nd line mild-moderate UC inducing remission

A

Corticosteroids

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12
Q

1st line severe UC inducing remission

A
  • IV corticosteroids
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13
Q

2nd line severe UC inducing remission (immunosuppressant calcineurin inhibitor)

A
  • IV ciclosporin
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14
Q

UC maintains remission

A
  • aminosalicylates
  • azathioprine
  • marcaptopurine
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15
Q

How is surgery for UC performed and what is removed

A
  • ileo-anal anastomosis (J-pouch)

- colon & rectum

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16
Q

IBD gold standard Ix

A

endoscopy

17
Q

ophthalmic symptoms of IBD

A
  • iritis
  • uveitis
  • episcleritis
18
Q

dermatological symptoms of IBD

A
  • erythema nodosum

- pyoderma gangrenosum

19
Q

MSK symptoms IBD

A
  • arthritis
  • osteoporosis
  • ankylosing spondylitis
20
Q

renal symptoms of IBD

A

nephrolithiasis

21
Q

haematological symptoms IBD

A
  • anaemia

- thromboembolism

22
Q

race vulnerable to IBD

A

Ashkanazi Jewish

23
Q

enzyme activity to be checked before azathioprine to reduce chances of mylosuppression

A

thiopurine methyltransferase (TPMT)

24
Q

UC biopsy

A
  • crypt abscess

- decreased goblet count

25
Q

Crohn’s biopsy

A

granulomas

26
Q

classic appearance of UC on barium enema

A

lead pipe