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FFP GI upset > Inflammatory bowel disease > Flashcards

Inflammatory bowel disease Flashcards

1
Q

What is inflammatory bowel disease

A

chronic relapsing and remitting condition of entire GI tract due to inappropriate immune activation in the mucosa

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2
Q

What is ulcerative colitis

A

Where body attacks own cells

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3
Q

what is crohns

A

bacteria causes innapporproate immune response

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4
Q

Who is IbD more likely ot affect

A

Teens and young adults, equal sex distribution, eastern European ashkenazi jews

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5
Q

What is the rise in incidence of IBD be due to

A

Hygiene hypothesis

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6
Q

Where are goblet cells more likely seen

A

Large intestine

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7
Q

Where are panet cells found

A

small intstine

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8
Q

What cells lie behind epithelium

-What do these act as

A

dendritic cells

-Act as antigen presenting cells

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9
Q

what do dendritic cells do

A

Activate T helper cells which initiate immune response

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10
Q

Which factors can lead to a barrier defect

A
  • Genetic susceptibility to barrier defect
  • These hyperreactive immune cells then secrete more cytokines (TNF and interleuins) which increases inflammation
  • This causes further impaired bacterial handling and further defect in barrier which allows more gut bacteria to enter submucosa
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11
Q

what does a barrier defect do

A

Allows gut micorbes to enter submucosal layer where immune cells are present

-dendritic cells present this microbe to t cell. T cells then activated and start immune cycle

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12
Q

Which polymorphisms cause IbD

A

NO2d gene mutation

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13
Q

SYmptoms of ibd

A

-fever
-night sweats
-Not able to eat
-vomiting
-Lack of appetite, -Nausea, summer -cramps
Weight loss- could be due to malnutrition (inadequate absorption)
-Blood in stools/on wiping
-Water loss and diarrhoea
-Change in bowel movements
-Presence of pus or mucus in stools

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14
Q

Symptoms of crohns

A

Ulcerations in mouth
Anal skin tags and ulcers
Abdo tenderness and diarrhoea common
Malnutrition

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15
Q

Which IBd is bloody diarrhoea more common

A

UC

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16
Q

Symptoms of UC

A

anaemia

17
Q

Most commonly involved sites in crohns

A

Terminal ileum
R colon
Can affect any part of GI tract (from mouth)

18
Q

What is ileo-colitis

A

Ileo-colitis (distal ileum and proximal colon)

-Ileitis (

19
Q

what is ileitis

A

terminal ileum or entire ileum

20
Q

What is ileojejunitis

A

continuous involvement of small bowel or skip areas separated by normal bowel

21
Q

What is perianal disease

A

crohns limited to anal area

22
Q

Difference between uC and crohns

A

UC continuous however crohns can be patchy and always involves the rectum

23
Q

Macroscopic features of crohns

A 
Skip lesions 
cobblestone appearance 
Aphthous and serpentine ulcers 
fat stranidng 
development of fistulas
24
Q

What do bloods look like in IBD

A

Raises CRP and ESR
LFT and coagulation can be changed in fistula formation
pANCA (serological markers) are positive esp in UC

25
Q

Iron and platelets and white cells?

A

Anaemia, raised WCC, raised platelets

26
Q

What is checked in stool samples

A
  • Antigen/enzyme testing (calprotectin, lactoferrin, elastase) which are raised.
  • Culture- c.diff and other microbes
27
Q

Radiographical investigations and findings

A

Plain abdo film, CT or MRI

-thumb printing, bowel wall dilatation, abscess and fistula, fat stranding, sacroiliitis

28
Q

Colonoscopy and findings

A

Macro-skip lesions, cobblestones, serpentine ulcers in CD; Ulcerations and pseudo-polyps in UC.
Micro-transmural/superficial chronic inflammation

29
Q

Barium studies

A

String sign in CD (now not commonly used)

30
Q

What drugs are used in mild disease

A

Aminosalicylates (5-ASA) –> inhibit oxygen radical production.
Abx (cipro and metro)
Topical corticosteroids

31
Q

5-ASA side effects

A

Anorexia
vomiting
Dyspepsia

32
Q

What is used on moderate disease

A 
Immunomodulators (azathioprine, methotrexate)
Oral corticosteroids (budesonide, hydrocortisone)
33
Q

Severe disease treatment

A

Anti-TNF (infliximab)

Surgery

FFP GI upset (9 decks)

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