Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Gastrointestinal > Inflammatory Bowel Disease > Flashcards

Inflammatory Bowel Disease Flashcards

1
Q

What is inflammatory bowel disease?

A

Group of condition characterised by idiopathic inflammation of the GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 2 common types of inflammatory bowel disease?

A

Crohn’s disease
Ulcerative colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Location of Crohn’s disease

A
  • Affects anywhere in GI tract: terminal ileum in most cases + rarely affects rectum
  • Skip lesions (multiple places)
  • transmural (full thickness)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Location of ulcerative colitis

A

Begins in rectum
Can extend to involve the entire colon
Continuous pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Presentation of Crohn’s disease

A
  • weight loss
  • right lower quadrant pain
  • low grade fever
  • mildly anaemic
  • perianal inflammation/ulceration/lesions e.g. skin tags, fistulae, abscesses, scarring
  • multiple non-bloody loose stools a day
  • 15-30 year olds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Presentation of ulcerative colitis

A
  • multiple blood stools per day
  • mild abdominal pain
  • no perianal disease
  • normal temperature
  • 20-30 year olds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Skin changes in inflammatory bowel disease

A

Erythema nodosum
Pyoderma gangrenosum
Psoriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What other symptoms can you get if you have inflammatory bowel disease other than the GI?

A
  • enteropathic arthritis
  • skin problems: erythema nodosum, pyoderma gangrenosum, psoriasis
  • primary sclerosing cholangitis (UC)
  • uveitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Causes of inflammatory bowel disease

A
  • genetic pre-disposition
  • gut organisms
  • immune response
  • triggers: antibiotics, infection, diet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Affect of smoking on Crohn’s disease and ulcerative colitis

A
  • worsens Crohn’s disease
  • can be beneficial to ulcerative colitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a fistula?

A

Abnormal connection between two epithelial lined things

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Classic microscopic presentation of Crohn’s disease

A

Epitheloid granuloma formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are people with Crohn’s disease likely to have that those with UC don’t?

A

Perianal disease
e.g. skin tags, fistula, abscesses, scarring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Investigation of IBD

A
  • FBC: anaemic
  • U&Es: possibly deranged electrolytes or AKI due to GI losses
  • faecal calprotectin
  • anti tTG: to exclude coeliac disease
  • stool sample + culture: exclude infective colitis
  • MRI for monitoring
  • CT for acute flare
  • colonoscopy + intestinal biopsies
  • flexible sigmoidoscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the safest test in cases of bloody diarrhoea?

A

flexible sigmoidoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does Crohn’s disease look like?

A
  • skip lesions
  • red appearance
  • ulcers
  • mucosal oedema
  • transmural inflammation + thickening of bowel wall + narrowing lumen (strictures)
  • cobblestone appearance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Features of Crohn’s disease

A
  • C: obblestone appearance
  • R:ose thorn ulcers (deep penetrating linear ulcers)
  • O:bstruction of bowel (strictures)
  • H:yperplasia of mesenteric lymph nodes
  • N:arrowing of intestinal lumen
  • S:kip lesions

granuloma formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is pathognomonic to Crohn’s disease?

A

Epithelioid granuloma formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pathological changes in ulcerative colitis

A
  • chronic inflammatory infiltrate of lamina propria
  • crypt abscesses + distortion
  • reduced numbers of goblet cells
  • pseudopolyps after repeated episodes
  • loss of haustra (inflammation reduces appearance)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Compare Crohn’s disease + ulcerative colitis:
- location
- rectal involvement
- continuous
- gross bleeding
- perianal disease
- fistula formation
- malnutrition
- smoking affect
- transmural inflammation
- granulomas
- fibrosis
- crypt abscesses

A

_Crohn’s disease
- location: anywhere in GI tract, mainly terminal ileum
- rectal involvement: rarely
- continuous: no, skip lesions
- gross bleeding: 25%
- perianal disease: yes
- fistula formation: yes
- malnutrition: potential
- smoking affect: damaging
- transmural inflammation: yes
- granulomas: yes
- fibrosis: common
- crypt abscesses: rare

Ulcerative colitis
- location: from rectum to colon
- rectal involvement: yes
- continuous: yes
- gross bleeding: yes
- perianal disease: no
- fistula formation: no
- malnutrition: no
- smoking affect: potentially beneficial
- transmural inflammation: no
- granulomas: no
- fibrosis: no
- crypt abscesses: yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are haustra?

A

Small pouches of the colon wall between folds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Treatment of IBD in hopsital

A
  • IV hydrocortisone 100mg qds
  • heparin to reduce risk of VTE whilst in hospital
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Treatment of UC flare up

A
  • first line: oral or rectal mesalazine
  • second line: oral or rectal prednisolone
    .
    if severe:
  • first line: IV hydrocorisone
  • additional options: IV ciclosporin, infliximab or surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Maintenance drug treatment of ulcerative colitis

A

oral or rectal mesalazine first line
azathioprine if M doesn’t work

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What type of drug is used first line in UC?
aminosalicylate *mesalazine*
26
Surgical options for ulcerative colitis
- **panprotocolectomy** - removal of the large bowel + rectum then: - **ileostomy**: ileum is brought onto the skin with a spout into stoma bag - **J-pouch**: ileum is folded back on itself + fashioned into a larger pouch which attaches to the anus (acting like a rectum)
27
What is pouchitis?
inflammation of ileal pouch
28
Presentation of pouchitis
- abdominal pain - bloody diahrroea
29
Treatment of pouchitis
metronidazole ciprofloxacin
30
Treatment of Crohn's flare up
- **first line**: oral *prednisolone* or IV *hydrocortisone* - **enteral nutrition** - addition of *azathioprine, infliximab, metocaptopurine* if needed
31
How does enteral nutrition induce remission in crohn's?
- treating nutritional deficiencies - improving gut microbiome - removing inflammatory foods
32
maintenance drug treatment of Crohn's
*azathioprine* or *mercaptopurine* or biologics (first line in perianal or fistulating crohn's)
33
Surgical options for Crohn's
- resecting distal ileum - treating strictures of fistulas
34
Types of stomas
- colostomy - ileostomy - gastrostomy - urostomy
35
What is a stoma?
Artificial openings of a hollow organ *e.g. bowel*
36
Outline a colostomy
- colon is brought onto the skin - drain solid stools - found in LIF
37
Outline an ileostomy
- ileum is brought onto the skin - drain liquid stools - have a spout that drains into stoma bag - located in RIF
38
Outline a gastrostomy
- artificial connection between stomach and abdominal wall - used to provide feeds directly into stomach for pt who cannot meet nutritional needs by mouth
39
Outline a urostomy
- used to drain urine from kidneys - bypasses ureters, bladder + urethra - typically in RIF
40
What is a J pouch colostomy?
- wher the ileum is folded back on itself + fashioned into a larger pouch that functions like the rectum - J pouch is attached to anus + collects stools before opening bowels - ileo-anal anastomosis
41
Outline loop colostomy/ileostomy
- temporary stoma used to allow distal portion of bowel to heal after surgery - allows for faeces to bypass distal healing portion of bowel - reversed 6-8 weeks later
42
What is an anal fissure?
tear in the mucosal lining of the anal canal Most commonly due to trauma from hard stool
43
Classification of anal fissures
- **acute**: <6 weeks - **chronic**: >6 weeks. . - **primary**: no underling disease - **secondary**: underling disease *e.g. Crohns*
44
Risk factors of anal fissures
- constipation - dehydration - Crohn’s disease
45
Presentation of anal fissures
- intense pain post defecation - feeling of passing glass - bright red blood on wiping - itching
46
Most common location of anal fissures
Posterior midline
47
Management of anal fissure
- treat underlying cause - analgesia - increase fibre + fluid intake - stool softening laxatives *e.g. movicol* - topical anaesthetics *e.g. lidocaine* - GTN cream - surgery for chronic fissures: Botox injection to anal sphincters then lateral spincterotomy
48
What is a perianal fistula?
Abnormal connection between anal canal and perianal skin
49
Risk factors of perianal fistulas
- anorectal abscess - Crohn’s disease - diabetes mellitus - trauma to anal region - previous radiation to anal region
50
Presentation of perianal fistulas
- recurrent perianal abscesses - intermittent or continuous discharge per rectum *e.g. mucus, blood, pus, faeces*
51
Classifications/locations of perianal fistulas
- inter-sphincteric (most commonly) - trans-sphincteric - supra-sphincteric - extra-sphincteric
52
What is the Goodsall rule of perianal fistulas?
used to predict the trajectory of the fistula tract, depending on the external opening location in comparison to the transverse anal line: - **anterior to line**: direct tract straight to the dentate line - **posterior to line**: tract follows curved course to posterior midline
53
First line imaging of perianal fistulas
MRI scan
54
Management of perianal fistula
- medical management of crohn’s if the cause - fistulotomy - placement of seton - allows fistula to drain
55
What are anorectal abscesses?
Collection of pus in anal or rectal region
56
Types of anorectal abscesses
- perianal abscess (most common) - ischiorectal abscess - supralevator abscess - intersphincteric abscess
57
Pathophysiology of anorectal abscesses
- plugging of anal ducts > fluid stasis > infection - most commonly E. Coli - most commonly located in perianal area
58
Presentation of anorectal abscesses
- severe pain in perianal region - worse when sat down - perianal discharge or bleeding - erythematous, fluctuant, tender swelling on examination
59
Investigations of anorectal abscess
- clinical diagnosis - inspection + DRE - colonoscopy + blood cultures if query underlying cause - MRI - transperineal USS
60
Management of anorectal abscesses
- antibiotics *e.g. Ciprofloxacin + metronidazole* - analgesia - **incision + drainage** (first line) under LA if simple or GA if complex - intra-operative proctoscopy to check for any perianal fistulas
61
Simple vs complex anorectal abscess
- **simple**: superficial + no involvement of sphincter complex - **complex**: involves anal sphincter, underlying condition, deeper

Gastrointestinal (34 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions