Inflammatory bowel disease

Question 1

Symptoms of Crohn’s disease

Answer 1

Diarrhoea (with blood and mucus), Weight loss, Abdominal pain, Malaise

Question 2

Signs of Crohn’s disease

Answer 2

Apthous ulcers, Abdominal tenderness, Perianal abscesses, Fistulae, Clubbing, Erythema nodosum, Pyoderma gangrenosum, Conjunctivitis, Iritis

Question 3

Investigations for Crohn’s disease

Answer 3

Bloods: FBC, U+Es, LFTs

Stool culture, Sigmoid/Colonoscopy

Question 4

Blood findings with Crohn’s disease

Answer 4

FBC: Raised WCC, CRP - Low Hb
U+Es: Low K
LFTs: Low Alb

Question 5

Management of a mild flare of Crohn’s disease

Answer 5

Prednisolone PO

Question 6

Classification of a mild flare of Crohn’s disease

Answer 6

Systemically well

Question 7

Management of a severe flare of Crohn’s disease

Answer 7

Hydrocortisone IV, Metronidazole PO or IV

Question 8

Classification of a severe flare of Crohn’s disease

Answer 8

Systemically unwell

Question 9

Long term management of Crohn’s disease

Answer 9

Azathioprine first line

Methotrexate, Biologics

Question 10

Indications for surgery in Crohn’s

Answer 10

Obstruction, No response to drugs

Question 11

Symptoms of ulcerative colitis

Answer 11

Diarrhoea (blood and mucus), Abdominal pain (cramps), Weight loss, Tenesmus, Malaise

Question 12

Signs of ulcerative colitis

Answer 12

Fever, Tachycardia, Abdominal mass, Clubbing, Erythema nodosum, Conjuctivitis, Iritis, Episcleritis, Arthritis

Question 13

Investigations for ulcerative colitis

Answer 13

Bloods: FBC

Stool culture and microscopy, Sigmoid/Colonoscopy

Question 14

Blood findings with ulcerative colitis

Answer 14

FBC: Raised CRP and WCC

Question 15

Classification of a mild flare of ulcerative colitis

Answer 15

Less than 4 stools a day

Question 16

Classification of a moderate flare of ulcerative colitis

Answer 16

Between 4-6 stools a day

Question 17

Classification of a severe flare of ulcerative colitis

Answer 17

Greater than 6 stools a day

Question 18

Management of a mild/moderate flare of ulcerative colitis

Answer 18

7 day course of Prednisolone PO, 5-ASA

Question 19

Management of a severe flare of ulcerative colitis

Answer 19

IV hydrocortisone, 5-ASA

Question 20

Management options of an ulcerative colitis flare unresponsive to initial management

Answer 20

Medical: Ciclosporin, Biologics
Surgical: Colectomy

Question 21

Indications for surgery in ulcerative colitis

Answer 21

Perforation, Haemorrhage, Toxic dilation, Failure to respond

Question 22

Long term management of ulcerative colitis

Answer 22

5-ASA

Azathioprine