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GI diseases > Inflammatory Bowel Disease > Flashcards

Inflammatory Bowel Disease Flashcards

1
Q

What are the two types of IBD?

A

Ulcerative Colitis

Crohn’s disease

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2
Q

What does Crohn’s clinically present with?

A

Abdominal pain

Peri-anal disease

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3
Q

What does UC clinically present with?

A

Diarrhoea

Bleeding

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4
Q

What are the genetic factors in IBD?

A

NOD2/ CARD15 (IBD-1)

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5
Q

What is the genetic pathology underlying IBD?

A

A mutated form of NOD2
Encodes a protein involved in bacterial recognition
NOD2 contributes to normal mucosal defences.

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6
Q

What is the role of gut flora in IBD?

A

Diverting faecal stream helps Crohn’s.

Altered bacterial flora in colons with UC.

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7
Q

What is the effect of overactive effector T-cells cause?

A

Inflammation/ Disease

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8
Q

What is the effect of absent regulatory T-cells?

A

Uncontrolled Inflammation/ Aggressive Disease

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9
Q

Which form of IBD is a Th1 mediated disease?

A

Crohn’s

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10
Q

Which form of IBD is a mixed Th1/ Th2 mediated disease?

A

UC

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11
Q

Which form of IBD is associated with natural killer T-cells?

A

UC

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12
Q

What is the effect of smoking on Crohn’s disease?

A

Aggravates disease

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13
Q

What is the effect of smoking of Ulcerative Colitis?

A

Protects against UC

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14
Q

What type of drug is associated with contributing to IBD?

A

NSAIDs

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15
Q

What is UC?

A

Inflammation of the colon.

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16
Q

What age is the peak incidence?

A

20s-30s

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17
Q

Which type of IBD affects rectum extending proximally?

A

UC

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18
Q

What are the common diseases of UC?

A

Pancolitis
Proctitis
Left-sided colitis

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19
Q

What are the symptoms of UC?

A 
Diarrhoea
Bleeding
Increased bowel frequency
Urgency
Tenesmus
Incontinence
Night rising
Lower abdominal pain (esp. LIF)
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20
Q

What symptom can proctitis cause?

A

Constipation

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21
Q

What tests would you do for UC?

A 
FBC
CRP
Albumin
Plain AXR
Endoscopy
Histology
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22
Q

What would you see on AXR for UC?

A

Stool distribution: Absent in inflamed colon.
Mucosal oedema/ “thumb-printing”
Toxic megacolon

23
Q

What would you see on endoscopy for UC?

A

Confluent inflammation extending proximallty from anal margin to a “transition zone”
Loss of vessel pattern
Granular mucosa
Contact bleeding

24
Q

Which form of IBD causes loss of vessel pattern (seen on endoscopy)?

A

UC

25
Q

Which form of IBD causes confluent inflammation extedning proximally from anal margin to a “transition zone”?

A

UC

26
Q

Which type of cancer does UC give an increased risk of?

A

Colorectal caner

27
Q

What determines the risk of developing colorectal cancer from UC?

A

Severity of inflammation
Duration of disease
Disease extent

28
Q

What extra-intestinal manifestation(s) of UC would present in the patient’s mouth?

A

Stomatitis

Apthou ulcers

29
Q

What extra-intestinal manifestation(s) of UC would present in the patient’s eyes?

A

Episcleritis

Uveitis

30
Q

What is primary sclerosing cholangitis?

PSC

A

Chronic inflammatory disease of biliary tree

associated with IBD

31
Q

What symptoms are caused by primary sclerosing cholangitis?

A

Itch

Rigors

32
Q

What effect does primary sclerosing cholangitis have on LFTs?

A

Causes cholestatic LFTs

33
Q

Which form of IBD causes skip lesions?

A

Crohn’s

34
Q

Which form of IBD causes Transmural inflammation?

A

Crohn’s

35
Q

What is involved in peri-anal disease?

A

Recurrent abscess formation
Pain
Can lead to fistula with persistent leakage
Damaged sphincters

36
Q

What are the consequences of long-term crohn’s disease?

A

Stricture
Fistula
Abscess

37
Q

What are the symptoms of Crohn’s disease affecting the small intestine?

A

Abdominal cramps
Diarrhoea
Weight loss

38
Q

What are the symptoms of Crohn’s disease affecting the colon?

A

Abdominal cramps
Diarrhoea with blood
Weight loss

39
Q

What are the symptoms of Crohn’s disease affecting the mouth?

A

Painful ulcers
Swollen lips
Angular chielitis

40
Q

What are the symptoms of Crohn’s disease affecting the anus?

A

Peri-anal pain

Abcess

41
Q

What blood tests would you carry out for suspected crohn’s

A 
CRP
Albumin
Platelets
B12
Ferritin
42
Q

What would colonoscopy show for crohn’s disease?

A

“cobblestoning”
thickened wall
fat-wrapping
(fissure?)

43
Q

What would colonoscopy show for UC?

A

Ulceration
Surviving Mucosa (Pseudopolyps)
Loss of haustra

44
Q

Which form of IBD may be present unrecognised for years?

A

Crohn’s

45
Q

Which form of IBD has recurring periods of “flare-ups” and remission?

A

Crohn’s

46
Q

Which form of IBD has a history of weeks

A

UC

47
Q

Which form of IBD causes vomitting and nausea??

A

Crohn’s

48
Q

Which form of IBD is continuous from rectum up to colon?

A

UC

49
Q

Which form of IBD affects terminal ileum and may involve colon, stomach, mouth etc?

A

Crohn’s

50
Q

What is seen histologically with Crohn’s disease?

A

Granuloma

51
Q

What is seen histologically with UC?

A

Shortened and branched crypts

Plasma cell infiltrates

52
Q

What symptom of IBD affects the skin?

A

Pyoderma gangrenosum

53
Q

What effect does IBD have on the blood?

A

Anaemia

54
Q

First line drug for IBD?

for decades

A

5-AS

GI diseases (8 decks)

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