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GI > Inflammatory Bowel Disease > Flashcards

Inflammatory Bowel Disease Flashcards

1
Q

What are the 2 types of IBD?

A

Ulcerative Colitis

Chrohn’s Disease

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2
Q

What causes IBD?

A

Mostly idiopathic

Environmental trigger or genetically susceptible people

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3
Q

Symptoms of UC?

A

Bloody diarrhoea
Abdominal pain
Weight loss

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4
Q

What is ulcerative colitis?

A

Continous inflammation which only affects the colon. It starts in the rectum and works proximally

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5
Q

What are the clinical features of UC?

A 
Temp >37.5 
Pulse >90 
Albumin <30g/l 
>6 stools/day with blood 
Hb <10g/l
ESR raised
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6
Q

What is Crohn’s?

A

Patchy inflammation affecting mouth to anus with skip lesions. Can cause ulcers, strictures and fibrosis

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7
Q

What are the symptoms of Crohn’s?

A 
Diarrhoea 
Weight loss 
Abdominal pain 
Malaise 
Lethargy
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8
Q

What are the clinical features of Crohn’s?

A 
High ESR and CRP 
High platelet count 
High WCC
Low Hb
Low albumin
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9
Q

What are the main histological differences between UC and Crohn’s?

A

UC is transmural
Crohn’s will have non caveating granulomas
More crypt abscesses in UC
Goblet cells depleted in UC

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10
Q

What extra-intestinal manifestations could occur in IBD?

A 
Eyes 
Joints
Renal calculi 
Liver and biliary tree 
Skin
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11
Q

What disease can present very similarly to Crohn’s?

A

Ileo-caecal TB

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12
Q

What disease is associated with UC?

A

Sclerosing cholangitis

Colonic carcinoma

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13
Q

What method is used to continue surveillance of IBD?

A

Colonoscopy

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14
Q

What drugs are aminosalicylates (5ASA)?

A 
Mesalazine
Pro drugs (Balsalazide, Olzalazide, Sulfasalazide)
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15
Q

How are 5ASA used in UC?

A

> 3g/day
Reduces number and severity of relapses
Reduces CRC risk

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16
Q

How is 5ASA used in Crohn’s

A

Used for Crohn’d colitis

17
Q

What steroids are used in IBD?

A

Prednisolone (40mg per day then tapering reduction)

Budenoside

18
Q

What thiopurine is used in IBD?

A

Azathioprine (Side effects incl leucopenia, pancreatitis and hepatotoxicity)

19
Q

How is methotrexate used in IBD?

A

Unlicensed use in Crohn’s

Requires specialist follow up

20
Q

Name some immunosuppressants used in IBD?

A

Ciclosporin
Mycophenolate
Tacrolimus

21
Q

What are the Anti-TNF alpha antibodies in IBD treatment called?

A

Infliximab (8 weekly infusions)

Adulimumab (bi weekly SC injections)

22
Q

What is the alpha4b7 intern blocker used in IBD called?

A

Vedolizumab

23
Q

What are the surgical indications for Crohn’s?

A 
Failure of medical treatment
Relief of obstructive symptoms 
Fistulae management 
Intra-abdominal abscesses 
Anal conditions management

GI (27 decks)

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