Inflammatory Bowel Disease

Question 1

Signs of IBD

Answer 1

Fever, tachycardia, anaemia

Question 2

Pathophysiology of IBD

Answer 2

Idiopathic inflammation of bowel mucosa

Question 3

Difference between UC and crohns

Answer 3

UC: limited to colon, continuous, mucosal layer only, mucosal bleeding
Crohns: anywhere from mouth to anus, skip lesions, transmural, fistulas and strictures, cobblestone appearance

Question 4

Investigations of IBD

Answer 4

Stool analysis for parasites eg. C.difficile
Barium enema
Colonoscopy and biopsy

Question 5

Management of IBD

Answer 5

DMARDs eg. Methotrexate, Sulfasalazine
Corticosteroids for acute disease flare ups
Immunosuppressants eg. Azathioprine, cyclophosphamide
Surgical resection of bowel

Question 6

Mechanism of action of azathioprine

Answer 6

Acts as a cytotoxic anti metabolite

Prodrug, gets converted to 6-Mercaptopurine, inhibits purine metabolism so reduces DNA synthesis.

Question 7

ADRs of immunosuppression

Answer 7

Bone marrow suppression
Increased infection risk
Increased malignancy risk
Hepatitis

Question 8

IBD differential diagnosis

Answer 8

Bowel obstruction
GI cancer
Infection
IBS

Question 9

Symptoms of IBD

Answer 9

Abdominal pain, irregular bowel habits- diarrhoea, weight loss, fever, malaise, rectal bleeding (UC), perianal disease