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The Gastrointestinal System > Inflammatory Bowel Disease > Flashcards

Inflammatory Bowel Disease Flashcards

1
Q

Inflammatory bowel disease is an umbrella term encompassing which two conditions?

A
  1. Crohn’s disease
  2. Ulcerative colitis
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2
Q

Which three main factors contribute to IBD?

A
  1. Mucosal immune system
  2. Genetic predisposition
  3. Environmental triggers
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3
Q

Which gene, when mutated, gives a greatly increased risk of Crohn’s disease?

A

NOD2

(it codes for bacterial recognition)

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4
Q

Crohn’s disease is mediated by which immune cell type?

A

TH1

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5
Q

Ulcerative colitis is mediated by which immune cell types?

A

TH1 and TH2

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6
Q

How does smoking affect both Crohn’s and UC?

A

Crohn’s - aggravates

UC - protects

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7
Q

How do NSAIDS impact IBD?

A

Causes aggravtion

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8
Q

What are the main symptoms of UC?

A
  • Diarrhoea and bleeding
  • Increased bowel frequency
  • Tenesmus
  • Incontinence
  • Lower abdominal pain
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9
Q

A rash on the front of the shins is indicative of what?

A

UC

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10
Q

How is severe UC defined?

A

>6 bloody stools daily plus 1 of:

  • Fever (>37.8 degrees)
  • Tachycardia (>90/min)
  • Anaemia (haemoglobin <10.5g/dl)
  • Elevated ESR (>30mm/hr)
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11
Q

How can UC be investigated and assessed?

A
  • Bloods - CRP, albumin
  • Plain CXR - thumb printing
  • Endoscopy
  • Histology
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12
Q

Why is there an increased risk of cancer long term with UC?

A
  • Severity of inflammation
  • Duration of disease
  • Disease extent
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13
Q

Where else in the body may UC signs manifest?

A
  • Skin - erythema nodosum, pyoderma gangrenosum
  • Joints - axial and peripheral
  • Eyes
  • Deranged LFTs
  • Oxalate renal stones
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14
Q

Which disease can affect the whole GI tract?

A

Crohn’s

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15
Q

Why is resection minimised for Crohn’s patients?

A

It is a non curative disease and can recur

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16
Q

What are the main symptoms of Crohn’s disease?

A
  • Abdominal cramps
  • Diarrhoea - with or wthout blood
  • Weight loss
  • Painful mouth ulcers
  • Swollen lips
  • Angular cheilitis
  • Peri-anal pain and abscess
17
Q

What can happen to red blood cells if the terminal ileum is affected in IBD?

A

They become macroscopic

Vitamin B12 absorption is disrupted

18
Q

How does the greater omentum interact with the colon during Crohn’s?

A

It has a cobblestoning effect and wraps arong the colon

19
Q

In which IBD are the haustra of the colon lost?

A

UC

20
Q

Which IBD involves a thickened gut wall?

A

Crohn’s

21
Q

How can the small bowel be assessed?

A

Barium follow through

Small bowel MRI

Technetium-labelled white cell scan - such cells can be followed to areas of inflammation

The Gastrointestinal System (27 decks)

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