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GI system > Inflammatory bowel disease > Flashcards

Inflammatory bowel disease Flashcards

1
Q

What are the causes of inflammatory bowel disease?

A

Genetic

Normal flora of large intestine

Immune response

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2
Q

What are the types of inflammatory bowel disease?

A

Crohn’s disease

Ulcerative colitis

Intermediate colitis

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3
Q

What age group is more commonly affected by Crohn’s disease? And by ulcerative colitis?

A

Crohn’s - young adults, elderly

Ulcerative colitis - young adults

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4
Q

What part of the GI tract can be affected by Crohn’s disease? And by ulcerative colitis?

A

Crohn’s - any part of GI tract

Ulcerative colitis - colon

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5
Q

What part of the GI tract is most commonly affected by Crohn’s disease? And by ulcerative colitis?

A

Crohn’s - ileum

Ulcerative colitis - rectum then extends proximally

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6
Q

How continuous are the parts of the GI tract affected by Crohn’s disease? And by ulcerative colitis?

A

Crohn’s disease - discontinuous, unaffected then affected than unaffected, called skip lesions

Ulcerative colitis - continuous

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7
Q

How deeply does Crohn’s disease affect the wall of the GI tract? And ulcerative colitis?

A

Crohn’s disease - transmural, meaning entire depth of wall

Ulcerative colitis - mucosa

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8
Q

What are the signs and symptoms of Crohn’s disease?

A

RLQ pain

Diarrhoea

Weight loss

Fever

Anaemia

Perianal inflammation

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9
Q

What is the macroscopic appearance of the intestines with Crohn’s disase?

A

Inflamed - red, swollen

Deep ulceration

Cobblestone appearance

Thickening of wall

Strictures

Fistulae

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10
Q

Why do the intestines have a cobblestone appearance with crohn’s disease?

A

Deep ulceration

adjacent to inflamed swollen tissue, or adjacent to fibrosing tissue, or adjacent to healthy tissue

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11
Q

What is a fistula?

A

Abnormal connection between two epithelia-lined surfaces

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12
Q

What do fistula occur between with Crohn’s disease?

A

Intestines
and
other part of intestine, bladder, skin etc.

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13
Q

What is a stricture?

A

Narrowing of lumen

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14
Q

What is the microscopic appearance of Crohn’s disease?

A

Granuloma

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15
Q

What investigations are done for a patient with Crohn’s disease?

A

Full blood count

CT and MRI scans

Barium follow through or enema

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16
Q

What might the full blood count of a patient with Crohn’s disease show?

A

Anaemia

17
Q

Why do patients with Crohn’s disease get anaemia?

A

Iron deficiency, due to bleeding, malabsorption

B12 deficiency, due to malabsorption

Anaemia of chronic disease

18
Q

What do CT and MRI scans of a patient with Crohn’s disease show?

A

Intestinal wall thickening

Strictures

19
Q

What might barium enema and follow throughs of a patient with Crohn’s disease show?

A

Strictures

Fistulae

20
Q

What are the signs and symptoms of ulcerative colitis?

A

Lower abdominal pain

Diarrhoea with blood and mucus

Weight loss

Anaemia

21
Q

What is the macroscopic appearance of the intestines with ulcerative colitis?

A

Ulcerations

Pseudopolyps

Lead pipe colon

22
Q

What is a pseudopolyp?

A

Projecting masses of oedematous tissue, granulation tissue or scar tissue
between areas of ulceration

23
Q

What is meant by a lead pipe colon?

A

No haustra

24
Q

What is the microscopic appearance of the intestines with ulcerative colitis?

A

Crypt distortion

Crypt abscesses

25
Q

What investigations are done for a patient with ulcerative colitis?

A

Full blood count

Stool culture

Colonoscopy

Plain abdominal radiographs

Barium enema for more mild cases

CT/MRI scan for more severe cases

26
Q

What might a full blood count of a patient with ulcerative colitis show?

A

Anaemia

27
Q

Why causes anaemia in a patient with ulcerative colitis?

A

Iron deficiency, due to bleeding

28
Q

What are the extra-intestinal signs and symptoms of inflammatory bowel disease?

A

Arthritis

Erythema nodosum

Pyoderma gangrenosum

Psoriasis

Primary sclerosing cholangitis

Eye problems

29
Q

What is intermediate colitis?

A

The in between Crohn’s and ulcerative colitis

30
Q

What is erythema nodosum?

A

Red round lumps beneath the skin

31
Q

What is pyoderma gangrenosum?

A

Deep ulcers on the skin

32
Q

What is primary sclerosing cholangitis?

A

Inflammation and fibrosis of the bile ducts

33
Q

How is inflammatory bowel disease treated?

A

Medically

Surgically if medical treatment is unsuccessful

34
Q

What are the medical treatments of inflammatory bowel disease?

A

Aminosalicyclates for flare-ups, remission

Corticosteroids for flare ups

Immunomodulators for more severe disease

35
Q

What are the surgical treatments of inflammatory bowel disease?

A

Crohn’s - removing small amounts of most affected bowel e.g. strictures, fistula

Ulcerative colitis - colectomy

36
Q

How successful is the surgical treatment for Crohn’s disease? Why?

A

Not successful

because may affect another part of the GI tract

37
Q

How successful is the surgical treatment for ulcerative colitis?

A

Cures ulcerative colitis

38
Q

When is surgical treatment for ulcerative colitis done?

A

Medical treatment was unsuccessful

colon is still inflamed and ulcerated, becoming precancerous

GI system (21 decks)

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