Inflammatory Bowel Disease Flashcards
what does transmural mean
across the entire wall of the vessel or structure
which IBD features non-caseating granulomas on histology
crohn’s
serosa in CD pathological appearance
dull, grey and granular
mesentery of CD
thick, oedematous and fibrotic
what wraps around the gut tube in CD
mesenteric fat
intestine wall in crohn’s
thick with fluid and inflammatory cells
inside wall appearance in CD
‘cobblestone’ with clear demarcation between diseased and normal segments
two IBDs
crohn’s and ulcerative colitis
presentation of UC
bloody diarrhoea abdominal pain weight loss tenesmus rectal bleeding erythema nodosum
classification of UC attacks
mild moderate and severe
features of a severe UC attack
>6 bloody stools a day raised CRP and ESR fever tachtycardic anaemia
blood investigations in UC
WCC CRP and ESR albumin Hb vitamins and minerals
special test in IBD of faeces
faecal calprotectin (inflammatory marker)
biopsy in UC
rectal biopsy from a sigmoidoscopy
imaging in UC
abdominal XR, US, CT, MRI
Barium flurososcopy
colonoscopy
5 points of treatment in UC
anti-inflammatories immunosuppressants biologics surgery nutrional support
what type of drug is azathioprine
an immunosuppressatn
what type of drug is prednisolone
a corticosteroid (anti-inflammatory)
what type of drug is aminosalicylate
anti-inflammatory
what is the first line treatment for first presentation of UC
topical aminosalicylate (may need enema)
surgical option in UC
removal of colon (proctocolectomy) with an ileostomy and stoma bag or pouch procedure to maintain anal function
complications of UC in colon
haemorrhage, perforation, fistula, toxic dilatation
colonic carcinoma
what screening do UC patients recieve
colonic carcinoma
what is UC
an autoimmune condition that causes inflammation in the colon only and moves continuously from the rectum
peak incidence of UC
20-30 y/o and again at 70-80 y/o
what causes the autoimmune response in UC
normal gut flora
true/false granulomas are observed in UC
false
difference in ulceration of UC and CD
UC will not spread past the submucosa
CD will spread down into the entire intestinal wall (transmural)
which IBD in granulomatous
Crohn’s
pathology of crohn’s
immune reaction to gut flora is dysregulated and results in cellular damage
routes of treatment in crohn’s
anti-flammatory, antibiotics, immunosuppressants, surgical and nutritional support
process of treatment in IBD
5ASA (aminosalicylates) –> prednisolone or budesonide –> immunosuppressants –> biologics –> surgery
presentation of Crohn’s
diarrhoea abdominal pain weight loss malaise, lethargy etc anaemia vitamin deficiency arthritis erythema nodosum PSCholangitis
faeces marker in IBD
faecal calprotetin
where do you biopsy in Crohn’s
terminal ileum and colon
where does crohn’s affect
anywhere from mouth to anus but mostly the small and large intestine
what lifestyle factor is important to stop in Crohn’s
smoking
cancer risk of IBD
colon cancer
complications of IBD
fistula intra-abdominal abscess perforation obstruction colon cancer haemorrhage
