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BDS2 BAMS Gastroenterology > Inflammatory bowel disease > Flashcards

Inflammatory bowel disease Flashcards

1
Q

What part of the body does IBD affect

A

the large bowl

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2
Q

What are the 2 common IBD conditions

A

Crohn’s disease

Ulcerative colitis

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3
Q

How does age and gender affect liklihood of having Crohn’s or ulcerative colitis

A

15-25yrs
50-80yrs
Crohn’s = male> female
UC= female>male

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4
Q

What factors play a role in the aetiology of IBD

A
  • immunological
  • psychological
  • smoking
  • genetic
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5
Q

What is the aetiology of crohn’s disease

A

Granulomatous inflammation

  • food intolerance
  • persisting viral infection/immune activation
  • ? infection with mycobacteria
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6
Q

What is Johne’s disease? why is it relevant?

A

Crohn’s in cattle

  • infection with M. paratuberculosis
  • suggestion of zoonotic infection from cows to people
  • pasturisation doesn’t get rid of M.paratuberculosis therefore possibly involved in Crohn’s
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7
Q

What does Crohn’s look like

A

Lumps on the mucosa, also cobblestoning

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8
Q

Why does Crohn’s look like it does

A

Lumps caused by oedema because granulomas blocking lymphatics therefore preventing drainage of normal tissues, causes cobblestoning

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9
Q

Where does Crohn’s affect

A

Whole GI tract from mouth to anus?

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10
Q

Where does UC affect

A

colon and rectum?

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11
Q

Which of UC and C is the disease continuous

A

UC (starts from rectum and works its way up)

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12
Q

Which of UC and C is the disease discontinuous

A

C (skip areas in GI tract)

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13
Q

Which of UC and C is the rectum always involved

A

UC

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14
Q

Which of UC and C is the rectum always involved 50%

A

C

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15
Q

Which of UC and C has anal fissures 25%

A

UC

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16
Q

Which of UC and C has anal fissures 75%

A

C

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17
Q

Which of UC and C is the ileum involved 10%

A

UC

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18
Q

Which of UC and C is the ileum involved 30%

A

C

19
Q

Which of UC and C does the mucosa have granulomas and ulcers

A

UC

20
Q

Which of UC and C does the mucosa have cobbled and fissures

A

C

21
Q

Which of UC and C is vascular

A

UC

22
Q

Which of UC and C is non-vascular

A

C

23
Q

Which of UC and C is the serosa (smooth tissue membrane) normal

A

UC

24
Q

Which of UC and C is the serosa (smooth tissue membrane) inflamed

A

C

25
Q

Which of UC and C has superficial inflammation and which extends through the entire thickness of the bowel wall

A 
UC = superficial inflammation
C = extends through entire thickness
26
Q

What are the microscopic features of UC

A
  • mucosa
  • vascular
  • mucosal abcesses
27
Q

What are the microscopic features of C

A
  • transmural
  • oedematous
  • granulomas
28
Q

What other condition has the same histology as C

A

OFG

29
Q

What are the features of a C’s patient’s intestine compared to a healthy one

A
  • cobblestone appearance of mucosal surface due to linear ulceration
  • narrowed lumen
  • thickened wall
  • abcesses
30
Q

What are the features of a UC’s patient’s intestine compared to a healthy one

A
  • affects mucosal layer only
  • absence of goblet cells
  • crypt distortion and abscess
31
Q

What are the different severities of UC called

A
  • proctitis
  • proctosigmoidtitis
  • distal colitis
  • pancolitis
  • backwash ileitis
32
Q

What does proctitis mean

A

UC involving only the rectum

33
Q

What does proctosigmoidtitis mean

A

UC involving the rectum and sigmoid colon

34
Q

What does distal colitis mean

A

UC involving only the left side of the colon

35
Q

What does Pancolitis mean

A

UC involving the entire colon

36
Q

What does backwash iletis mean

A

UC involving the distal ileum

37
Q

Symptoms of UC

A
  • diarrhoea
  • abdominal pain
  • PR bleeding
38
Q

Symptoms of C

A

colonic disease
- same as UC

small bowel disease

  • pain
  • malabsorption
  • obstruction
  • anal disease

mouth
- ofg

39
Q

How might ofg indicate other problems

A
  • red thick looking gingiva, not a plaque related problem
  • commonly seen in children, tend not to chase bowel problems until symptoms
  • the younger people get OFG the more likely they’ll get IBD
40
Q

Investigations for IBD

A
  • blood tests
  • faecal calprotectin
  • endoscopy
  • leukocyte scan
  • barium studies
  • bullet endoscopy
41
Q

Why is calprotectin tested for in IBD

A

Calprotectin is released on inflammation, released into bowel, gives an idea of whether bowel is inflamed or not without doing an endoscopy (should work in significant cases)

42
Q

What are complications of IBD

A

Ulcerative colitis develops carcinoma

  • risk increases with time
  • judgement as to whether colectomy is justified
43
Q

Treatment for IBD

A
  1. Immunosuppressive medical treatment
    - systemic steroids
    - local steroids (rectal administered)
    - anti-inflammatory drugs
    - non steroid immunosuppresants
    - anti TNFalpha therapy (e.g. infliximab)
2. surgery
Ulcerative colitis: colectomy cures
Crohn's: pallitate symptoms
- remove obstructed bowel segments
- drain abscesses
- close fistulae, especially perianal

usually results in stoma/bag, may be reversible

BDS2 BAMS Gastroenterology (5 decks)

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