Inflammatory Bowel Disease

Question 1

What is IBD composed of?

Answer 1

• Crohn’s disease
• ulcerative colitis
• indeterminate colitis

Question 2

How do Crohn’s and Ulcerative colitis differ?

Answer 2

• clinical presentations

- pathology

Question 3

What genetic factor may be involved in IBD?

Answer 3

• NOD2

- 16q12 chromosome

Question 4

What immunological cell is involved in Crohn’s disease?

Answer 4

• Th1 mediated

Question 5

What immunological cell is involved in Ulcerative Colitis?

Answer 5

• Th1 and Th2

Question 6

What are some clinical features of ulcerative colitis?

Answer 6

• inflammation of the colon
• relapsing course
• affects rectum extending proximally

Question 7

What are the symptoms of ulcerative colitis?

Answer 7

• diarrhoea and bleeding
• increased bowel frequency
• urgency
• incontinence

Question 8

What questions should you ask in suspected ulcerative colitis?

Answer 8

• travel
• recent antibiotics
• NSAIDs
• family history
• smoking
• skin,eyes, joints

Question 9

What scoring system is used in ulcerative colitis?

Answer 9

• truelove and Witt criteria

Question 10

Why would an AXR be conducted?

Answer 10

• stool distribution
• mucosal oedema (thumb-printing)
• toxic megacolon

Question 11

Explain the histology of ulcerative colitis?

Answer 11

• affects mucosal layer only
• absence of goblet cells
• crypt distoriton

Question 12

What may be a complication of both ulcerative colitis and crohns disease?

Answer 12

• primary sclerosing cholangitis

Question 13

What is primary sclerosing cholangitis?

Answer 13

• long-term progressive disease of the liver and gallbladder
• inflammation of the bile ducts
• more common in UC than Crohn’s

Question 14

Skin lesions and cobblestoning is terms used in what disease?

Answer 14

• Crohns disease

Question 15

What are symptoms of Crohn’s disease?

Answer 15

• abdominal cramps
• diarrhoea
• weight loss
• painful mouth ulcers

Question 16

What small bowel assessments may be carried out in IBD?

Answer 16

• barium follow-through

- small bowel MRI

Question 17

What are the aims of treatment for IBD?

Answer 17

• Control inflammation + heal mucosa
• restore normal bowel habit
• improve quality of life

Question 18

What drugs can be used in Ulcerative Colitis?

Answer 18

• 5ASA
• Steroids
• Immunosuppressants
• Anti-TNF therapy

Question 19

What drugs can be used in Crohn’s disease?

Answer 19

• Steroids
• Immunosuppressants
• Anti-TNF therapy

Question 20

What is the mechanism of a 5ASA drug?

Answer 20

• anti-inflammatory properties

- can be given topically or orally

Question 21

Name a 5ASA drug?

Answer 21

• Mesalazine

- Pentasa

Question 22

What is the effect of corticosteroids?

Answer 22

• systemic anti-inflammatory properties

Question 23

Name a corticosteroid?

Answer 23

• prednisolone

Question 24

What is the drug triad for Ulcerative Colitis?

Answer 24

• topical 5ASA
• Oral 5ASA
• Corticosteroid

Question 25

What lifestyle advice should be given for Crohn’s disease?

Answer 25

• stop smoking

Question 26

What surgery is performed for Crohn’s disease?

Answer 26

• resection

- Stricturoplasty (alleviate bowel narrowing)

Question 27

What may be a complication of a pouch?

Answer 27

• Infertility
• haemorrhage
• urinary dysfunction

Question 28

What are some examples of indications for surgery in someone with Crohn’s disease?

Answer 28

• Stenosis causing obstruction
• Enterocutaneous fistulas
• Intra-abdominal fistulas
• Abscess

Question 29

Smoking aggravates _____ but may protect against _____

Answer 29

• aggravates Crohn’s

- may protect against UC

Question 30

Treatment conclusion for Crohns?

Answer 30

• glucocorticosteroid
• 5ASA
• Immunosuppresant
• Anti-TNF

Question 31

Treatment conclusion for Ulcerative colitis?

Answer 31

• 5ASA
• Glucocortiocsteroid
• Immunosuppresant
• Antib-TNF

Question 32

Example of a glucocorticosteroid used

Answer 32

• predinsolone