Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

#passmed 2022 > Inflammatory Bowel Disease (Crohn's and Ulcerative Colitis) > Flashcards

Inflammatory Bowel Disease (Crohn's and Ulcerative Colitis) Flashcards

1
Q

What is IBD?

A

Umbrella term for 2 diseases causing inflamm of GI Tract

  1. Ulcerative Colitis
  2. Crohn’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What acronyms tell you the difference between Crohn’s & UC?

A

Crohn’s: crows NESTS

UC: u - c - CLOSEUP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the Pathophysiology of Crohn’s?

A

Cause unknown, but strong genetic link

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where does Crohn’s most commonly affect? (2 things)

A
  1. Terminal ileum
  2. Colon

(But can be anywhere from mouth to anus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the Pathophysiology of UC?

A

Inapprop immune response vs abn colonic flora in genetically susceptibile individuals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why are Crohn’s patients prone to strictures n fistulas n adhesions?

A

Bc inflamm occurs in all layers down to serosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the acronym that tells you how Crohn’s is different to UC?

A

crows NESTS

N - No blood / mucus

E - Entire GI tract

S - “Skip lesions” on endoscopy

T - Terminal ileum most affected + Transmural (full thickness) Inflamm

S - Smoking = risk actor (don’t set the nest on fire)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the acronym that tells you how UC is different to Crohn’s?

A

u - c - CLOSEUP

C – Continuous inflamm

L – Limited to colon + rectum

O – Only superficial mucosa affected

S – Smoking is PROTECTIVE lol

E – Excrete blood + mucus

U – Use aminosalicylates

P – Primary Sclerosing Cholangitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the CF of Crohn’s? (7 things)

A
  1. Fever (low grade)
  2. Fatigue
  3. Abd pain (crampy) (most common in kids) / tenderness / mass
  4. Bowel ulceration
  5. Perianal abscess / fistula
  6. Diarrhoea (most common in adults)
  7. Weight loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the CF of UC? (4 + 7 things)

A
  1. Abd pain (crampy) (esp LIF)
  2. Urgency
  3. Tenesmus (feeling like u gotta poo)
  4. Bloody diarrhoea

Extraintestinal signs:

  1. Fever (low grade)
  2. Iritis (swelling of iris)
  3. Oral ulcers
  4. Tachycardia
  5. Clubbing
  6. Primary Sclerosing Cholangitis
  7. Erythema nodosum (swollen red nodules under shin skin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What investigations should you do for sus Crohn’s? (5 things)

A
  1. Bloods
  2. Stool studies
  3. Colonoscopy w Biopsy (even if mucosa looks normal)
  4. CT / MRI / XR w barium swallow
  5. Small bowel enema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What Bloods should you do for sus Crohn’s? (8 things)

A
  1. FBC
  2. ESR
  3. CRP
  4. UnE
  5. LFT
  6. INR
  7. Ferritin
  8. B12
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What will a FBC show in Crohn’s? (3 things)

A
  1. Anaemia
  2. Leucocytosis
  3. Thrombocytosis

(same as UC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What will the ESR n CRP be in Crohn’s?

A

Both raised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What will the iron and vit B in bloods of Crohn’s be?

A

Deficient in both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is it important to do UnE in Crohn’s?

A

Chronic diarrhoea can cause elec imb

(same as in UC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Why are stool studies done in sus Crohn’s? (3 things)

A
  1. To exclude other causes of inflamm diarrhoea (e.g infection)
  2. C. difficile toxin studies (if recent abx use)
  3. Maybe traces of blood in stool (less common in Crohn’s)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the Colonoscopy findings for Crohn’s? (3 things)

A
  1. Skip Lesions (usually spare the rectum)
  2. Deep ulcers + fistulas –> Cobblestone appearance
  3. Transmural (all layers) inflamm
19
Q

What is the use of CT / MRI / XR w barium swallow in sus Crohn’s? (4 things)

A
  1. Assessing extent / severity of disease
  2. Seeing complications (e.g perforation / fistulas / abscess / stenosis)
  3. Seeing signs of inflamm (wall thickening)
  4. Seeing ulcers (Cobblestone appearance)
20
Q

What investigations should you do for sus UC? (5 things)

A
  1. Bloods
  2. Stool studies
  3. Faecal calprotectin
  4. AXR
  5. Lower GI endoscopy
21
Q

What Bloods should you do for sus UC? (6 things)

A
  1. FBC
  2. ESR
  3. CRP
  4. UnEs
  5. LFT
  6. Blood culture
22
Q

What will a FBC show in UC? (3 things)

A
  1. Anaemia
  2. Leucocytosis
  3. Thrombocytosis

(same as Crohn’s)

23
Q

What will the ESR be in UC?

A

Raised

(same as Crohn’s)

24
Q

Why is it important to do UnE in UC?

A

Chronic diarrhoea can cause elec imb

(same as in Crohn’s)

25
Q

Why are stool studies done in sus UC? (2 things)

A
  1. To exclude other causes of inflamm diarrhoea (e.g infection)
  2. Maybe traces of blood in stool (more common in UC)
26
Q

What is Faecal calprotectin? (3 things)

A
  1. Simple non-invasive test for GI inflamm
  2. High sensitivity
  3. Done for UC
27
Q

What will be seen in a AXR of a UC pt? (3 things)

A
  1. No faecal shadows
  2. Mucosal thickening / islands
  3. Colonic dilatation (complication)
28
Q

What Lower GI endoscopy should you do for ACUTE UC?

Why? (2 things)

A

Limited flexible sigmoidoscopy

  1. To assess
  2. To biopsy
29
Q

What Lower GI endoscopy should you do for UC once it’s CONTROLLED?

Why?

A

Full colonoscopy

To define disease extent

30
Q

What does the treatment of UC depend on?

31
Q

How do you determine the severity of UC?

A

Truelove & Witts Criteria (mod. to include CRP)

32
Q

What are the Truelove & Witts Criteria for MILD UC? (6 things)

A
  1. Apyrexial (no fever)
  2. Resting pulse = less than 70bpm
  3. Hb = 110+
  4. ESR less than 30
  5. Less than 4 poos (motions) a day
  6. SMALL rectal bleeding
33
Q

What are the Truelove & Witts Criteria for MODERATE UC? (6 things)

A
  1. 37.1 - 37.8 C
  2. Resting pulse = 70 - 90 bpm
  3. Hb = 105-110
  4. ESR: n/a
  5. 5 poos (motions) a day
  6. MODERATE rectal bleeding
34
Q

What are the Truelove & Witts Criteria for SEVERE UC? (6 things)

A
  1. 37.8+ C
  2. Resting pulse = 90+ bpm
  3. Hb = less than 105
  4. ESR: 30+
  5. 6+ poos (motions) a day
  6. LARGE rectal bleeding
35
Q

What is the aim of treatment for UC?

A

Inducing + maintaining remission

36
Q

How do you induce remission for MILD + MODERATE UC? (1st + 2nd line)

A

1st line = Aminosalicylate (e.g. mesalazine oral / rectal)

2nd line = corticosteroids (e.g prednisolone)

37
Q

How do you induce remission for SEVERE UC? (1st + 2nd line)

A

1st line = IV corticosteroids (e.g. hydrocortisone)

2nd line = IV ciclosporin (calcineurin inhibitor aka immunosuppressant)

38
Q

How do you maintain remission in UC? (3 things)

A
  1. Aminosalicylate (e.g. mesalazine oral / rectal)
  2. Azathioprine
  3. Mercaptopurine
39
Q

What is the SURGICAL management option for UC? (2 things)

A
  1. Panproctocolectomy (colon + rectum removal , bc UC only fx colon + rectum)
  2. Then permanent ileostomy (pouch)
40
Q

How do you induce remission for Crohn’s? (1st + 2nd line)

A

1st line = Steroids (oral prednisolone / IV hydrocortisone)

2nd line = Add Immunosuppressant (Azathioprine / Mercaptopurine / Methotrexate)

41
Q

How do you maintain remission in Crohn’s? (1st line + alternatives)

A

1st line = Azathioprine / Mercaptopurine

Alternatives = Methotrexate / Infliximab / Adalimumab

Tailored to pt needs, e.g individual risks, side fx etc.

42
Q

What is the surgical management option for Crohn’s?

A

When disease ONLY fx small area = remove dis area

BUT, Crohn’s usually fx whole GI tract, + recurrence rate is high so small section resections aren’t rly advocated

43
Q

What are the complications of Crohn’s? (6 things)

A
  1. Small bowel obst
  2. Abscess
  3. Fistulae
  4. Perforation
  5. Colon cancer
  6. Malnutrition
44
Q

What are the complications of UC? (4 things)

A
  1. Toxic dilatation of colon (+ risk of perforation)
  2. Venous thromboembolism
  3. Colon cancer
  4. Large bowel obst

#passmed 2022 (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions