Inflammatory Bowel Dx

Question 1

Difference between IBD and IBS

Answer 1

Functional conditions so in investigations wouldn’t find anything

In inflammatory bowel disease , would have positive findings on investigations

Question 2

IBD definition

Question 3

IBD classification

Answer 3

Ulcerative colitis
Crohn’s disease

Question 4

Countries with highest incidence

Answer 4

Europe , UK , Nrth america

Question 5

Is it rare in Ghana

Answer 5

No

Question 6

Main form of IBD in Ghana

Answer 6

UC more common

Question 7

Peak age of IBD

Answer 7

Bimodal
15-30 yo
60-80 yo

Question 8

Mâle to female ratio in

Answer 8

1:1 UC
1.1-1.8: 1

Question 9

Risk factor protective in UC

Answer 9

Smoker

Question 10

Risk factors

Answer 10

Smoking ( CD )
Diet
Stress
Infections with microbial factors
Immunosupressoon
Genetic susceptibility

Question 11

Site of UC

Answer 11

Almost always rectum
Descending colon /sigmoid

Question 12

Site of CD

Answer 12

Commonest in ileum
Rectum not common
Anal lesions common
Can affect any part of GIT

Question 13

UC gross patho

Answer 13

Only mucosa with superficial ulcers
Exudation
Pseudopolyposis

Question 14

Micro of UC

Answer 14

Crypt abscess
Inflammatory polyps
Highly vascular granulation tissue
Reduced crypts in number
Atrophie crypts
Stem colon

Question 15

CD gross histo

Answer 15

Full thickness of with serosa
Cobble stone
Deep fissured ulcer
LN enlarged
Fistula
Skip areas

Question 16

CD micro histology

Answer 16

Rarely crypt abscess
Non caseating giant cell granuloma

Question 17

Common Clinical presentation

Answer 17

Abdominal pain cramping
Diarrhea but sometimes constipation
Diarrhea with bleeding

Question 18

Specific UC sy’ptodls

Answer 18

Watery or bloody diarrhea rectal discharge
Proctitis

Question 19

Specific CD symptoms’

Question 20

IBD systemic manifestation

Answer 20

Joints- Arthritis

Eyes - Uveitis, iritis, episcleritis

Skin / Mucus Membranes- Erythema nodosum, Pyoderma gangrenosum, Aphthous stomatitis

Liver/GI- Primary sclerosing cholangitis with elevated GGT, ALP, Cholelithiasis, Pancreatitis

Heme/Onc- Hyper coagulabilité

Increased risk for colorectal cancer

Question 21

IBD diagnosis principle

Answer 21

Patient’s history

Negative stool examination for bacteria, C. difficile toxin, and ova and parasites;

sigmoidoscopic appearance

Histology of rectal or colonic biopsy specim

Question 22

UC lab findings

Answer 22

Rise in CRP, platelet count, erythrocyte sedimentation rate (ESR)

decrease in hemoglobin.