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P2 GI > Irritable Bowel Disease (IBD) > Flashcards

Irritable Bowel Disease (IBD) Flashcards

1
Q

What is ulcerative colitis?

A

Inflammation of the colonic mucosa causing ulcers to form along the lumen of the large intestine

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2
Q

What is characteristic spread of UC?

A

Begins in the rectum and spreads in retrograde up to, but not beyond, ileocecal valve

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3
Q

What are the risk factors for UC? (4)

A

Genetic predisposition: FH, young women, Caucasians, Eastern European’s
NSAIDs
Chronic stress & depression
Diet

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4
Q

What are the symptoms of UC? (4)

A

Severe & frequent diarrhoea: BLOOD + MUCUS
LLQ pain
Crampy abdominal discomfort
Systemic sx in attacks: fever, malaise, anorexia, decreased weight

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5
Q

What are the signs of UC? (2)

A

May be none

Severe: fever, tachycardia, tender distended abdomen

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6
Q

How would you diagnose UC? (4)

A

Raised WCC, ESR & CRP
Faecal calprotectin
Stool samples = exclude infectious agents
Colonoscopy (GS)

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7
Q

What are the characteristic findings on colonoscopy for UC? (2)

A

Continuous inflammation in mucosa of LI

No skip lesions

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8
Q

How would you treat mild/moderate UC? (2)

A

Anti-inflammatory medications:

  • Mesalazine, olsalazine
  • Oral prednisolone
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9
Q

How would you treat severe UC? (4)

A

Oral prednisolone
Infliximab
Immunosuppressants
Colectomy (can cure disease)

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10
Q

What is Crohn’s disease?

A

Transmural granulomatous inflammation affecting ANY part of the gut from mouth to anus

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11
Q

What are the risk factors for CD? (5)

A 
Genetic association [NOD2 gene mutation]
Smoking
NSAIDs
FH
Chronic stress & depression
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12
Q

What are the symptoms of CD? (4)

A

Diarrhoea w/ bleeding
Pain in RLQ (mimicking appendicitis)
Weight loss
Fatigue

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13
Q

What are the signs of CD? (4)

A

Anorexia
Abdominal tenderness
Perianal abscess
Anal fistula

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14
Q

How would you diagnose CD? (4)

A

Raised ESR, CRP, WCC
Faecal calprotectin
Stool sample
Colonoscopy

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15
Q

What are the characteristic findings of CD on colonoscopy? (3)

A

Cobblestone mucosa
Skip lesions
Transmural inflammation

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16
Q

What is the treatment for moderate-severe attacks of CD?

A

Glucocorticoids eg oral prednisolone

17
Q

What are the treatments for severe attacks of CD?

A 
IV hydrocortisone
Antibiotics eg IV metronidazole
Biologics eg infliximab, adalimumab
Immunosuppressant eg methotrexate
Surgery
18
Q

What is a biologic?

A

Anti-TNF monoclonal antibody eg infliximab

19
Q

In which condition would you advise the patient to keep smoking?

A

Ulcerative colitis

  • Smoking can decrease severity of UC
  • Stopping smoking can exacerbate symptoms & disease activity

P2 GI (11 decks)

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