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GIHEP > L24: Inflammatory Bowel Disease > Flashcards

L24: Inflammatory Bowel Disease Flashcards

1
Q

Which layers of the intestinal wall does UC affect?

A

mucosa + submucosa

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2
Q

Which layers of the intestinal wall does Crohn’s disease affect?

A

transmural

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3
Q

What are some of the aetiological theories of IBD?

A
  • genetics
  • infection (e.g. E. coli, salmonella)
  • immunological
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4
Q

Which age group does IBD normally affect?

A

young adults [15 - 35 years]

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5
Q

Which part of the intestine does ulcerative colitis typically affect?

A
  • rectum
  • left side of colon
  • sometimes pancolitis
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6
Q

Which part of the intestine does Crohn’s disease typically affect?

A
  • small intestine (only)

- ileocolonic (around ileocaecal valve)

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7
Q

List some of the common symptoms of UC

A
  • bloody diarrhea (w/ mucus)
  • cramping abdominal pain
  • increased frequency + urgency of defecation
  • tenesmus (feeling of incomplete emptying)
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8
Q

What is the True-Love and Witt score used for?

A

determines severity of of a patient’s UC

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9
Q

What is the name of the severity assessment score that is used for UC?

A

True-Love and Witt Score

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10
Q

What are the criteria that are a part of the True-Love and Witt score?

A
  1. > 6 Blood Stool
  2. Pulse > 90 BPM
  3. Temperature > 37.8
  4. HB < 10.5 g/dL
  5. CRP: very raised
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11
Q

List some of the common symptoms of Crohn’s Disease

A
  • non-bloody diarrhea (usually)
  • abdominal pain
  • abdominal mass
  • malabsorption + weight loss
  • peri-anal fistulas a/w abscess formation
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12
Q

Is weight loss more common in UC or in Crohn’s disease? Why?

A

Crohn’s Disease

- Crohn’s more commonly affects the small intestine while UC mainly affects the large intestine

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13
Q

What fistulas are the most common in Crohn’s disease?

A

peri-anal fistulas

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14
Q

What is the Harvey Bradshaw Index used for?

A

determines the severity of a patient’s Crohn’s disease

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15
Q

What severity score is used for Crohn’s Disease?

A

Harvey-Bradshaw Index

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16
Q

List the 5 main categories of the Harvey Bradshaw Index which is used to determine the severity of Crohn’s disease

A
  1. General Well-Being
  2. Abdominal Pain
  3. # of Liquid Stools
  4. Abdominal Mass
  5. Complications
17
Q

List some of the extra-intestinal complications of Crohn’s Disease

A
  • enteropathic arthritis
  • uveitis
  • erythema nodosum
  • pyoderma gangrenosum
  • mouth ulcers (aphthous ulcers)
18
Q

List some of the extra-intestinal complications of Ulcerative Colitis

A
  • osteoarthritis
  • ankylosing spondylitis
  • primary sclerosing cholangitis (PSC)
  • erythema nodosum
  • pyoderma gangrenosum
19
Q

What is the Bristol stool chart used for?

A
  • investigates what type of diarrhea a patient may have

- helps measure the time it takes for food to pass through your body and leave as waste

20
Q

When can an abdominal x-ray or plain film abdomen (PFA) show when investigating IBD?

A
  • toxic megacolon

- colitis

21
Q

What can an erect CXR show when investigating IBD?

A

free air under the diaphragm (due to perforation)

22
Q

When is a barium follow-through imaging test used when investigating IBD?

A

for Crohn’s Disease in small intestine

23
Q

A “cobblestone” pattern upon endoscopy, is indicative of what illness?

A

Crohn’s Disease

24
Q

List some of the INTESTINAL complications of ulcerative colitis

A
  • toxic megacolon
  • stricture
  • bowel perforation
  • increased risk of colorectal carcinoma
  • fibrosis
  • shortening of colon
25
Q

List some of the INTESTINAL complications of Crohn’s disease

A
  • strictures (leading to obstruction)
  • obstruction
  • fistula formation (leading to abscess formation)
  • abscesses
  • adhesions
26
Q

List the types of fistulas that may occur as a complication of Crohn’s disease

A
  • peri-anal
  • entero-enteric (intestine-intestine)
  • entero-vesical (intestine-bladder)
  • mesenteric
  • retroperitoneal
  • entero-cutaneous
27
Q

What is the first-line medications given to treat UC?

A

5-aminosalicylic acid derivatives (5-ASAs)

  • Mesalazine
  • Sulphasalazine
28
Q

Give 2 examples of 5-ASAs which are used in the firstline treatment of UC

A
  • Mesalazine*

- Sulphasalazine

29
Q

What 2 treatments/medications are given to treat an acute flare of IBD/UC?

A
  1. Steroids (e.g. hydrocortisone, prednisolone)
  2. Antibiotics (if perforation, fistula, peri-anal disease..)
    - - e.g. metronidazole
30
Q

Give an example of an antibiotic that may be given to treat an acute flare of IBD

A

Metronidazole

31
Q

List 3 important drugs that may be given to treat resistant/refractory IBD

A

Immunomodulators:

  1. Azathioprine
  2. 6-Mercaptopurine

Biologic Therapy:
3. TNF(alpha) Inhibitors

32
Q

What can azathioprine and 6-mercaptopurine be used for?

A

resistant/refractory IBD

33
Q

In regards to the GIT, what can TNF(alpha) Inhibitors be used to treat?

A

resistant/refractory IBD

34
Q

Azathioprine and 6-mercaptopurine may be used to Crohn’s disease. List the side effects of these 2 drugs

A
  • pancreatitis
  • hepatotoxicity
  • bone marrow suppression
  • increased cancer risk
  • should not be used in pregnant people!
35
Q

List some of the indications for surgery in a patient that has IBD

A
  • bowel perforation
  • toxic megacolon
  • fibrostenotic strictures
  • massive haemorrhage
  • abscesses
  • complex peri-anal or internal fistulas
  • risk of cancer
  • chronic ill health
36
Q

Compare the intestinal wall thickness in UC and Crohn’s Disease

A

UC = normal thickness

Crohn’s Disease = increased thickness

GIHEP (24 decks)

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