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GI - Y2 > L6 - Inflammatory Bowel disease > Flashcards

L6 - Inflammatory Bowel disease Flashcards

1
Q

Describe acute diverticulitis?

A
  • altered gut motility
  • due to increased luminal pressure
  • disordered colonic microenvironment
  • commonly affects sigmoid column diverticula
  • severe pain in left iliac fossa
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2
Q

An abdominal examination of a patient with acute diverticulitis may show?

A
  • tenderness
  • guarding
  • ridgidity
  • palpable tender mass in left iliac fossa
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3
Q

Mild attack of acute diverticulitis treated with?

A

oral antibiotics

  • ciprofloxciccin
  • metronidazole
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4
Q

Complications of diverticular disease?

A

Perforation
- could lead to formation of paracolic or pelvic abscess or generalised peritonitis

Fistula formation
- into bladder, causing dysuria or pneumaturia

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5
Q

Pneumaturia

A

Passage of air in urine.

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6
Q

What happens do the mucosal surface in diverticullitis?

A

Mucosal surface becomes ridged due to hypertrophy of the underlying muscle.

Opening of the diverticular can be seen between the mucosal ridges.

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7
Q

State two main examples of inflammatory bowel disease?

A

Ulcerative colitis

  • colon, rectum
  • extends only into the mucosa and submucosa

Crohns disease

  • involves any area of the GI tract
  • typically occurs across entire length (transmucosal)
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8
Q

How might IBD result from?

A
  • altered composition of gut microbiome
  • aberrant mucosal immune response
  • intestinal epithelial dysfunction
  • alteration on host interaction with intestinal microbiota
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9
Q

Describe appearance of Crohns disease

A
  • linear mucosal ulcers which impart cobblestone like appearance in mucosa.
  • thickened intestinal wall.
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10
Q

Ulcerative colitis

A

Relapsing disorder characterised by attacks of bloody diarrhoea with stringy mucoid material, lower abdo pain and cramps.

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11
Q

Increase in CRP might indicate?

A

Gangrenous evolution of disease esp if associated with leukocytosis and neutrophilia.

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12
Q

Appendicitis

A

Inflammation of the inner lining of the vermiform.

Obstruction of appendiceal lumen.

Cause an increase of pressure within the lumen.

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13
Q

Compare and contrast Crohn’s disease with ulcerative colitis?

A

Crohn’s disease

  • common in smokers
  • can affect mouth to anus
  • transmural inflammation
  • surgery not curative

Ulcerative colitis

  • common in non/-ex smokers
  • affects only the colon
  • superficial inflammation
  • surgery regarded as curative
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14
Q

Peak onset of IDB

A

15-30 y/o

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15
Q

Pouchitis

A

Inflammation of the ileal pouch.
Ileal pouch is an artifical rectum surgically created out of ileal gut tissue in patients who have undergone a colectomy.

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16
Q

Strictureplasty

A

Surgical procedure performed to alleviate bowel narrowing due to scar tissue that has built up in the intestinal wall from inflammatory bowel conditions such as Crohn’s disease.

17
Q

Dysbiosis

A

Microbial imbalance.

  • loss of beneficial bacteria in gut
  • potentially harmful bacteria taking over gut
  • less diverse bacteria
18
Q

Tenesmus

A

Continual or recurrent inclination to evacuate the bowels.

19
Q

Some symptoms of ulcerative colitis

A 
Rectal bleeding 
Tenesmus 
Urgency 
Diarrhoea 
Cramping 
Nocturnal symptoms
20
Q

Erythema nodosum

A

Swollen fat under the skin causing red bumps and patches.

21
Q

What factors indicate acute severe colitis?

A
  • Excessive stoools per day
  • high temperature >37.8 degrees
  • bpm >90
  • haemoglobin < 10.5
  • erythrocyte sedimentation rate >30
22
Q

Typical symptoms of Crohn’s disease?

A
  • abdominal pain
  • diarrhoea
  • weight loss
  • rectal bleeding
  • fistulae
23
Q

Extra-intestinal manifestation of Crohn’s disease?

A 
Arthralgia 
- pain in joint 
Uveitis 
- eye inflammation affecting middle layer of tissue in eye wall (uvea)
Iritis 
- inflammation of iris 
Pyoderma gangrenosum 
- large painful sores that develop on skin
24
Q

T-cell trafficking mediated by what…

A

Interactions between integrins (on leukocytes) and ligands (receptors) on endothelium.

25
Q

Treatment for IBD

A

Anti-TNF
Azathioprine
Steroids
5-ASA, antibiotics

26
Q

Summarise types of surgery which may be conducted in a patient with IBD

A
  • Right hemicolectomy with or without temporary ileostomy
  • strcituroplasties (multiple strictures)
  • small bowel resections
  • permament stomach

GI - Y2 (18 decks)

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