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GI > Week 8 - IBD > Flashcards

Week 8 - IBD Flashcards

1
Q

Who does crohns predominantly affect?

A

-15-30 years then 60

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2
Q

Who does UC predominantly affect?

A

-Young adults up to 30

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3
Q

Name 3 less common IBD

A
  • Diversion colitis
  • Pouchitis
  • Microscopic colitis
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4
Q

What is diversion colitis?

A

-Section of bowel has been removed and ileostomy -> remaining bit of bowel with no flow can become inflamed

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5
Q

What is microscopic colitis?

A

-Inflammation on a microscopic level

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6
Q

Where does crohn’s disease affect?

A
  • Anywhere in GI tract from mouth to anus

- Ileum involved in most cases

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7
Q

Where does UC affect?

A

-Begins in rectum and can extend to involve entire colon

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8
Q

Which IBD has skiplesions? What are they?

A
  • Crohns

- The ulceration occurs in patches leaving islands of uninflammed mucosa forming skip lesions

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9
Q

Which IBD is transmural? What is meant by this?

A
  • Crohns

- Affects the whole thickness of the bowel wall

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10
Q

Which IBD is described as continuous? Why?

A
  • UC

- Ulceration is continuous along the tract

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11
Q

Which IBD only has mucosal inflammation?

A

-UC

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12
Q

What is backwash ileitis?

A

-Complication of UC where ulceration can breach the ileocecal valve and cause inflammation of terminal ileum

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13
Q

Describe some of the systemic problems which can occur in conjunction with IBD in order of incidence

A
  • MSK pain eg arthritis (50%)
  • Skin eg erythema nodosum, psoariasis
  • Liver/biliary tree eg primary sclerosing cholangitis
  • Eye eg sceritis
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14
Q

Which IBD is more associated with primary sclerosing cholangitis?

A

-UC

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15
Q

What is the main cause of IBD?

A

-Idiopathic

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16
Q

Name some factors which are thought to contribute to the development of IBD

A
  • Genetic
  • Immunological
  • Gut organisms
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17
Q

In which IBD is smoking thought to be protective?

A

-UC

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18
Q

Describe a typical presentation of crohns disease

A
  • Abdo pain (RLQ)
  • Weight loss
  • Loose stools (non-bloody)
19
Q

Which IBD can involve perianal inflammation and ulceration?

A

-Crohns

20
Q

Describe the pathological changes which occur in crohns

A
  • Superficial and deep ulcers
  • Hyperaemia
  • Mucosal oedema
  • Inflammation causing thickening of bowel and narrowing of lumen
21
Q

Why is crohn’s described as a cobblestone appearance?

A

-Skip lesions created by criss crossing of linear ulcers leaving islands of non-ulcerating or oedematous tissue gives a cobblestone appearance

22
Q

Which IBD do you get fistulae formation? Why?

A
  • Crohn’s

- Due to transmural ulceration

23
Q

Which IBD has the presence of granulomas?

A

-Crohn’s

24
Q

Why is IBD assiciated with anaemia?

A

-Failure to absorb iron and vitamins

25
Q

Why would you not just do colonoscopy when you had suspicion of crohns?

A

-Colonoscopys cannot visualise small bowel

26
Q

How does UC typically present?

A
  • Loose bloody stools with mucus
  • Weight loss
  • Lower abdo pain
27
Q

Describe the pathological changes which occur in UC?

A
  • Chronic inflammation upto lamina propria
  • Crypt abscesses
  • Decreased goblet cells
  • Pseudopolyps
  • Loss of haustra
28
Q

Why is there mucus and blood in UC stool?

A

-Large areas of superficial mucosa affected causing sloughing of cells and mucus

29
Q

What is a crypt abscess? What is the consequence?

A
  • Crypts of lieberkuhn fill with inflammatory cells

- Causes loss of renewal of epithelia

30
Q

Why does anaemia occur in UC?

A

-Loosing blood in stool

31
Q

Why do you do stool culture if UC is suspected?

A

-Want to rule out infection because it is bloody and mucus

32
Q

What is indeterminate colitis?

A

-IBD which cannot be classified into one of crohn’s r UC

33
Q

State 3 distinguishing features between crohn’s and IBD

A
  • Crohns= anywhere UC=rectum/colon
  • Crohns = perianal disease UC=no
  • Crohns=fistula formation UC =no
34
Q

State 2 pathological differences between crohns and UC

A
  • Crohns has skip lesions and granulomas

- UC is continuous and no granulomas but crypt abscesses

35
Q

Which IBD has liner ulcers?

A

-Crohn’s

36
Q

Which IBD gets lead pipe colon?

A

-UC (loss of haustra)

37
Q

What is the stepwise pharmacological approach for treating IBD?

A

1) Anti-inflammatory
2) Corticosteroids
3) Immunomodulators

38
Q

What are the surgical options for crohn’s?

A

-Not curable so want to remove as little bowel as possible to prevent short bowel syndrome

39
Q

What are the surgical options for UC? What are indications for surgery?

A
  • Curable via colectomy

- Inflammation not settling, precancerous changes, toxic megacolon

40
Q

What imaging is often used in Crohn’s?

A

-CT/MRI

41
Q

Why can crohn’s have periods of exacerbations?

A

-It is a relapse and remitting disease where by the acute inflammation can be treated but the underlying chronic condition is still present

42
Q

What anti-inflammatories are used in UC?

A

-Amino-salicylates

43
Q

When can crohn’s present like UC?

A

-When only the colon is affected

44
Q

What are the two common types of irritable bowel disease?

A
  • Crohns

- Ulcerative colitis

GI (16 decks)

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